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Ann Emerg Med. 2019 Jul 17. pii: S0196-0644(19)30444-5. doi: 10.1016/j.annemergmed.2019.05.032. [Epub ahead of print]

Recommendations for the Emergency Department Prevention of Sport-Related Concussion.

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Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY. Electronic address:
Department of Emergency Medicine, Mayo Clinic, Rochester, MN.
Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY.
Department of Emergency Medicine, University of South Carolina School of Medicine, Greenville, SC.
Departments of Emergency Medicine and Sports Medicine, Brown University, Providence, RI.
Department of Emergency Medicine, Baystate Medical Center, Springfield, MA.
Department of Emergency Medicine, University of Illinois College of Medicine, Peoria, IL.
Department of Emergency Medicine, Harvard Medical School, Boston, MA.
Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, FL.
Department of Emergency Medicine, Emory University, Atlanta, GA.
Department of Emergency Medicine, Stanford University, Palo Alto, CA.


Sport-related concussion refers to the subset of concussive injuries occurring during sport activities. Similar to concussion from nonsport mechanisms, sport-related concussion is associated with significant morbidity, including migrainous headaches, disruption in normal daily activities, and long-term depression and cognitive deficits. Unlike nonsport concussions, sport-related concussion may be uniquely amenable to prevention efforts to mitigate these problems. The emergency department (ED) visit for sport-related concussion represents an opportunity to reduce morbidity by timely diagnosis and management using best practices, and through education and counseling to prevent a subsequent sport-related concussion. This article provides recommendations to reduce sport-related concussion disability through primary, secondary, and tertiary preventive strategies enacted during the ED visit. Although many recommendations have a solid evidence base, several research gaps remain. The overarching goal of improving sport-related concussion outcome through enactment of ED-based prevention strategies needs to be explicitly studied.

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