Pediatric Meltdown

225. Youth Concussion: Assessment and Management


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Ever wondered how a simple injury can change the course of one's life? 

This episode explores the fascinating journey of a sports enthusiast turned medical professional, inspired by a personal encounter with a sports medicine provider after a college injury. The conversation delves into the complex world of concussions, discussing the evolution of treatment protocols, the importance of individualized care, and the severe risks of prematurely returning to play. You'll learn about tools like the SCAT symptom score and the VOMS for monitoring recovery, and the often-overlooked psychological impacts of concussions on young athletes. But perhaps the most crucial takeaway is the stark reminder: concussions are no joke, and honesty about symptoms can be a matter of life or death. 

Are you ready to rethink what you know about concussions?

 [00:33- 10:59]Initial Assessment and Management of Concussions 

  • The SCAT (Sport Concussion Assessment Tool) is mentioned as a crucial tool for evaluating concussions.
  • The importance of understanding the broad nature of concussions and their varied symptoms.
  • Reassuring patients and their families about the management plan.
  • An emphasis on the need for individualized treatment plans for concussions.

[11:00 -16:47] Red Flags and Immediate Concerns

  • Red flags that indicate a more serious condition, such as worsening symptoms and unusual behavior.
  • Specific symptoms like nausea, vomiting, and severe headaches that should raise concern.
  • Trusting your instincts and gut feelings when assessing a concussion.
  • Immediate action is needed if a patient's condition deviates from expected recovery patterns.

   

[16:48 - 44:47]  High-Risk Sports and Gender-Specific Risks    

  • High-risk sports for concussions, including for men: wrestling, basketball, soccer: For women: cheerleading
  • There is a potential for prolonged recovery in athletes with underlying medical issues.
  • Initial visits should focus on identifying concerning symptoms and ruling out underlying conditions.
  • A comprehensive approach to managing concussions is needed, especially in high-risk sports.


[44:48- 58:16] Treatment Algorithm and Activity Management 

  • Treatment Algorithm and Activity Management
  • An outline of a general treatment algorithm for managing concussions in the first 48 hours and beyond.
  • The importance of gradually returning to activity while ensuring symptoms do not worsen.
  • Provide physical therapy orders and ensuring PT sites treat concussions effectively.
  • Educate patients and families about the expected recovery process and potential setbacks.


[58:17 - 01:10:00] Takeaways


Resources:

AAP Sports-Related Concussion Recommendations:

AAP Concussion Recommendations 

AAP article and Amsterdam Consensus: Statement: AAP and Amsterdam Consensus Statement

AAP Vision and Concussion:  Vision and Concussion VOMS

SCAT 5 (13+) and Child SCAT (5-12y):  https://cattonline.com/scat 

SCOAT: https://bjsm.bmj.com/content/57/11/651


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Tweetable Quotes:

"It's not just about managing physical symptoms; mood changes post-concussion are critical and often overlooked."…. Dr. Fitton on addressing all symptoms 

"If a child shows prolonged recovery, it might be a silent cry to leave the sport, driven by fear rather than external pressure."...Dr. Fitton on kids hiding symptoms

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Pediatric MeltdownBy Lia Gaggino

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