Management strategies and medication use for treating paediatric patients with concussions

Acta Paediatr. 2013 Sep;102(9):e424-8. doi: 10.1111/apa.12315. Epub 2013 Jul 10.

Abstract

Aim: To assess management strategies for paediatric patients suffering from concussions.

Methods: A 17-item questionnaire was distributed to 1305 section members of the American Academy of Pediatrics Sections on Adolescent Health, Sports Medicine and Fitness, Community Pediatrics and School Health. The use of medications, neuropsychological testing, neuroimaging and published guidelines in concussion management was queried.

Results: Two hundred and twenty respondents (17%) completed the questionnaire, of which 64% had been an attending for greater than 10 years. A majority of respondents (92%) managed patients with concussions, with 26% treating more than 24 patients per year. Most paediatricians (84%) reported using a published guideline. The majority of respondents (89%) manage the symptoms of concussed patients with medications, most commonly acetaminophen (62%) or nonsteroidal anti-inflammatory medications (54%). The use of prescriptions medications such as tricyclic antidepressants (23%), amantadine (10%) and methylphenidate (8%) was also commonly reported. Paediatricians treating >16 patients per year with concussion were more likely to prescribe tricyclic antidepressants, stimulants and agents used for sleep disturbance.

Conclusion: Paediatricians nationwide routinely use medications when managing patients with concussions. The pharmacological agents used differ according to number of patients treated per year. In addition, most paediatricians use published guidelines in concussion management.

Keywords: Concussion; Medication management; Paediatric patient.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Attitude of Health Personnel
  • Brain Concussion / diagnosis*
  • Brain Concussion / drug therapy*
  • Child
  • Child, Preschool
  • Disease Management
  • Female
  • Health Care Surveys
  • Humans
  • Male
  • Neurologic Examination
  • Neuropsychological Tests
  • Pediatrics / standards
  • Pediatrics / trends
  • Practice Patterns, Physicians'
  • Prognosis
  • Risk Assessment
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Sports Medicine / standards
  • Sports Medicine / trends
  • Surveys and Questionnaires*
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Serotonin Uptake Inhibitors