Pediatric Associates of the NW Blogs

Teen Concussions: A New Approach to Care

Scott Spencer, MD, MPH
January 07, 2015 08:45AM

Understanding concussions in the student athlete has become a big issue in the news and medical research.  In order to stay ahead in this field, Pediatric Associates of the Northwest (PANW) turned to the specialists.  This November we invited Dr. James Chestnutt from OHSU Sports Medicine Department to talk about all aspects of care for a child with a concussion. We are proud to say, that at PANW we provide the latest in concussion care for your child.

One of the most important parts of concussion care starts outside the clinic.  Recognizing a concussion can be difficult.  Head injuries that result in a loss of consciousness are obviously concerning, but this only accounts for 10% of concussions (Pediatrics 2010). Some players after a head injury may just “not feel right” and this can certainly be a sign of a concussion.  It is important that student athletes and their parents, teachers, trainers and coaches are always thinking about this during athletic activities.  To learn more about how to recognize a concussion you can go to these websites: http://www.cdc.gov/concussion/headsup/ and http://www.osaa.org/healthandsafety .  Here you will read about both the early and late symptoms of a concussion which include physical, emotional, mental/cognitive and sleep problems.

After a head injury or whiplash type injury, every student should be evaluated for a concussion. This can include an evaluation with a trainer, coach or medical provider.   Once a child is suspected of having a concussion, a child should not be allowed to return to play and should be evaluated by a medical professional (Max’s Law - Oregon Concussion Awareness and Management Program).   How quickly to be seen by a medical professional depends on the severity of the concussion or head injury.    Parents can call our PANW clinic 24 hours a day 7 days a week for advice to determine what care may be necessary for their child.

Once a child is seen by a medical provider at PANW, they will craft a care plan to help aid recovery and ensure the safety of the child.   The first step in care for a concussion is often complete mental and academic rest until symptoms have begun to improve.  This typically means limited to no school, no screen time including cell phones and video games and no significant physical activity.   However, once a child shows improvement, some mental and physical activity can be beneficial. This may include social interactions with friends or light activity.  The provider will also talk about graduated return to play, which includes a slow reintroduction to sports.   How quickly a child can return to play depends on his or her progress. Each child will recover at their own pace which can range from just a few weeks, but can also take months.  Students that take longer than 3-4 weeks to recover may benefit from referral to a specialist.

Our providers receive many questions from parents how best to prevent concussions.  Innovations, such as head sensors to measure the level of impact, are still in the research phase and cannot yet be recommended.    The most important tool is education of the student athlete and their coaches.  At PANW, we strive to bring this education to you and your child, through our annual well child visits. If you have questions about concussions, this is an important time to ask your pediatrician. We look forward to these opportunities to help teach student athletes.