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关注脑震荡,急诊医生了解些什么?一项范围综述。

Heads up for concussion, what do emergency physicians know? A scoping review.

作者信息

Gowdy Adam, Heron Neil

机构信息

School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BA, UK.

Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BA, UK.

出版信息

BMC Sports Sci Med Rehabil. 2025 Mar 27;17(1):61. doi: 10.1186/s13102-025-01091-9.

Abstract

INTRODUCTION

Concussion is a common condition, with sources estimating between 1.2% and 6.6% of all ED presentations are related to head injury, and concussion has significant healthcare costs. In April 2023, the UK Government published guidelines for diagnosis and management of concussions in grassroots sport, recommending anyone that has sustained a suspected concussion has a same day review by an appropriate healthcare professional. It is therefore essential that emergency medicine physicians have the required knowledge and use current clinical practice guidelines in managing suspected concussions presenting to their departments. This scoping review aims to review the current literature regarding concussion knowledge, diagnosis and management amongst emergency physicians.

MATERIALS AND METHODS

This scoping review was conducted using the six-step process laid out by Arksey and O'Malley and included 17 papers from January 2012 to February 2023, identified by searching 5 online databases (MEDLINE, Embase, Web of Science, Scopus and Google Scholar) in February 2023 alongside a hand search of references. Search terms relevant to concussion, emergency medicine and medical education were used.

RESULTS

14 of the 17 papers originated from North America, all studies utilised either an online survey or chart review methodology. 3 papers included an educational intervention. 12 studies looked at all grades of EMPs. 14 of the studies highlighted knowledge gaps amongst EMPs, the 3 that did not specifically mention this were the 3 interventional studies.

CONCLUSION

EMPs have large knowledge gaps regarding concussion and limited adherence to current guidelines. Efforts should be made at improving these results amongst EMPs. Further research is needed to find the most beneficial and cost-effective approach to improving concussion knowledge of concussion diagnosis and management in EDs, particularly within the UK.

摘要

引言

脑震荡是一种常见病症,据估计,在所有急诊就诊病例中,1.2%至6.6%与头部损伤有关,且脑震荡产生了高昂的医疗费用。2023年4月,英国政府发布了基层体育运动中脑震荡诊断和管理指南,建议任何疑似脑震荡的患者由合适的医疗专业人员在当天进行复查。因此,急诊医学医生必须具备所需知识,并在管理其科室中出现的疑似脑震荡时采用当前临床实践指南。本范围综述旨在回顾有关急诊医生脑震荡知识、诊断和管理的当前文献。

材料与方法

本范围综述采用了阿克西和奥马利提出的六步流程,纳入了2012年1月至2023年2月的17篇论文,这些论文于2023年2月通过搜索5个在线数据库(MEDLINE、Embase、科学网、Scopus和谷歌学术)以及手工检索参考文献确定。使用了与脑震荡、急诊医学和医学教育相关的检索词。

结果

17篇论文中有14篇来自北美,所有研究均采用在线调查或图表审查方法。3篇论文包括教育干预。12项研究关注了各级急诊医生。14项研究强调了急诊医生之间的知识差距,未特别提及这一点的3项研究是干预性研究。

结论

急诊医生在脑震荡方面存在较大知识差距,对当前指南的遵循程度有限。应努力改善急诊医生的这些情况。需要进一步研究以找到最有益且具成本效益的方法来提高急诊科对脑震荡诊断和管理的知识水平,尤其是在英国。

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Head injury assessment in rugby union: clinical judgement guidelines.英式橄榄球联合会中的头部损伤评估:临床判断指南
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