Roughly 800,000 children are brought to emergency rooms after sustaining a blow to the head every year, according to the Centers for Disease Control and Prevention. Clearly, many others appear in urgent care centers—and that segment is likely to grow as parents continue to become more aware that urgent care is often the best choice for many complaints. Now the CDC has released new guidelines on evaluation and treatment of children who’ve sustained a blow to the head. All told, there are 19 recommendations based on five core concepts:
1. Do not routinely image pediatric patients to diagnose mTBI.
2. Use validated, age-appropriate symptom scales to diagnose mTBI.
3. Assess for risk factors for prolonged recovery, including history of mTBI or other brain injury, severe symptom presentation immediately after the injury, and personal characteristics and family history (such as learning difficulties and family and social stressors).
4. Provide patients and their parents/caregivers with instructions on returning to activity customized to their symptoms.
5. Counsel patients and their parents/caregivers to return gradually to non-sports activities after no more than a 2-3 days of rest.
The new advisory, CDC Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children, covers diagnosis, prognosis, and management and treatment and is designed to be applicable to all healthcare providers, regardless of their practice setting, according to the CDC. JUCM has published original, urgent care-specific articles on treating minor traumatic brain injury, including one focused on mTBI in children. The Effect of PECARN Guidelines on Minor Head Injury Referrals from the Urgent Care Center to the Emergency Room is available in our archive.