First pediatric concussion living guideline from Ontario Neurotrauma Foundation

Experts aim to reduce "bedroom jail" following a concussion diagnosis

The Ontario Neurotrauma Foundation (ONF) has issued the first Living Guideline for Diagnosing and Managing Pediatric Concussion. The guideline, targets health-care providers and offers a series of recommendations to help children and adolescents get back to their everyday life.

This is the first ONF clinical practice guideline to be available in a fully digital version, ensuring it will be quickly available to those who can use it. Clinicians are provided with 22 tools and a broad range of recommendations in the 14 domains covered in the guideline. The new guideline replaces one originally published by ONF in 2014.

An expert panel facilitated and funded by ONF and led by Dr. Nick Reed (Adjunct Scientist, Holland Bloorview Kids Rehabilitation Hospital and Associate Professor, University of Toronto) and Dr. Roger Zemek (Senior Scientist, CHEO Research Institute and Professor, University of Ottawa) included over 50 experts in childhood and adolescent concussion from Canada and the United States. Expert panel members represented various clinical disciplines such as physicians, nurses, diagnosticians, rehabilitation specialists, etc.

Facts about children and concussion   

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  • There are more than 35, 000 pediatric (children and adolescents under the age of 18) visits for concussion in Ontario every year.
  • For the majority of children and adolescents,  concussion symptoms will resolve in the first 1-4 weeks.
  • After a brief period of rest (24-48 hours), most children and adolescents are encouraged to resume a graduated return to school and low-risk physical activities, as can be tolerated and in consultation with a health professional.
  • Injury during sports and recreational activities are the most frequent cause of concussion in children and adolescents.
  • Injuries to children and adolescents lead to a loss of work-time for parents and caregivers.

Why a living guideline?

A living guideline is developed and maintained in an interactive digital format through a continual process of review, evaluation and revision by a group of clinical experts. The ONF Living Guideline for Diagnosing and Managing Pediatric Concussion will be updated as research supporting change in clinical practice becomes available. Practically, this means the guideline or parts of it could be updated as often as every few months.

Quotations from project leads

“Children, adolescents and their families are seeking care for concussion at higher rates than ever before.  In order to meet their needs, health-care professionals require a trustworthy, evidence-based and easy to use way to know how to best support their patients.  This guideline is a ‘one stop shop’ for health care professionals to provide the right care, in the right way and at the right time when diagnosing and managing concussion in children and adolescents”.
—Nick Reed - Adjunct Scientist, Holland Bloorview Kids Rehabilitation Hospital | Associate Professor, University of Toronto

“Every month we learn more about how to better treat children and youth with concussion due to ground-breaking clinical research, much of which is being led out of Canada.  Prior recommendations used to demand that children simply rest, which was often misinterpreted as home jail.  We now know that to improve recovery, it is important that children remain physically active and engaged in school as they recover from concussion, while ensuring their activities remain as safe as possible.”
—Dr. Roger Zemek - Senior Scientist, CHEO Research Institute | Emergency physician, CHEO | Professor, University of Ottawa

“ONF has been happy to facilitate the development of this evidence-based Guideline as the funder. There was a real need for a pediatric-focused guideline that is based on research. We look forward to supporting the implementation of the guideline recommendations across the province and further, working with our national and international partners. The first edition has been widely referenced throughout the world; we are pleased to be a leader in the development of clinical-practice guidelines and hope this “living format” has an even broader reach to improve the quality of pediatric concussion care.”
—Judy Gargaro - Program Director, Acquired brain injury

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About the Ontario Neurotrauma Foundation

The Ontario Neurotrauma Foundation (ONF) is a non-profit organization funded by the Ontario government that works to prevent neurotrauma and ensure Ontarians with spinal cord and brain injuries lead full, productive lives. ONF is the leader in moving research to evidence-informed health practices that improve the quality of life and health outcomes. Through collaborations and partnerships ONF connects healthcare practitioners, researchers, policymakers and stakeholders including those living with neurotrauma to the information they need to make positive changes in health practices, outcomes and policies.

Media Contact

Mara Shaw
o. 416-422-2228, ext. 209 | mara.shaw@onf.org 

About Holland Bloorview Kids Rehabilitation Hospital

Holland Bloorview Kids Rehabilitation Hospital creates a world of possibility by supporting children and youth living with disability, medical complexity, illness and injury. Holland Bloorview is a top 40 Canadian research hospital that is fully affiliated with the University of Toronto and serves over 7,500 families annually. Providing both inpatient and outpatient services, Holland Bloorview is renowned for its expertise in partnering with clients and families to provide exceptional care and is the only organization to ever achieve 100 per cent in two successive quality surveys by Accreditation Canada. Holland Bloorview is a founding member of Kids Health Alliance, a network of partners working to create a high quality, consistent and coordinated approach to pediatric health care that is centred around children, youth and their families. For more information or to donate, please visit hollandbloorview.ca or connect on Twitter, Facebook, Instagram, LinkedIn and parent-blog BLOOM.

Media Contact

Ashley Cruz
o. 647-406-3567 | acruz@hollandbloorview.ca