Sponsoring Organization: Ontario Neurotrauma Foundation
Target Population: Healthcare professionals and others who deal with concussion, including physicians, neuropsychologists, physical therapists, family, and schools/community sports organizations
Background and Objective
The panel used an evidence-based, systematic review to standardize diagnosis, assessment, and management of children (age range, 5–18 years) with suspected concussion.
Key Recommendations
—For children participating in high-risk sports (contact and collision sports), consider baseline neurocognitive testing.
—On initial presentation, assess and treat physical, cognitive, and other neurologic deficits:
- Manage acute symptoms, including identifying any so-called red flags and assessing need for emergent neuroimaging.
- Perform an acute concussion evaluation based on a standardized tool.
- Prescribe physical and cognitive rest.
—On discharge, provide education and a postconcussion care plan with explicit direction for teachers and school-based activities:
- Educate about the risks for persistent symptoms including managing sleep, headaches, and fatigue.
- Counsel patients on avoiding alcohol, recreational drugs, and driving during recovery.
- Instruct patients to have close primary care follow-up and referral to a specialist in concussion management if symptoms persist beyond 1 month.
—On interim assessment, have return-to-learn and return-to-play stepwise plans and refer children with multiple concussions to specialized care by a concussion expert.
—At 1 month, if symptoms persist, patients should undergo a more comprehensive health evaluation
Guidelines can be viewed here: Link.
