title: Management strategies and medication use for treating paediatric patients with concussions.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA. kkinnaman@partners.org
authors.forename: Karen A
authors.initials: KA
authors.lastname: Kinnaman
authors.forename: Rebekah C
authors.initials: RC
authors.lastname: Mannix
authors.forename: R Dawn
authors.initials: RD
authors.lastname: Comstock
authors.forename: William P
authors.initials: WP
authors.lastname: Meehan
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001924:Brain Concussion / Q000175:diagnosis* / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D010372:Pediatrics / Q000592:standards / Q000639:trends; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D018570:Risk Assessment; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013178:Sports Medicine / Q000592:standards / Q000639:trends; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Concussion; Medication management; Paediatric patient