A Big Bump to the Head: Guidelines for Recovery

Concussion guidelines for children and teens issued

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) One of the scariest moments for a parent can be seeing their child hit their head, especially if that hit is hard. If they sustain a concussion, it's important to know so that the child gets needed recovery time.

Comprehensive pediatric concussion guidelines were recently published to provide guidance to medical professionals in diagnosing and treating these injuries.

The guidelines may provide useful information to parents as well.

The guidelines are not limited only to sports concussion, one of the most common causes of head injury.

"Rest your mind and body while recovering from a concussion."

The guidelines were compiled by pediatric emergency medicine researchers at the Children's Hospital of Eastern Ontario and the Ontario Neurotrauma Foundation, led by Dr. Roger Zemek, an assistant professor of pediatrics and emergency medicine at the University of Ottawa.

Although the target audience for the guidelines are health care professionals, they were also written with parents, caregivers and school and/or community organizations and leaders in mind.

The guidelines address concussions sustained within the previous month among children aged 5 to 18.

They do not, however, apply to children under 5 years old because no validated diagnostic tools exist for this age group.

The recommendations only suggest considering baseline testing of a child's neuro-cognitive skills if they play a high-risk sport, such as football, soccer or hockey.

The treatment recommendations with the highest level of evidence were to assess and treat any physical, cognitive or neurological deficits and to determine whether a CT (computed tomography) scan is needed.

A CT scan may reveal a brain bleed if one is suspected.

The recommendations also suggest considering admission if the child's symptoms include any of the following red flags: neck pain, increasing confusion or irritability, repeated vomiting, seizure or convulsion, weakness or tingling/burning in the legs, deteriorating conscious state, severe or increasing headache, unusual behavior change or double vision.

After discharge, care providers should adequately advise parents on the risk of re-injury and the need for cognitive and physical rest.

According to the recommendations, advice should be provided on how to manage sleep, headaches, fatigue, maintaining social interactions, avoiding alcohol or recreational drugs and avoiding driving during recovery.

Persistent symptoms after one month require a follow-up visit with a specialist, the guidelines recommend.

If the concussion was sustained as a result of a sports injury, the recommendations suggest gradual return-to-play only after all symptoms have resolved.

Children or teens who sustain multiple concussions should consult with a specialist on any decisions to return to play.

These guidelines were published online June 25. Information regarding funding or conflicts of interest were not provided.

Review Date: 
June 30, 2014
Last Updated:
July 2, 2014