Current recommendations on management of pediatric concussions

Concussions are a form of traumatic brain injury (TBI). Concussion is defined by the American Academy of Neurology as a “trauma-induced alteration in mental status that may or may not involve loss of consciousness” (Kirkwood, Yeates, & Wilson, 2012, p. 1360). At least 1.7 million TBIs occur annually, with 75% being in the form of concussion. Almost half a million patients ages 14 years and younger visit emergency rooms annually for TBI (Centers for Disease Control and Prevention [CDC], 2011). Diagnosing a concussion can be difficult because symptoms vary among individuals and may be subtle and vague, and neuro-radiologic imaging studies typically reveal no abnormalities. Due to the varying degree of symptomatology and recovery, there are no specific recommendations on when it is safe for patients to resume normal activity. Complications can arise if a second injury occurs prior to complete healing from the initial concussion. This literature review identifies current recommendations on the screening and management of concussion in the pediatric population. A clear, concise definition of concussion is presented, as well as recommendations for concussion management. Return to play and return to learn guidelines are explored. The nursing role in concussion management is discussed, and future implications are explored.