The United States may be currently underestimating the number and severity of pediatric concussions – children are likely bumping their heads more than reported at present, a new report has revealed.
Researchers from The Children’s Hospital of Philadelphia (CHOP) and the Centers for Disease Control and Prevention (CDC) analyzed electronic health data from CHOP on over 8,000 diagnoses of concussions over the past four years.
Of patients up to age 17, 82 percent had their initial diagnosis of a concussion at a pediatrician’s office or another primary care area, while a mere 12 percent had theirs at the emergency department – even though many current estimates of pediatric concussions revolve only around that data. Five percent had their diagnosis, too, at specialty care locations such as sports medicine and trauma centers.
These findings mean that concussion injury rates among the youth may be vastly underreported, with four out of five in this diverse children’s group actually diagnosed at a primary care site, not the E.R.
“[O]ne-third were under age 12, and therefore represent an important part of the concussion population that is missed by existing surveillance systems that focus on high school athletes,” explained lead author Dr. Kristy Arbogast.
During the research period, primary care visits as the point of entry for the children rose 13 percent. On the other hand, emergency department visits dropped 16 percent.
Study co-author Dr. Christina Master said the results will help direct targeted healthcare training and resources toward pediatricians and other primary care givers, which could be well-positioned to diagnose and then treat most concussions in this age group.
Concussion therapy greatly depends on early detection, giving primary care doctors an advantage. They can see affected patients sooner and can begin treatment earlier than specialized providers.
With most cases of concussions, rest is encouraged before a supervised return to regular routine is recommended. If the symptoms linger longer than the ideal two to three weeks, it could be time the patient is referred to a specialist.
Pediatric sports medicine specialist Alex Diamond from Vanderbilt University echoed the belief that pediatricians are best for the job, particularly at the first signs of the injury. Unless it’s an emergency, parents should make an appointment with their pedia first, he urged.
“They know the kid at baseline and they know the family,” he told ABC News.
He also called for parents to trust their instinct about seeking treatment for a potential case of concussion in their children. Medical help should be sought, too, if the child lost consciousness, suffered a seizure, or had “headache plus” — meaning accompanied by vomiting, sickness in the stomach, or a balance issue.
The findings were published May 31 in the journal JAMA Pediatrics.
Photo: University of the Fraser Valley | Flickr