Using the Living Guideline to make pediatric concussion care easier
Impact Stories from Concussion Experts
Thoughts from a Concussion Expert
Meet Dr. Carla Edwards, an expert panel member for the Living Guideline for Pediatric Concussion Care (Living Guideline). In this interview, she shares her thoughts on providing concussion care and the role of the Living Guideline.
I'm Dr. Carla Edwards, a Psychiatrist whose practice works with athletes on a daily basis. I treat everybody from kids to adults and older athletes, in supporting their mental health care across the board, including concussion care.
Carla Edwards
MD, FRCPC
There can be inconsistency in the time when the patient presents for care. It can be in the immediate aftermath of a head trauma or it can be days or weeks later. This means the clinical picture may look very different. There can be varying durations of time loss that could have been used for a useful approach to management.
We rely pretty heavily on subjective reporting of symptoms. So, we rely on the person who has experienced the concussion or head trauma, their parents or other people who were there. Sometimes that information is accurate, but there's no guarantee of that.
Concussion is a very complex constellation of symptoms and we understand that it cannot be treated in isolation. A multidisciplinary team and approach is needed. There are many other professionals that have expert perspectives on various symptom presentations, and they all should be involved in concussion assessment and care. We know that this isn't always available in every Center or to every practitioner, and practitioners aren't always aware of who is available to help with treatment.
What can make providing concussion care challenging?
No clinician needs to reinvent the wheel when it comes to treating concussion. Accessing expert opinions and other networks of excellence can help with your job. The Living Guideline provides a comprehensive, accessible approach to concussion management from many different perspectives, using the newest evidence available. It is a curated collection of recommendations, guided by experts in the field.
What can make providing concussion care easier?
The Living Guideline for Pediatric Concussion Care provides practitioners with a one-stop shop of information, to ensure that they can follow best practices in concussion management. My advice to healthcare providers is to access the Living Guideline as frequently as they need to take advantage of the wealth of information it contains. An easy shortcut would be to bookmark the web page.
The Living Guideline is loaded with information that can be searched for different aspects of concussion care. It contains algorithms, procedures, and forms to help guide the clinician in post-concussion management. Keep it at your fingertips! It changes as we learn more about concussions, and it contains great information. Tap into the expertise that is available.
How can the Living Guideline help healthcare providers with their concussion practices?
Thoughts from a Concussion Expert
Meet Dr. Christina Master, an expert panel member for the Living Guideline for Pediatric Concussion Care (Living Guideline). In this interview, she shares her thoughts on providing concussion care and the role of the Living Guideline.
Christina Master
MD, FAAP, FACSM, FAMSSM
I'm Dr. Christina Master, a Pediatric Sports Medicine Specialist at the Children's Hospital of Philadelphia. I'm the co-director of the Minds Matter Concussion Program and my primary interest, in both clinical care and research, is the care of children with concussion.
Concussions may not be a common thing that you see in your practice. In that case, it can be very challenging to keep up with the changing evidence-base that we use in terms of diagnosing and managing concussions.
Concussions are all very different. They can be different between people. They can also be different in the same individual, where one concussion experience is different from the one before. This can be challenging for both the family, as well as for the clinician who is trying to take care of them. We have to draw on our broad experience and skills and look at each situation, not only from the lens of concussion, but from the lens of the entire patient.
Children are always changing. They are at a stage in life where they are developing skills that are neurodevelopmental in nature. Anything that involves the brain or an injury to the brain such as a concussion, can look different between children, as well as within the same child who is in a different stage of life than the previous injury.
Our patients have so much to teach us. I would encourage every clinician taking care of a concussion to: carefully listen to what patients and families are telling them, think about what their questions are, and consider how to make sense of things based on the understanding we have of the physiology and the biology of injury.
Don't hesitate to ask questions. I still ask questions of my partners and multidisciplinary team members, such as 'Have you seen this before? Have you heard this before?' It takes a village to take care of patients with concussion. When we tap into the corporate knowledge that we have as a group, that really makes a huge difference in making it easier to take care of concussions. We're all here to help each other in terms of getting the best outcomes for our patients with concussion.
What can make providing concussion care challenging?
What can make providing concussion care easier?
You can turn to the literature to see what others are learning in their study of concussion.
There is concussion research coming out on a daily basis and it can be really hard to keep up. While the internet is a great resource for information, it can also be a source of misinformation if we don't know where to look.
The goal of the Living Guideline is to have it be a living entity that you can turn to for the most recent, up-to-date information. You can use the Living Guideline in real-time, and in an active way while you're managing your patients, so that you can feel confident that you're giving them the most up-to-date care.
How can the Living Guideline help healthcare providers with their concussion practices?
Taking care of your patients with concussion can also require the involvement of a diverse, multidisciplinary team. Besides physicians and nurses, you may work with physical therapists, occupational therapists, or athletic training staff. You may be interacting with schools and school nurses, and teachers as well. This is where the Living Guideline can be really helpful, as it takes a multidisciplinary approach.
The Living Guideline provides standardized, high quality direction in terms of how to approach the diagnosis and management of concussion. There are also opportunities to tailor the Living Guideline to what your patient and family needs as they're trying to recover from their concussion, without spending time reinventing the wheel.
We know from the evidence that there are active ways that we can support and manage our patients with a concussion so they can get better in the most optimal and quickest way possible. I would really encourage you to search through the Living Guideline to find the most up-to-date recommendations in terms of active management of concussion.