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CDC Issues New Guideline for Youth Concussions

By Paul Ohanian, US Lacrosse, 10/19/18, 12:00PM PDT

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US Lacrosse also encourages teams, clubs and leagues to have a written concussion management plan that is reviewed regularly and developed with the consultation of a local physician trained in the evaluation and management of concussion.  

Last month, the Centers for Disease Control and Prevention issued new guidelines for the care and treatment of children with mild traumatic brain injury (mTBI), commonly referred to as concussion.

Based on the latest science, the goal of the CDC’s Pediatric Mild Traumatic Brain Injury (mTBI) Guideline is to help healthcare providers take appropriate action to improve the health of young patients. 

The Guideline consists of 19 sets of clinical recommendations that cover diagnosis, prognosis, management and treatment of concussion. These recommendations are for healthcare providers working in all practice settings: inpatient, emergency, primary and outpatient care.

“More than 800,000 children seek care for TBI in U.S. emergency departments each year, and there was no evidence-based guideline in the United States on pediatric mTBI — inclusive of all causes,” said Deb Houry, MD, MPH, director of the CDC’s National Center for Injury Prevention and Control. 

The CDC Guideline was developed through a rigorous process guided by the American Academy of Neurology and 2010 National Academy of Sciences methodologies. An extensive review of scientific literature, spanning 25 years of research, formed the basis of the Guideline.

Among the recommendations for healthcare providers are:

● Do not routinely image patients to diagnose mTBI.

● Use validated, age-appropriate symptom scales to diagnose mTBI.

● Assess evidence-based risk factors for prolonged recovery.

● Provide patients and parents/caregivers with instructions on return to activity customized to their symptoms.

● Counsel patients and parents/caregivers to return gradually to non-sports activities after no more than 2-3 days of rest.

“Healthcare providers will now be equipped with the knowledge and tools they need to ensure the best outcomes for their young patients who sustain an mTBI,” Houry said.

Every year, players of all ages in all sports receive concussion injuries during games and practice. Characterized by an impairment of the brain’s normal function, concussions may cause alterations in cognitive function, vision, eye movement, facial movement, or speech.

US Lacrosse and the CDC partnered for many years in developing educational resources regarding concussions. These resources, titled Heads Up, contain practical, easy-to-use information designed to help reduce the numbers of this type of injury. 

Led by its Sports Science and Safety Committee, US Lacrosse has committed significant resources toward the study, understanding and analysis of concussion injuries in men’s and women’s lacrosse throughout its history. From video analysis studies to head acceleration research, the organization has funded and sought greater understanding of concussion injury mechanisms. 

“The CDC guidelines for youth are very important, up-to-date with the international literature, and emphasize the age-specific evaluation and management of this injury,” said Margot Putukian, chair of the US Lacrosse Sports Science and Safety Committee and director of athletic medicine at Princeton University. “It also underscores the importance of avoiding CT scans when they are not indicated.”

US Lacrosse also encourages teams, clubs and leagues to have a written concussion management plan that is reviewed regularly and developed with the consultation of a local physician trained in the evaluation and management of concussion.  

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