05 Sep CDC Guidelines for Diagnosis and Management of Mild Pediatric Traumatic Brain Injury
MedicalResearch.com Interview with:
Matt Breiding, PhD
Team Lead, Division of Unintentional Injury Prevention
Center for Disease Control and Prevention
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Caused by a bump, blow or jolt to the head or body, a mild traumatic brain injury (mTBI) can lead to short- or long-term problems that can affect how a child thinks, acts, feels, and learns. CDC’s Pediatric mTBI Guideline is based on the most comprehensive review of the science on pediatric mTBI diagnosis and management to date—covering 25 years of research.
The guideline consists of 19 sets of clinical recommendations that cover diagnosis, prognosis, and management and treatment. These recommendations are applicable to healthcare providers who care for pediatric patients with mTBI in all practice settings and outline actions healthcare providers can take to improve the health of their patients with this injury.
The CDC Pediatric mTBI Guideline outlines specific actions healthcare providers can take to help young patients and includes 5 key recommendations. Specifically, they recommend that physicians:
- Refrain from routinely imaging pediatric patients to diagnose mTBI.
- Use validated, age-appropriate symptom scales to diagnose mTBI.
- 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).
- Provide patients with instructions on returning to activity customized to their symptoms.
- Counsel patients to return gradually to non-sports activities after no more than a 2-3 days of rest.
MedicalResearch.com: What should readers take away from your report?
Response: There are actions healthcare providers can take to improve the care of their young patients with mTBI. The CDC Pediatric mTBI Guideline outlines evidence-based strategies to help. CDC also created tools, such as patient discharge instructions and a symptom-based recovery tips handout, to help healthcare providers with implementing the recommendation in their day-to-day practice. These can be downloaded at: www.cdc.gov/HEADSUP.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Through development of the CDC Pediatric mTBI Guideline outlines multiple research gaps were identified. Details on opportunities for future research on mTBI are outlined in the Systematic Review. Specifically, it was noted that while we know quite a bit about the prognosis of recovery there remains a significant need to expand the evidence related to the evaluation, treatment, and follow-up of pediatric patients who experience mTBI.
MedicalResearch.com: Is there anything else you would like to add?
Response: As the nation’s leading public health agency, CDC is committed to helping those at increased risk for mTBI and other serious brain injuries. There is not a one-size-fits-all approach to protecting young Americans from these injuries. However, this guideline is helping fill a critical gap aimed at improving the care of this vulnerable population.
Healthcare providers, parents, and others can learn more about mTBI (commonly called concussion), including signs and symptoms and how to safely return to school and sports at CDC HEADS UP website.
Lumba-Brown A, Yeates KO, Sarmiento K, et al. Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children. JAMA Pediatr. Published online September 04, 2018. doi:10.1001/jamapediatrics.2018.2853
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