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A STUDY OF HEAD INJURY ADVICE ON RETURN TO SPORT IN ACCIDENT AND EMERGENCY
  1. R Dhand1,2,
  2. D Khamoo1,
  3. D Eastwood1
  1. 1Sunderland Royal Hospital, Sunderland, England
  2. 2University Hospital of North Durham, England

Abstract

Return to play (RTP) post head injury is a controversial yet important topic in sport. Repeated head injuries have been linked to long-term neurological conditions such as Chronic Traumatic Encephalopathy (McKee, A. et al, NEN 2008, 68 (7), 709–735). NICE Guidance states that there should be printed advice given to patients for returning to sports (www.nice.org.uk/guidance/cg176/chapter/1- recommendations#discharge-and-follow-up). International consensus guidelines indicated that elite and non-elite athletes should be managed using the same treatment and RTP model. A minimum of 48 hours rest is recommended before attempting a graduated RTP protocol. (McCrory, P.et al CJSM 2013,23(2), 89–117. Some professional bodies recommend 14 days of complete rest (http://www.englandrugby.com/mm/Document/MyRugby/Headcase/01/30/49/33/returntoplayafterconcussion_Neutral.pdf). The project aimed to assess whether RTP advice was given to patients being discharged home from Accident and Emergency (A+E) after a head injury. Firstly, head injury advice cards for all 8 trusts in the Northern Deanery were analysed for advice on RTP. Secondly, there was retrospective analysis of the notes of all A+E patients aged 18–50 who attended University Hospital of North Durham over a 6-month period, and were discharged home. 6 trusts (75%) had no information on when to RTP after a head injury. 326 patients were analysed. 49 patients (15%) attended due to a documented sporting cause. 243 patients (75%) displayed symptoms suggestive of concussion. 2 patients (0.6%) were given advice on when to RTP. Results indicate that we may be neglecting RTP advice for our patients attending A+E with a head injury. A+E departments should be encouraged to include advice on RTP for patients with emphasis on greater education for both healthcare professionals and patients. Further research is needed for the recommended rest period before RTP and the definite long-term effects of repeated head injury.

  • Sports medicine

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