Concussion Impacts More Than the Brain of the Student Athlete

George Monteverdi, MD and Rene Wachtel, MD

Assessment and management of the student athlete experiencing school sports related head injury was the focus of the most recent meeting of the CC1AAP School Health Committee (CC1AAP SHC). Participating Committee members and guests, including Cindy Chang, MD, co-Director of the, Sports Concussion Program at UC Benioff Children's Hospital Oakland,  and Dvora Citron, RN, MS, Supervising School Nurse of the Acalanes Union High School Student Concussion Program,  focused on the current diversities of programs which evaluate and manage sports related head injury in Northern California students.

Recent publications note that many pediatricians are consulted by parents after a student athlete sustains a concussion, and students must get medical approval to return to sports participation. In addition, current  research shows that brain rest is important after concussion to minimize the traumatic effects of brain injury. Therefore, pediatricians need to be aware of the available protocols for returning the student athlete to learning and sports. Despite attempts to standardize current practices, resource availability  (such as the presence of a licensed school health nurse), resource utilization, and effective inter-professional collaborations vary and may adversely affect the quality care provided this complex brain injury. In addition to serving the injured student, pediatric management often involves teamwork with, and education of professionals and parents who are concerned about  the potential effects of concussion on the student's immediate and long term psychological and social functioning, sports participation, and academic future.

CC1AAP SHC has completed a survey of 61 colleagues attending our December 2016 Chapter 1 CME event, "Pediatric Puzzles. The survey sought to identify present practices and the needs of pediatricians who provide a medical home for student athletes exposed to Traumatic Brain Injury (TBI) and its risks.  Our results found that most pediatricians treat concussions, many using a concussion protocol, but with only limited interaction with school personnel.  Many of the respondents would be willing to participate in the implementation of a new protocol and education about current concussion research and state laws regarding concussions.

The School Health Committee  is  developing a project to implement the needs identified. We intend to post a new Concussion Assessment and Management Protocol on the Chapter website, and explore educational opportunities.  We will utilize the survey information provided by the CME Chapter attendees and comments by  Chapter members on the documents posted on the Chapter Website to determine 'next steps' to achieve the goals of the project.

 Please review the posted documents. Comments are valued for their ability to help us critically focus on our goal and the 'ways and means' to assist you and the youth you serve.

Thank you for assisting!Direct your comments/recommendations to the SHC co-chairs at :

George Monteverdi MD FAAP  

Rene Wachtel MD FAAP