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Are pediatric concussion patients compliant with discharge instructions?
Vivian Hwang1, Amber W Trickey, Christy Lormel
1From the Department of Emergency Medicine, Inova Fairfax Hospital, Falls Church, Virginia.
Most pediatric concussion patients follow emergency department (ED) discharge instructions. However, some return to play (RTP) while symptomatic or without medical clearance, indicating a need for improved concussion management.
Area of Science:
- Pediatric Emergency Medicine
- Neurology
- Sports Medicine
Background:
- Concussions are frequently diagnosed in pediatric emergency departments (EDs).
- Effective concussion management relies on patient adherence to discharge instructions.
- This study evaluated compliance with ED concussion discharge protocols in children.
Purpose of the Study:
- To assess adherence to concussion discharge instructions in pediatric patients.
- To identify factors influencing compliance and outcomes.
- To evaluate the rate of return to play (RTP) and symptom status post-concussion.
Main Methods:
- Prospective cohort study of 150 pediatric patients (8-17 years) diagnosed with concussion in a pediatric ED.
- Standardized discharge instructions were provided, with telephone follow-up at 2 and 4 weeks.
- Exclusion criteria included prior head injury, skull fracture, or neurological conditions.
Main Results:
- Most pediatric concussion patients (67%) were sports-related, with soccer and football being common.
- 39% of patients returned to play (RTP) on the day of injury.
- At 2 weeks, 44% had returned to activities, with 35% symptomatic and 58% lacking medical clearance.
Conclusions:
- Pediatric patients generally comply with ED concussion discharge instructions.
- A notable proportion of patients RTP prematurely, while symptomatic or without medical clearance.
- Further interventions may be needed to ensure safe concussion recovery and RTP.
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