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.
To evaluate the current practice of EP evaluation and management of sports-related concussions.
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.
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.
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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Emergency Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Nonfatal traumatic brain injuries from sports and recreational activities—United States, 2001–2005.MMWR Morb Mortal Wkly Rep. 2007; 56: 733-737
- Grade 1 or “ding” concussions in high school athletes.Am J Sports Med. 2004; 32: 47-54
- Recovery from mild concussion in high school athletes.J Neurosurg. 2003; 98: 296-301
- Does age play a role in recovery from sports related concussion? A comparison of high school and collegiate athletes.J Pediatr. 2003; 142: 546-553
- The clinical management of sports concussion.Curr Sports Med Rep. 2002; 1: 12-22
- Practice parameter: the management of concussion in sports (summary statement). Report of the Quality Standards Subcommittee.Neurology. 1997; 48: 581-585
- Post traumatic retrograde and anterograde amnesia: pathophysiology and implications in grading and safe return to play.J Athl Train. 2001; 36: 241-248
- A survey of practice patterns in concussion assessment and management.J Athl Train. 2001; 36: 145-149
- Current sport-related concussion teaching and clinical practices of sports medicine professionals.J Athl Train. 2009; 44: 400-404
- The management of sports related concussion: current status and future trends.Clin Sports Med. 2009; 28: 95-111
- Summary and agreement statement of the 2nd International Conference on Concussion and Sport, Prague 2004.Br J Sports Med. 2005; 39: 196-204
- Summary and agreement statement of the 3rd International Conference on Concussion and Sport, held in Zurich, November 2008.Phys Sportsmed. 2009; 37: 141-159
- Symptom-based assessment of the severity of a concussion.J Neurosurg. 2003; 98: 477-484
- On-field predictors of neuropsychological and symptom deficit following sports-related concussion.Clin J Sports Med. 2003; 13: 222-229
- Standardized mental status testing on the sideline after sport-related concussion.J Athl Train. 2001; 36: 274-279
- Second impact syndrome: a risk in any sport.Phys Sports Med. 1995; 23: 27-36
- Sports-related recurrent brain injuries—United States.MMWR Morb Mortal Wkly Rep. 1997; 46: 224-227
- The second impact in catastrophic contact-sports head trauma.JAMA. 1984; 252: 538-539
- Concussion in sports: guidelines for the prevention of catastrophic outcome.JAMA. 1991; 266: 2867-2869
Published online: May 10, 2011
Accepted: March 20, 2011
Received in revised form: January 31, 2011
Received: June 23, 2010
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.