Over 630,000 children visit the ED every year with a diagnosis of concussion

Predictors of persistent post-concussive symptoms (PPCS):

• female sex
• age over 13 years
• previous concussive symptoms lasting over 1 week
• headache
• sensistivity to noise
• fatigue
• slow response to questions.

Appromixately 1/3 of pediatric patients will have PPCS lasting over 2 weeks

Likelihood of PPCS increases to >50% in those with risk factors identified in the ED

Every state has a youth concussion law. The basic tenants are a) immediate removal from play b) written clearance from health professional to return to play c) education for athlete, parents, coaches.

References

• Babcock, L, Kurowski, BG. Identifying childeren and adolescents at risk for persistent postconcussion symptoms. JAMA. 2016. 315(10): 987-988.
• Kruse AJ, Nugent, AS, Peterson AR. Using sideline concussion tests in the emergency department. Open Access EM. 2018(10): 113-121. 
• Tarimala, A, Singichetti, B. Initial emergency department visit and follow-up care for concussions among children with Medicaid. J. of Pediatrics. 2018(206): 178-183.