title: Concussion management by paediatricians: a national survey of Canadian paediatricians.
abstract: OBJECTIVE
  To assess the use of concussion/mild traumatic brain injury (mTBI) guidelines, criteria used in the initiation of return-to-play (RTP) and management of RTP for brain injured children and youth by Canadian paediatricians.
  
  
  METHODS
  A cross-sectional survey was mailed through the Canadian Paediatric Surveillance Program to ∼2600 paediatric specialists and sub-specialists.
  
  
  RESULTS
  Of 809 respondents (31%), 503 encountered newly diagnosed paediatric concussion/mTBI within the past 12 months, reporting ∼6900 cases. Of the respondents, 96.7% (95% CI = 94.7-98.6%) reported using one or more of the presented concussion/mTBI guidelines in the management of their patients. The most frequently reported criteria (>50%) used to determine asymptomatic status were: free from all concussion symptoms, by patient report (92%), by proxy report (76%), normal physical examination (65%), in school full-time, with usual school performance (53%). Most respondents (84.9%) did not initiate RTP immediately after their patients became asymptomatic. The median time waiting before initiating RTP was 7 days. The median duration of the RTP sequence was 7 days, with considerable variation reported.
  
  
  CONCLUSIONS
  Canadian paediatricians frequently encounter patients with concussion/mTBI. Their concussion/mTBI care appears to be consistent with current guidelines, but also shows practice variation, particularly when current guidelines become less proscriptive.
authors.affiliation: Canadian Paediatric Society , Ottawa, Ontario , Canada .
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Gordon
authors.forename: Minh T
authors.initials: MT
authors.lastname: Do
authors.forename: Wendy
authors.initials: W
authors.lastname: Thompson
authors.forename: Steven
authors.initials: S
authors.lastname: McFaull
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D001924:Brain Concussion / Q000503:physiopathology / Q000534:rehabilitation*; D002170:Canada; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D010372:Pediatrics; D011159:Population Surveillance; D017410:Practice Guidelines as Topic; D020127:Recovery of Function; D018570:Risk Assessment; D011795:Surveys and Questionnaires