Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
  • LinkedIn
  • Instagram
LetterCorrespondance

Guidelines for mild head injuries in children

Juan Antonio Garcia-Rodriguez and Roger E. Thomas
Canadian Family Physician November 2014; 60 (11) 985-986;
Juan Antonio Garcia-Rodriguez
Calgary, Alta
MD MSc CCFP DipSportsMed
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Roger E. Thomas
Calgary, Alta
MD PhD CCFP MRCGP
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • eLetters
  • Info & Metrics
  • PDF
Loading

We would like to reply to Dr Zemek’s letter1 about the new Guidelines for Diagnosing and Managing Pediatric Concussion2 and his reference to our clinical review of the office management of mild head injury in children and adolescents.3

We are very pleased that the theme of concussion in the pediatric population has been the focus of much attention recently at different levels and in different institutions and associations. Clear and readily available information about concussion is an obvious need that family physicians, emergency physicians, and pediatricians are currently facing.

Our recommendations and those of the guidelines follow each other very closely. The guideline recommendations are organized into 5 topics in tables at the beginning of the document. Clicking on the number automatically jumps to the details of each recommendation in this very extensive guideline.2 Their topics include the following: “In advance (before the first activity)”; “On presentation (what are the ‘red flags’?)”; “On discharge (what do we tell parents and/or caregivers?)”; “On interim assessment (when can the child/adolescent return to learn/play?)”; and “On re-assessment after one month (what do we do next if the child/adolescent still has symptoms?).”2

The intention of our review was to provide practical, current approaches and specific tools for family physicians to help diagnose, manage, and provide information to families, teachers, and coaches. We appreciate that the guidelines advocated by Dr Zemek have a similar purpose, which is to equip physicians with updated information to facilitate their work to identify patients suffering from concussion and its complications, and to guide adequate focused management.

Our review advocates for a full clinical initial evaluation that requires not only a complete history and a comprehensive focused physical examination, but also identification of the mechanism of injury, the evolution and timeline of the symptoms, and determination of any factors that could affect its presentation or management. We stated that family physicians should be well aware of the available standardized tools and where to quickly find them to assess the general symptoms and cognitive status of pediatric patients. Adequate observation of patients with concussion is paramount, and family physicians should guide parents in this process by providing the correct information and providing education; the available resources we presented can be used to accomplish this task. When complications need to be ruled out, the physician can make evidence-based decisions whether to request imaging studies by using information from the CATCH (Canadian Assessment of Tomography for Childhood Head Injury) study.4

The management of concussion is based on the status and progress of the individual patient, and the treating doctor should coordinate adequate follow-up assessments, allow return to study or to play in a safe manner, and use neuropsychologic testing when needed.

We gladly welcome the presented guidelines, which contribute to cooperative work directed to facilitate the efforts of treating physicians and to improve the attention offered to children and adolescents.

Footnotes

  • Competing interests

    None declared

  • Copyright© the College of Family Physicians of Canada

References

  1. 1.↵
    1. Zemek R
    . Pediatric concussion guidelines [Letters]. Can Fam Physician 2014;60:890. 892.
    OpenUrlFREE Full Text
  2. 2.↵
    1. Zemek R,
    2. Duval S,
    3. Dematteo C,
    4. Solomon B,
    5. Keightley M,
    6. Osmond M,
    7. et al
    . Guidelines for diagnosing and managing pediatric concussion. Toronto, ON: Ontario Neurotrauma Foundation; 2014. Available from: www.onf.org/documents/guidelines-for-pediatric-concussion. Accessed 2014 Sep 29.
  3. 3.↵
    1. Garcia-Rodriguez JA,
    2. Thomas RE
    . Office management of mild head injury in children and adolescents. Can Fam Physician 2014;60:523-31. (Eng), e294–303 (Fr).
    OpenUrlAbstract/FREE Full Text
  4. 4.↵
    1. Osmond MH,
    2. Klassen TP,
    3. Wells GA,
    4. Correll R,
    5. Jarvis A,
    6. Joubert G,
    7. et al
    . CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury. CMAJ 2010;182(4):341-8. Epub 2010 Feb 8.
    OpenUrlAbstract/FREE Full Text
PreviousNext
Back to top

In this issue

Canadian Family Physician: 60 (11)
Canadian Family Physician
Vol. 60, Issue 11
1 Nov 2014
  • Table of Contents
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Guidelines for mild head injuries in children
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Guidelines for mild head injuries in children
Juan Antonio Garcia-Rodriguez, Roger E. Thomas
Canadian Family Physician Nov 2014, 60 (11) 985-986;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Respond to this article
Share
Guidelines for mild head injuries in children
Juan Antonio Garcia-Rodriguez, Roger E. Thomas
Canadian Family Physician Nov 2014, 60 (11) 985-986;
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Footnotes
    • References
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Rocket Doctor mischaracterized in article
  • Response
  • Correction
Show more Correspondance

Similar Articles

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • LinkedIn
  • Instagram
  • RSS Feeds

Copyright © 2025 by The College of Family Physicians of Canada

Powered by HighWire