Canadian family physician Médecin de famille canadien
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To determine whether the proportion of sport-related concussion (SRC) cases among student athletes that resulted in a relapse of their symptoms due to premature return to play (RTP) or premature return to learn (RTL) has changed compared with a prior (2006 to 2011) study. ⋯ An important decrease in the relapse of symptoms in the context of premature RTP occurred over the 2006 to 2016 period. However, this decrease was minimal for RTL. This may reflect the fact that efforts to implement structured RTP strategies arose earlier than those to implement RTL strategies. Efforts are needed to find the best method of implementing a coordinated plan for the postconcussion athlete who is returning to school.
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To analyze the implementation of a concussion management protocol in which a team physiotherapist is involved in the identification of concussions and return-to-play (RTP) decisions. ⋯ A very low rate of SSR was achieved whether the team physician made all RTP decisions or the team physiotherapist was allowed to make some of the RTP decisions through the terms of the protocol.
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To identify barriers to and facilitators of return to learning (RTL) for female secondary school students following a sport-related concussion (SRC), and to identify critical junctures on the injury-to-recovery continuum that can be targeted to enhance the RTL process. ⋯ Results of this study support existing findings in the realm of concussion research. A novel finding includes the importance of a primary contact person as a facilitator of RTL. This person could help to overcome some of the identified barriers to RTL and improve outcomes by assisting with academic accommodations, providing reassurance regarding these accommodations, improving education among teachers and students, and enhancing communication between stakeholders.
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A 1-year-old child presented to my clinic after falling from a couch and landing on his head. In the clinic, the child was asymptomatic and acting normally. Does this child need imaging of his head? If so, how do I decide between sending the child for a skull x-ray scan and sending him to the hospital for a computed tomography (CT) scan? ⋯ The Pediatric Emergency Care Applied Research Network clinical decision rule for CT scans helps identify children younger than 2 years of age at high risk of intracranial injury. Application of the rule, which has 100% sensitivity and 53.8% specificity for clinically important traumatic brain injury in children, is the first step to assessing children with minor head injury. If a CT scan is not needed urgently, it is recommended that children younger than 2 years get a skull x-ray scan only if a skull fracture is suspected. The presence and type of skull fracture can determine if a CT scan of the head and consultation with a neurosurgeon is warranted.