Department of Surgery, University of Manitoba , Winnipeg, MB, Canada.
Department of Pediatrics and Child Health, University of Manitoba , Winnipeg, MB, Canada.
Int J Circumpolar Health. 2020 Dec;79(1):1832390. doi: 10.1080/22423982.2020.1832390.
Concussion is a form of traumatic brain injury that affects thousands of children and adolescents across Canada annually. With timely access to comprehensive medical care, the majority of patients with acute concussion will recover within 1-4 weeks. Those who develop persistent post-concussion symptoms often benefit from early recognition and referral to multi-disciplinary concussion clinics that have the personnel and resources to meet their complex needs. Youth who live in remote and isolated communities within Canada's North, a significant proportion of whom are Indigenous, face unique barriers and obstacles to accessing primary and specialised concussion care. Although telemedicine has recently emerged as a tool that can help address these gaps in care, there are presently no clinical guidelines or tools available to assist multi-disciplinary concussion clinics in providing remote concussion care to these medically underserved patients. Here we incorporate literature from a scoping review and our early institutional experience to present an evidence-informed preliminary clinical algorithm and resources to help guide and optimise remote paediatric concussion care delivery in Canada's North. We also discuss how innovative technologies and partnerships can be leveraged to enhance the delivery of safe, equitable, cost-effective and culturally appropriate care to these communities.
脑震荡是一种创伤性脑损伤，每年在加拿大影响着成千上万的儿童和青少年。通过及时获得全面的医疗护理，大多数急性脑震荡患者将在 1-4 周内康复。那些出现持续性脑震荡后症状的患者，通常通过早期识别和转介到多学科脑震荡诊所中受益，这些诊所拥有满足他们复杂需求的人员和资源。居住在加拿大北部偏远和孤立社区的年轻人，其中很大一部分是土著人，他们在获得初级和专门的脑震荡护理方面面临着独特的障碍和困难。尽管远程医疗最近作为一种可以帮助解决这些护理差距的工具出现，但目前还没有临床指南或工具来帮助多学科脑震荡诊所为这些医疗服务不足的患者提供远程脑震荡护理。在这里，我们结合了范围综述的文献和我们早期的机构经验，提出了一个循证的初步临床算法和资源，以帮助指导和优化加拿大北部的远程儿科脑震荡护理。我们还讨论了如何利用创新技术和伙伴关系，为这些社区提供安全、公平、具有成本效益和文化上适当的护理。
