The Robert Larner, M.D. College of Medicine at The University of Vermont, Burlington, VT, USA.
Division of Neurosurgery at The University of Vermont Medical Center, Burlington, VT, USA.
Childs Nerv Syst. 2024 Apr;40(4):1199-1205. doi: 10.1007/s00381-023-06231-5. Epub 2023 Nov 28.
Children and adolescents who sustain concussion in rural communities are lost to follow-up after initial evaluation more often than their urban counterparts. Thus, this study aims to determine the feasibility and accessibility of a novel virtual pediatric concussion clinic at a rural academic hospital.
Data regarding patients referred to a virtual concussion clinic at a rural Pediatric Level 2 Trauma Center over a 16-month period was prospectively collected. Patients experiencing concussive symptoms were referred to the pediatric neurosurgery clinical registered nurse and received a phone call following an injury. Referrals to therapy were made based on symptoms reported.
Data from 44 patients was collected: 9 did not follow-up in concussion clinic despite leaving a voicemail. Forty-three were referred from the emergency department. The median time from referral placed to completing a virtual follow-up was 4.5 days. Among the referrals, 3 (8.6%) were to pediatric neurology, 10 (28.6%) to occupational therapy (OT), 6 (17.1%) to physical therapy (PT), 4 (11.4%) to speech-language pathology (SLP), and 25 (71.4%) did not receive referrals as their symptoms had abated. Patients followed with pediatric neurology post-injury for an average of 75.9 days, OT for an average of 52.7 days, and PT for an average of 2.3 days.
This is a feasible model to follow patients and place referrals for additional therapeutic services in a rural community. With 79.5% of patients completing a follow-up, the clinic demonstrates easy accessibility and reliable adherence.
与城市相比，在农村社区遭受脑震荡的儿童和青少年在初次评估后失访的情况更为常见。因此，本研究旨在确定在农村学术医院开设新型虚拟儿科脑震荡诊所的可行性和可及性。
前瞻性收集了在农村儿科 2 级创伤中心接受虚拟脑震荡诊所治疗的患者在 16 个月期间的数据。出现脑震荡症状的患者会被转介到儿科神经外科临床注册护士，在受伤后会接到电话。根据报告的症状进行治疗转诊。
共收集了 44 名患者的数据：9 名患者未在脑震荡诊所就诊，尽管留了语音邮件。43 名患者从急诊转来。从转介到完成虚拟随访的中位数时间为 4.5 天。在这些转介中，3 例（8.6%）转至儿科神经科，10 例（28.6%）转至职业治疗（OT），6 例（17.1%）转至物理治疗（PT），4 例（11.4%）转至言语治疗（SLP），25 例（71.4%）因症状缓解而未转介。受伤后，患者平均接受儿科神经科治疗 75.9 天，OT 治疗 52.7 天，PT 治疗 2.3 天。
这是一种可行的模式，可以在农村社区随访患者并为额外的治疗服务转介。79.5%的患者完成了随访，表明该诊所易于获得且患者依从性良好。
