Abstract
Background
Numerous guidelines to grade and manage sports-related concussions have been published.
However, little is known about how frequently they are implemented in the emergency
department. This study evaluates the current practices of emergency physicians (EPs)
in managing sports-related concussions.
Objectives
To evaluate the current practice of EP evaluation and management of sports-related
concussions.
Methods
All EPs and emergency medicine residents in Kalamazoo County were surveyed regarding
their management of sports-related concussions. The surveys obtained demographic data,
participants’ use of guidelines, and the importance of clinical and non-clinical factors
in deciding when to allow a player to return to play.
Results
Of the 73 EP respondents, only 23% used a nationally recognized guideline, with no
significant difference between attending and resident EPs. The symptomatic complaints
of loss of consciousness, amnesia of the event, and difficulty concentrating were
ranked most important by EPs in assessing patients with sports-related concussions.
Among non-clinical factors, residents were significantly more likely than attendings
to report that medical-legal, parental, and players’ concerns were more likely to
influence their decision in allowing a patient to return to play.
Conclusion
EPs take into consideration important clinical factors in assessing patients with
sports-related concussion. However, almost 75% do not use any nationally recognized
guideline in their evaluation. Residents are more likely than attendings to be influenced
by non-clinical factors.
Keywords
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Article info
Publication history
Published online: May 10, 2011
Accepted:
March 20,
2011
Received in revised form:
January 31,
2011
Received:
June 23,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
