CDC Sets New Guidelines for Children with Concussions

With the 2018-2019 youth sports season up and running, parents and pediatricians are again urged to be vigilant of concussions and head injuries in children. Medical research is constantly discovering new information about head injury and its consequences on young people. The advice that may have been recommended a decade ago may not be the most effective today.

Coinciding with the start of autumn and the new school year, in September the Centers for Disease Control & Prevention (CDC) released brand-new guidelines for physicians, families, and coaches to follow and refer to when a child has suffered a head injury.

The CDC reports that more than 800,000 children receive emergency care for traumatic brain injury (TBI) each year. Until now, however, there were never any standardized guidelines on care for pediatric head injury cases.

These guidelines are unique because they exclusively address treatment for mTBI, which stands for mild traumatic brain injury. And, they are specific to mTBIs in children. The CDC bases their guidelines on a comprehensive review of data from 25 years of research of pediatric mTBI.

Matt Breiding of the CDC’s Traumatic Brain Injury Team and a co-author, explained, “The goal of the guideline is to standardize clinical practice and steer clinicians toward what we currently know.”

Usage of the term “traumatic brain injury” rather than “concussion” is purposeful, as the former phrase makes people take the injuries more seriously and get children the medical help they need. The guidelines also recommend and suggest ways for medical professionals, parents, and school personnel to work together to ensure any symptoms and irregular behavior are reported.

Five key recommendations

The CDC’s guidelines actually include 19 sets of recommendations, but the organization has highlighted five key actions for care of a child with an mTBI:

1. Do not routinely image pediatric patients to diagnose mTBI – this helps children avoid unnecessary radiation exposure.
2. Use validated, age-appropriate symptom scales to diagnose mTBI.
3. Assess for risk factors for prolonged recovery, including:

• a history of mTBI or other brain injury
• severe symptoms presenting immediately after the injury
• personal characteristics or family history (such as learning disability or stressors in the home)

1. Provide patients with customized instructions on returning to activity according to their symptoms.
2. Counsel patients to gradually return to non-sports activities after no more than two to three days. Research has shown that children can recover more quickly if they return to non-sports activities faster.

In a CDC news release, Deb Houry, MD, MPH, director of CDC’s National Center for Injury Prevention and Control, said, “Until today, there was no evidence-based guideline in the United States on pediatric mTBI – inclusive of all causes. 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.”

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