According to the Centers for Disease Control and Prevention, an estimated 1.6 million to 3.8 million concussions occur in the United States each year. Of those, 65 percent are estimated to occur in the pediatric and adolescent population. Although concussions dominate the sports literature, half of those occurring in the 11- to 15-year-old population are not sports-related. Therefore, concussions in children are not just a sports injury; they are a major pediatric public health problem.
Within The Children’s Hospital of Philadelphia (CHOP) Care Network, subspecialist concussion visits have quadrupled since 2009 to 1,800 concussion patients and 4,000 concussion visits for fiscal year 2012. Our primary care pediatricians have seen a similar increase. In order to continue to provide a high level of care to our patients, CHOP needed to consider a new model of care for concussion in children. [Abstracted from Pediatric Annals, Sept. 2012]
Minds Matter: Improving Pediatric Concussion Management
The objective of this two-year project is to prevent the long-term consequences associated with mTBI (mild traumatic brain injury), or concussion, in children by developing a comprehensive pediatric concussion management program for CHOP. This is being accomplished in several phases:
- Phase I - Comprehensively characterize the current state of pediatric mTBI management within the CHOP Care Network, including primary care, emergency care, specialty care, and after-hours services. Read a study abstract on providers' self- reported knowledge, practice and attitudes on concussion; and a study abstract on primary care providers' experience with prescribing cognitive rest. This phase is completed.
- Phase II - Use current evidence and best practices to develop a clinical practice model for diagnosis, treatment and follow-up management, along with appropriate training for CHOP Care providers on the use of the new model. This phase is completed and implementation is being monitored for quality improvement and assurance.
- Phase III - Develop an internet-based resource on comprehensive concussion care for parents, healthcare providers, athletic coaching and training staff, and school personnel. Visitors to the website can download educational resources such as video FAQs, infographics, posters and fact sheets. This phase is completed.
- Phase IV - Develop the architecture of a prospective clinical database on pediatric mTBI which will be instrumental in informing future clinical, research, and quality improvement initiatives.
Funder: The Children's Hospital of Philadelphia Department of Pediatrics Chair’s Initiatives
Institute of Medicine Report on Sports-Related Youth Concussion
On October 30, 2013, the Institute of Medicine (IOM) released a report, Sports-Related Concussions in Youth: Improving the Science, Changing the Culture, which reviews the state of the science on sports-related concussion in children and youth ages 5 to 21. CIRP’s Director of Engineering Kristy Arbogast, PhD was a member of the 17-person expert committee that reviewed the science and created the evidence-based recommendations to improve concussion prevention, diagnosis, and management.