Concussed children return to play

On-field management of sport-related head injuries in children does not follow international guidelines with many children continuing to play despite signs of concussion, a new study has found. Honours medical...

On-field management of sport-related head injuries in children does not follow international guidelines with many children continuing to play despite signs of concussion, a new study has found.

Honours medical student at Monash University, Harini Haran, is conducting a study at the Murdoch Children’s Research Institute (MCRI) of children who presented to the paediatric emergency department at Royal Children’s Hospital with sport-related head injury.

In collaboration with colleagues from MCRI and Austin Health, almost 100 patients have been interviewed so far. Injuries were due to Australian football (52 per cent), soccer (12 per cent), rugby (7 per cent), and other sports (29 per cent).

Most of the children aged between five and 18 years reported presented with symptoms of concussion including loss of consciousness (38 per cent), disorientation (34 per cent), vomiting (20 per cent), amnesia (29 per cent), headache (49 per cent).

For organised sports, overall 41 per cent did not comply with internationally recommended concussion guidelines. Up to 27 per cent were not immediately assessed by qualified personnel and 28 per cent were allowed to return to play on the same day of their injury.

Around 91 per cent of parents and 96 per cent of patients were unaware of any concussion or return-to-play guidelines from their organisations.

At follow-up, 72 per cent had followed a step-wise return-to-play process as recommended by the Royal Children’s Hospital based on international guidelines. Injured children should slowly proceed from rest, to mild exercise to full contact game play over a minimum of one week.

“Despite the attempts of sports organisations to improve the management of concussions, on-field concussion management and return to play practices are suboptimal in sport-related head injuries,” Ms Haran said.

The study is ongoing and final data will be presented at the Australasian College for Emergency Medicine's annual scientific meeting in Adelaide on Tuesday.