title: Driving After Adolescent Concussion: Advice From Nurse Practitioners in the Absence of Standardized Recommendations.
abstract: Nurse practitioners (NPs) are authorized to manage concussion recovery. Common adolescent activities, like driving, are omitted from guidelines. We investigated NP driving guidance and its clinical basis for restriction or limitation following adolescent concussion.
  
  
  
  NPs completed a web-based questionnaire after viewing a scripted video scenario of an adolescent describing symptoms of concussion occurring 72 hours prior. Driving recommendations were collected using an open-ended query, then coded and categorized by type, characteristic, and basis.
  
  
  
  1,051 (20%) responded to the question of interest. The majority (93.8%) provided driving recommendations: 32.6% based on time, 49.8% based on symptoms, and 28.5% based on health care utilization. 5.3% mentioned fatigue and sleep symptoms. 1% advised use of a standardized assessment tool.
  
  
  
  Symptomatology, examination, and time were key factors in clinical decision-making for post-concussion driving, rather than use of standardized tools. Persistent symptoms that can impact driving, such as sleep and visual disturbances, may warrant consideration.
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Klein
authors.forename: Janessa M
authors.initials: JM
authors.lastname: Graves
authors.forename: Jasmine Y
authors.initials: JY
authors.lastname: Graham
mesh_terms: D000293:Adolescent; D001334:Automobile Driving / Q000331:legislation & jurisprudence; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D008004:Licensure; D008297:Male; D009722:Nurse Practitioners; D038223:Post-Concussion Syndrome / Q000503:physiopathology* / Q000534:rehabilitation*; D017410:Practice Guidelines as Topic; D011930:Reaction Time / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology*; D013997:Time Factors; D014481:United States
keywords: Adolescent; concussion; driving; nurse practitioner; traumatic brain injury