The Centers for Disease Control and Prevention (CDC) released new clinical recommendations for healthcare providers treating children with mild traumatic brain injury (mTBI), often referred to as concussion. The CDC Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children, published on 4th September 2018 in JAMA Pediatrics, is based on the most comprehensive review of the science on pediatric mTBI to date—covering 25 years of research.

“More than 800,000 children seek care for TBI in U.S. emergency departments each year, and until today, there was no evidence-based guideline in the United States on pediatric mTBI—inclusive of all causes,” said Deb Houry, MD, MPH, director of CDC’s National Center for Injury Prevention and Control. “Healthcare providers will now be equipped with the knowledge and tools they need to ensure the best outcomes for their young patients who sustain an mTBI.”

Offering 19 sets of clinical recommendations that cover diagnosis, prognosis, and management and treatment, the CDC Pediatric mTBI Guideline is applicable to healthcare providers in all practice settings.

The CDC Pediatric mTBI Guideline outlines specific actions healthcare providers can take to help young patients and their parents/caregivers, including five key practice-changing recommendations:

• Do not routinely image pediatric patients to diagnose mTBI.
• Use validated, age-appropriate symptom scales to diagnose mTBI.
• Assess for risk factors for prolonged recovery, including history of mTBI or other brain injury, severe symptom presentation immediately after the injury, and personal characteristics and family history (such as learning difficulties and family and social stressors).
• Provide patients and their parents/caregivers with instructions on returning to activity customized to their symptoms.
• Counsel patients and their parents/caregivers to return gradually to non-sports activities after no more than a 2-3 days of rest.

“We have heard from healthcare providers that they want and need consistent, current, and evidence-based guidance for diagnosing and managing mTBI. And this guideline can help,” said Houry. “However, we also designed the guideline so it can help inform efforts aimed at supporting families, sports coaches, and schools—who are all integral to keeping children safe and healthy.”

In developing the guideline, CDC followed a rigorous process. An extensive review of scientific literature, as well as feedback from clinical experts, the public, and partner organisations informed the development of the recommendations. The hope is that this Guideline will lead to future studies and guidelines that further advance the care of patients of all ages with mTBI and other serious brain injuries.”

To help healthcare providers implement the recommendations, CDC developed supporting tools and materials. Ranging from screening forms to assess young patients to discharge instructions and recovery tips for parents, these resources will help healthcare providers take action to improve the care of young Americans with mTBI. These tools and materials are available at www.cdc.gov/HEADSUP.

As the nation’s leading public health agency, CDC is committed to helping those at increased risk for mTBI and other serious brain injuries. There is not a one-size-fits-all approach to protecting young Americans from these injuries. However, this guideline is helping fill a critical gap aimed at improving the care of this vulnerable population.