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Concussions in Children May Be Vastly Underreported

New research by a medical team at the Center for Injury Research and Prevention at the Children’s Hospital of Philadelphia suggests that many parents may overlook the severity of their child’s head injury.

Researchers came to this conclusion after conducting a study to see where children were treated for their head injuries. Surprisingly, more than 80 percent of the nearly 8,100 children in the study were first seem by their primary care doctor, not the emergency department, meaning parents may not have taken the injury very seriously.

“Four in five of this diverse group of children were diagnosed at a primary care practice — not the emergency department,” said study author Kristy Arbogast. Moreover, “one-third were under age 12, and therefore represent an important part of the concussion population that is missed by existing surveillance systems that focus on high school athletes.”

According to Arbogast, only 12 percent of children had their first concussion-linked medical visit in an emergency room. The team also noted that visits to the emergency room for concussion-like injuries appeared to decline with age. More than 75 percent of children ages 5-17 were first diagnosed by a primary care physician, but for children 4 and under, 52 percent first visited an emergency room.

The team said their findings are an important step in measuring the true toll of concussions in children.

“Efforts to measure the incidence of concussion cannot solely be based on emergency department visits, and primary care clinicians must be trained in concussion diagnosis and management,” researchers wrote.

When it’s all said and done, taking your child to your primary physician instead of a crowded emergency rooms isn’t a bad move, so long as you make a timely appointment after the injury. The findings simply suggest that we may not have the most accurate grip on concussions in children if we’re just relying on emergency room data, and it’s also a call to action to ensure primary care physicians are well versed in the diagnosis, symptoms and treatment of different types of concussions.

It would be interesting if authors would conduct future studies to determine concussion treatment success of emergency departments, primary care physicians and neuro-specialists. Emergency room doctors and primary care physicians are great options, but a head specialist focuses solely on trauma to the head and brain, and is probably best equipped to ensure your child gets the exact treatment they need.

If your child has fallen off the swing set or bumped heads with another child during sports or gym class, please ensure they get looked over by a medical expert. Treatment is best when a concussion is diagnosed earlier rather than later, so don’t wait!

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David Chang, MD-PhD, DABNS, Roseville, MN
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