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Clin Pediatr (Phila). 2019 Mar 31:9922819839230. doi: 10.1177/0009922819839230. [Epub ahead of print]

Pediatric Patient Compliance With Recommendations for Acute Concussion Management.

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1 Children's National Health System, Washington, DC, USA.
2 GW Medical Faculty Associates, Washington, DC, USA.
3 Johns Hopkins University, Washington, DC, USA.


Emerging evidence supports an active approach for acute pediatric concussion management. The current practices of pediatric emergency providers following acute concussions has not been well studied. We prospectively enrolled 134 pediatric patients with an acute concussion. Providers completed a real-time survey to assess their recommendations for time off from school and sports. Seven to 10 days post-injury, patient compliance with provider recommendations was assessed. Forty-seven (35.1%) providers recommended moderate time off from school. In this cohort (n = 44), 14 (31.8%) patients took more than 2 days off from school. When minimal rest was prescribed (n = 80), 26 (32.5%) patients took more than 2 days off from school, P = .94. One third of our pediatric emergency providers are still recommending moderate time off from school. Regardless of physician prescriptions, patients took a similar amount of time off from school. Our study questions the influence of physician recommendations on management of acute pediatric concussions.


compliance; concussion; rest


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