Social visits both in and out of the home and trips should be limited During

Social visits both in and out of the home and trips

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including absence from school. Social visits both in and out of the home and trips should be limited. During this period of reasonable rest, the child may often engage in light mental activities, such as watching limited amounts of television and family interaction, without exacerbating symptoms. However, close follow-up with a pediatrician, sports medicine specialist, or other capable provider is needed to help guide the liberalization of mental activity. Patients can return to school as soon as they can tolerate 30 to 45 minutes of concentration (Santiago, 2016). concussed patients typically require one to two days of reasonable rest before returning to school. To avoid the harm of prolonged absence from school, we usually return student athletes to school after a maximum of five days of rest. There is no consensus or strong evidence for a single specific protocol to be followed for return to play or to school after a concussion. Return to exercise, practice, or play should not be permitted until the athlete has been evaluated by a licensed health care provider with experience in the evaluation and management of patients with a concussion. Before return to play, a gradual, stepwise increase in general physical activity, followed by sports-specific activities, is recommended. Progression to more strenuous steps is only recommended if the athlete is asymptomatic at the current level of activity (West & Marion, 2014).During this stepwise increase in activity, the athlete should not be taking any sedative or analgesic medications that might mask common post-concussive symptoms such as headaches or dizziness. Key recommendations of all three groups are that any athlete suspected of having a concussion should not be allowed to return to play on the day of theinjury, athletes with concussion should not return to play until they have been evaluated by a licensed health care provider, and even then, there should be a gradual, stepwise increase in physical activity. Recovery from concussion is a dynamic process, and is different between patients and even different between concussions in the same patient. The majority of concussionsresolve with rest and gradual return to physical and cognitive activity (Santiago, 2016). Althoughpatients may be asymptomatic within hours or days, they may not return to neurocognitive baseline until later (Makdissi et al., 2017). Any activities, physical or cognitive, that exacerbate concussion symptoms must be ceased temporarily.Reference:Makdissi, M., Schneider, K. J., Feddermann-Demont, N., Guskiewicz, K. M., Hinds, S., Leddy, J. J., . . . Johnston, K. M. (2017). Approach to investigation and treatment of persistent
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symptoms following sport-related concussion: A systematic review.British Journal of Sports Medicine, 51(12), 958. doi:Santiago, S. (2016). Adolescent concussion and return-to-learn.Pediatric Annals, 45(3), e73-75.
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