title: Concussion evaluation and management in pediatrics.
abstract: Concussions are among the most complex injuries to assess and manage in sports medicine and primary care. Sports concussion in youth has received much attention in recent years because research shows that improperly managed concussion can lead to long-term cognitive deficits and mental health problems. There are several notable risk factors affecting the incidence and severity of concussion in school-age children and adolescents, including a history of a previous concussion. A more conservative approach for return to activities following concussion has been proposed for children and adolescents. Programs of individualized, stepwise increases in physical activity have largely replaced use of algorithms for assigning a grade and activity expectations to concussions. Although validity and reliability testing is ongoing to support use of concussion assessment instruments in pediatric patients, it is practical and appropriate that clinicians incorporate symptom checklists, sideline and balance assessment tools, and neurocognitive assessment instruments into their practice in accordance with evidence-based guidelines.
authors.affiliation: Robin G. Rivera is a Nurse Practitioner, Division of Pediatric-Adolescent Medicine, Cohen Children's Medical Center of the North Shore-LIJ Health System, New Hyde Park, NY. Susan P. Roberson is a Nurse Practitioner, Division of Pediatric-Adolescent Medicine, Cohen Children's Medical Center of the North Shore-LIJ Health System, New Hyde Park, NY. Margaret Whelan is a Coordinator, Family Nurse Practitioner Track, Molloy College, Division of Nursing, Rockville Centre, NY. Annie Rohan is Director of Pediatric Research, Stony Brook University, School of Nursing, Stony Brook, NY, and a Nurse Practitioner, Neonatal Intensive Care Unit, Cohen Children's Medical Center of the North Shore-LIJ Health System, New Hyde Park, NY. She can be reached via e-mail at annie.rohan@stonybrook.edu.
authors.forename: Robin G
authors.initials: RG
authors.lastname: Rivera
authors.forename: Susan P
authors.initials: SP
authors.lastname: Roberson
authors.forename: Margaret
authors.initials: M
authors.lastname: Whelan
authors.forename: Annie
authors.initials: A
authors.lastname: Rohan
mesh_terms: D000293:Adolescent; D001924:Brain Concussion / Q000175:diagnosis* / Q000451:nursing / Q000628:therapy*; D002648:Child; D019468:Disease Management; D004509:Education, Nursing, Continuing; D006801:Humans; D010372:Pediatrics / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D012307:Risk Factors; D013178:Sports Medicine / Q000379:methods; D055815:Young Adult