Daniel Seichepine, professor and program coordinator of neuropsychology, was recently published in the Journal of Neurotrama.
Seichepine's study centered on how concussions are assessed and treated in emergency departments across New England. The study found that there is little consistency in the use of evidence-based clinical practice guidelines in evaluating and managing concussions. Additionally, over one third of emergency departments are not using any clinical practice guidelines. The study concluded that future work needs to be done to address this concern so patients can receive the best possible treatment.
Abstract
Evidence-based clinical practice guidelines can facilitate proper evaluation and management of concussions in the emergency department (ED), often the initial and primary point of contact for concussion care. There is no universally adopted set of guidelines for concussion management, and extant evidence suggests that there may be variability in concussion care practices, and limited application of clinical practice guidelines in the ED. This study surveyed EDs throughout New England to examine current practices of concussion care, and utilization of evidence-based clinical practice guidelines in the evaluation and management of concussions. A 32-item online survey was emailed to 149/168 EDs throughout New England in 2013 (Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire, Maine). Respondents included senior administrators asked to report on their EDs use of clinical practice guidelines, neuroimaging decision-making, and discharge instructions for concussion management. Of the 72/78 respondents included, 35% reported absence of clinical practice guidelines, and 57% reported inconsistency in the type of guidelines used. Practitioner preference guided neuroimaging decision-making for 57%. Although 94% provided written discharge instructions, there was inconsistency in the recommended time frame for follow-up care (13% provided no specific time frame), the referral specialist to be seen (25% did not recommend any specialist), and return to activity instructions were inconsistent. There is much variability in concussion care practices and application of evidence-based clinical practice guidelines in the evaluation and management of concussions in New England EDs. Knowledge translational efforts will be critical to improve concussion management in the ED setting.
