Concussion Symptom Prevalence, Severity and Trajectory: Implications for Nursing Practice

The purpose of this study was to describe the symptom severity and trajectory in concussed children who were followed during a one year period at a concussion clinic. A retrospective chart review was completed to describe the symptom trajectory up to three months during the recovery. One hundred and thirty-six patients were included (74 female, 62 male) with a median age of 15.4years (range 13–17). The most common mechanisms of injury included: falls (19.9%), hockey injuries (15.4%), soccer (14.0%) and football injuries (6.6%). Most concussion symptoms decreased in severity or improved over time. Four symptoms including fatigue/low energy, drowsiness, concentration difficulties and irritability had the highest symptoms scores at both 28 and 84days post-injury in patients with persistent symptoms. Emotionality and nervousness/anxiousness and nausea/vomiting scores were seen to increase over time in patients with persistent symptoms. Clinical use of standardized assessment tools can help caregivers track and monitor concussion symptoms over time. Appropriate management strategies need to be devised for symptoms that are prevalent or increasing over time.