Giebel Stephen, Kothari Rashmi, Koestner Amy, Mohney Gretchen, Baker Robert
Department of Emergency Medicine, Michigan State University/Kalamazoo Center for Medical Studies, Kalamazoo, Michigan, USA.
J Emerg Med. 2011 Dec;41(6):649-54. doi: 10.1016/j.jemermed.2011.03.021. Epub 2011 May 7.
Numerous guidelines to grade and manage sports-related concussions have been published. However, little is known about how frequently they are implemented in the emergency department. This study evaluates the current practices of emergency physicians (EPs) in managing sports-related concussions.
To evaluate the current practice of EP evaluation and management of sports-related concussions.
All EPs and emergency medicine residents in Kalamazoo County were surveyed regarding their management of sports-related concussions. The surveys obtained demographic data, participants' use of guidelines, and the importance of clinical and non-clinical factors in deciding when to allow a player to return to play.
Of the 73 EP respondents, only 23% used a nationally recognized guideline, with no significant difference between attending and resident EPs. The symptomatic complaints of loss of consciousness, amnesia of the event, and difficulty concentrating were ranked most important by EPs in assessing patients with sports-related concussions. Among non-clinical factors, residents were significantly more likely than attendings to report that medical-legal, parental, and players' concerns were more likely to influence their decision in allowing a patient to return to play.
EPs take into consideration important clinical factors in assessing patients with sports-related concussion. However, almost 75% do not use any nationally recognized guideline in their evaluation. Residents are more likely than attendings to be influenced by non-clinical factors.
已发布了众多关于体育相关脑震荡分级和管理的指南。然而，对于这些指南在急诊科的实施频率知之甚少。本研究评估了急诊医生（EPs）管理体育相关脑震荡的当前做法。
评估急诊医生对体育相关脑震荡进行评估和管理的当前做法。
对卡拉马祖县的所有急诊医生和急诊医学住院医师进行了关于他们对体育相关脑震荡管理情况的调查。调查获取了人口统计学数据、参与者对指南的使用情况，以及临床和非临床因素在决定运动员何时可以重返赛场时的重要性。
在73名急诊医生受访者中，只有23%使用了全国认可的指南，主治急诊医生和住院急诊医生之间无显著差异。在评估体育相关脑震荡患者时，急诊医生将意识丧失、事件失忆和注意力不集中等症状性主诉列为最重要的因素。在非临床因素方面，住院医师比主治医生更有可能报告医疗法律、家长和运动员的担忧更有可能影响他们允许患者重返赛场的决定。
急诊医生在评估体育相关脑震荡患者时会考虑重要的临床因素。然而，近75%的急诊医生在评估时未使用任何全国认可的指南。住院医师比主治医生更有可能受到非临床因素的影响。
