New pediatric traumatic brain injury guidelines

Concussions and traumatic brain injury are top of mind, especially during football season.

We've seen how devastating these sometimes fatal injuries can be.

In 2006, 13-year-old Zackery Lystedt suffered a head injury in a football game that resulted years later in the Zackery Lystedt Law, which regulates when athletes can return to play in Washington state.

Dozens more states soon followed.

However, it's not just football at fault.

Skiing, biking, car accidents and more can all cause traumatic brain injury.

According to the Centers for Disease Control and Prevention, more than 800,000 children seek care for traumatic brain injury throughout the U.S. each year, and until now, there were no evidence-based guidelines for how to diagnose and treat those injuries.

Dr. Rich Ellenbogen -- attending surgeon at Harborview Medical Center, Seattle Children's and UW Medical Center -- was one of many healthcare professionals who recently reviewed 25 years of pediatric traumatic brain injury research and came up with 19 new guidelines for diagnosis, prognosis and treatment.

The recommendations include nearly-universal red flags that will help identify which injuries are more serious.

“That means that child doesn’t go home, that child gets a scan,” Ellenbogen explained to KIRO 7.

Other children who “just bumped their head, who are neurologically normal, acting normal” might be sent home, according to Ellenbogen.

The CDC Pediatric Minor TBI Guidelines include specific actions health care providers should take with their young patients to ensure the best outcome, including:

  1. Not ordering CT scans unless symptoms are serious in order to lessen future cancer risks
  2. Using age-appropriate scales for diagnosis
  3. Assessing multiple risk factors for prolonged recovery -- including history of other brain injuries, even family history
  4. Providing personalized instructions on returning to activity that are customized to symptoms
  5. Counseling patients and parents to return to non-sports activities after no more than two to three days of rest

Ellenbogen said, “For parents, the take-home message is we know a lot about traumatic brain injury, but there are still gaps in our knowledge.  So taking your children to a health care provider that has some expertise in traumatic brain injuries is the way to go, because they may have read this paper, and they may be a more skilled provider as a result.”

>> More information on guidelines from the Centers for Disease Control and Prevention

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