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UPDATE Regarding Concussion Medical Management

Clinical issues| Legal Nurse Consulting

March 23, 2013•1 min read

The American Academy of Neurology has published new medical evaluation and management guidelines for sports related concussions.

Based on review of clinical literature of clinical guidelines from 1955 to 2012 of diagnostic tools and clinical factors that previous guidelines attempted to predict appropriate return to play guidelines based on the severity of the injury. However, individualized clinical patient evidence has not supported this past management.

New clinical guidelines included:
No set date to return to sports or military activity.
No evidence that pharmacology improved recovery.
The greatest risk for boys/men were in football, rugby, hockey and soccer.
The greatest risk for girls/women were soccer and basketball.
Less support for 'Second Impact Syndrome' causing cerebral edema and death. However, repeated concussions increased for slower reactions and decreased cognitive processing, increasing risk for subsequent injuries.
The first 10 days is the period of greatest risk.
Needed monitoring or prolonged symptoms including migraine-type headaches, dizziness and fogginess.
Risk factors for chronic behavioral impairment include prior concussion and ApoE4 gene, tau protein disposition.
Encouragement of multi-disciplinary diagnosis and not relying only on scoring systems.

The new clinical research, experience and guidelines are leading to a new area of medicine: Sports Neurology and is leading to having more Sports Neurologists at gameside.

Click here for The American Academy of Neurology article.

Click here for the Medscape Mar 18 2013 American Academy of Neurology Releases New Sports Concussion Guidelines

Click here for the Jan 2013 Friedman Medical legal News: Chronic Traumatic Encephalopathy

As guidelines change, it is important to have the guidelines related to the dateline corresponding to the injury and find medical experts in Sports Neurology to evaluate these specific cases.

Helping You Find The Answers,

Audrey Friedman, RN

Friedman Medical Legal Consulting, LLC

Audrey Friedman, RN

Audrey Friedman, RN has been a nurse for over 37 years with a wide variety of amazing experiences helping people in clinical situations in newborn intensive care, oncology, bone marrow transplant, cardiology, and adult intensive care units. Audrey has enjoyed providing care to patients, their families, the community in a variety of clinical roles including bedside nursing, case manager, education, travel nurse, office nurse, community speaker, online educator and legal nurse consultant. Audrey has loved being a mentor to nurses in various stages of their career from nursing students to experienced nurses as well as collegial opportunities to paramedics and firefighters in mentor roles as a creative clinical preceptor, educator, and blogger. Audrey always wanted to be a nurse and fondly remembers reading children’s’ books on Clara Barton and Florence Nightingale and costumes of nurses’ caps around her house believing there was magic in the white cap. Audrey graduated in nurses whites and caps and still believes in the magic nurses have, to affect change in healing in people’s lives. Audrey’s ‘Nursing Wit and Wisdom’ project for nurses was nominated for the 2015 Nightingale awards. One of the wonderful things about nursing, Audrey believes, is the ability to be a nurse in so many different clinical specialties, environments, and locations that as we are helping people heal, they are changing us too and we, as healers are never the same.

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