By Harry Kerasidis, MD
Recent changes to concussion protocols raise previous standards of clinical pediatric care. Pediatricians and Family Practitioners are now in position to adopt a new standard of care, which will have positive side effects for the patient and practice vitality.
As a neurologist treating concussions for 25 years, I have to say that my fellow medical professionals in pediatrics and family practice provide the first line of defense for protecting the welfare of the brain, and therefore patients’ futures.
The question is, how?
For example, the current American Academy of Pediatrics guidelines, leave a pediatrician with a number of immediate challenges. The guidelines say what to do, but they don’t answer how to adopt many of the requirements into clinical practice. Another example is here with the “First Comprehensive Guidelines for Pediatric Concussion” launched by pediatric emergency medicine researchers at the Children’s Hospital of Eastern Ontario and the Ontario Neurotrauma Foundation. The guidelines provide healthcare providers with evidence-based recommendations to standardize the diagnosis and management of concussion in children aged 5 to 18 years old, from the initial assessment through to the period of recovery, which can last months.
The most alarming risk is the number of repeated “sub-concussive” hits that don’t register as a concussion, but can leave a lasting impression. Although depicted in the movie “Concussion” among former professional football players, chronic encephalopathy (CTE) which is caused by repeated hits, may begin at early ages.
We know the younger, the more vulnerable the brain is to injury. We also know sports are far from the only cause of concussion.
The Center for Disease Control and Prevention (CDC) reports:
- More than half (55%) of TBIs among children 0-14 years were from falls.
- More than a quarter (27%) of all TBIs in children less than 15 years are from blunt trauma, including assaults.
Think of skateboarding, skiing, rough-housing, hard bumps, whiplash-like knocks, bike riding, an open drawer, low cabinet, and then add contact sports. The concussion risk is imminent in life.
Beginning concussion care with the primary care practitioner allows the parent and patient to begin monitoring cognitive, emotional and balance related testing along with typical annual pediatric exams. This is powerful data to support future plans in academic and athletic endeavors.
Until now, however, primary care providers have not typically been equipped to provide this kind of comprehensive concussion care program. But, implementing tools from advanced concussion management systems like XLNTbrain.com, gives pediatric doctors a way to comply with all the new standards, while creating a new service with potential to be a new revenue stream.
It’s worked in my clinic, and surely will fit nicely into a pediatrician/family practice setting as well.
What Parents Should Expect
- You may be immediately referred to a neurologist. Most primary care providers aren’t equipped with tools like XLNTbrain yet.
- Ask your pediatrician or family practitioner for annual concussion baseline testing as early as age 9. They are affordable, and can be administered along with other annual pediatric exams. Baseline tests measure neuro-cognitive functions such as language, decision-making, memory, oculomotor, balance and emotions. All of these domains give doctors data that compare with should a concussion be suspected. Youth sports leagues rarely provide any concussion protocols, so ask your pediatrician on concussion education, baseline testing, detection, symptom monitoring and recovery guidance for a safe return-to-learn and return-to-play. (And, suggest they add com.)
- Know your state concussion protocol laws, especially with contact sports.
- Know the basic satety tips and symptoms, and respect the injury. I have assembled the latest news on xlntbrain.com/blog/, as well in “Concussion-ology: Redefining Sports Concussion Management For All Levels,” available on Amazon.
- Take an active role. Concussions are everyone’s responsibility. With XLNTbrain, everyone can also be included in the notification process. Beyond that, parents are on the front lines of concussion care.
Primary care practitioners may receive a FREE concussion protocol consultation and demonstration of XLNTbrain, by emailing firstname.lastname@example.org or register for the next demonstration here.
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Harry Kerasidis, M.D is the founder and medical director for the sports concussion management platform XLNTbrain, LLC, based in Maryland. He is also the founder of Chesapeake Neurology Associates in Prince Frederick, Maryland and serves as the Medical Director for the Center for Neuroscience, Sleep Disorders Center and Stroke Center at Calvert Memorial Hospital.