Mild traumatic brain injury in children: practice guidelines for emergency department and hospitalized patients. The Trauma Program, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine

Abstract

Mild traumatic brain injury (MTBI) is a frequent occurrence in children. Current practice in treating such injuries varies in terms of evaluative studies, length of observation, need for inpatient hospitalization, sports restrictions, and follow-up. A multidisciplinary panel of experts from a level I pediatric trauma center was convened to develop and implement a clinical pathway to improve the quality and consistency of care provided to children after MTBI. The clinical pathway, based on current literature and expert consensus, provides a management guideline for the management of MTBI in the emergency department through discharge. The algorithm provides reasonable management options based on the child's clinical presentation, history, and age. Exemplary care of children and their families after MTBI includes appropriate patient/family education. Standardized discharge instructions for MTBI were developed to provide comprehensive information in a succinct and easy-to-read format. The instructions for home management focus on expected symptoms and guidance for when to seek further medical attention. They also incorporate injury prevention, return to sports guidelines, and resources for additional information.