title: Acute Concussion Management with Remove-Reduce/Educate/Adjust-Accommodate/Pace (REAP).
abstract: BACKGROUND
  With increased concussion awareness and significantly increased numbers of emergency department (ED) visits for pediatric concussion, a seamless process of managing a patient with a concussion can begin in the ED.
  
  
  METHODS
  This article demonstrates the effectiveness of the Remove-Reduce/Educate/Adjust-Accommodate/Pace (REAP) concussion management program in the evaluation, management, and return to play of an acutely concussed pediatric patient. The REAP program was developed in Colorado and promotes a multidisciplinary team approach to concussion management. The team consists of parents, teachers, athletic personnel, and clinicians. The patient described in this case report had concussion management initiated in the ED. He was able to successfully return to sports, having recovered from his concussion with the guidance of the Center for Concussion (Centennial, Colorado) staff utilizing the REAP model of care and the currently recommended graduated return-to-play process. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Busy EDs are often the initial point of contact for school-aged patients with concussion. We present a program that we believe represents a good model of patient care with concussion management implemented in the ED and carried through to clearance of the patient.
authors.affiliation: Center for Concussion at Rocky Mountain Hospital for Children at Presbyterian/St. Luke's Medical Center, Centennial, Colorado.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Kirelik
authors.affiliation: Center for Concussion at Rocky Mountain Hospital for Children at Presbyterian/St. Luke's Medical Center, Centennial, Colorado.
authors.forename: Karen
authors.initials: K
authors.lastname: McAvoy
mesh_terms: D000208:Acute Disease; D001924:Brain Concussion / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D003142:Communication; D003266:Continuity of Patient Care; D004636:Emergency Service, Hospital; D006801:Humans; D008297:Male; D010348:Patient Care Team; D010353:Patient Education as Topic; D005082:Physical Exertion; D011320:Primary Health Care; D000068958:Return to Sport; D012574:Schools; D063189:Symptom Assessment
keywords: concussion; emergency department; pediatrics; return to school; traumatic brain injury