Pilot study of knowledge and management of concussion in emergency department doctors in singapore

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Abstract

Objective

1. To gain an understanding of Singapore Emergency Physicians (EPs) knowledge and practice habits when assessing concussions in the Emergency Department (ED).

Objective

2. To determine what knowledge exists regarding current international concussion management and return-to-play guidelines

Design

A 21 item anonymous internet survey was developed and disseminated to EPs in Singapore. A limited time period for completion was given. Because of anonymity, non-responders could not be specifically targeted. Participation was voluntary and no incentives were offered.

Results

26 responses which included 9 Associate Consultants or above, 4 Registrars, 14 junior doctors. 63% were Singapore trained.

Results

88.9% were aware of the concussion diagnosis but only 50% could document the salient points required to diagnose concussion.

Results

The highest percentage (33.3%) reported seeing cases of concussion monthly, 18.5% fortnightly, 29.6% weekly and 14.8% daily. 33.3% of EPs were aware of Internationally Recognised guidelines but only 11% use them.

Results

70.4% refer concussions for follow up (47.4% to Neurosurgery and 21.1% to Sports Medicine). Only 14.8% of EPs have had specific training in sports concussion management.

Conclusions

1. It is likely that concussion is under diagnosed; many EPs only report seeing cases monthly and are unaware of the salient features to diagnose concussion.

Conclusions

2. International guidelines regarding return-to-play and standardised assessment have not reached the majority of EPs.

Conclusions

3. A small proportion of concussion cases are referred to Sports Clinics for follow up.

Conclusions

4. Further training in sports concussion management in Singapore EDs is needed.

Conclusions

5. Further studies in this area are required.

Competing interests

Joanne Probert – Trainer for World Rugby.

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