CONCUSSION MANAGMENT

Helmets and Lacrosse Sticks Concussion Basics A concussion is a mild traumatic brain injury. It commonly occurs due to a sports injury or an accident. Concussions are diagnosed by performing a series of physical and cognitive (thinking) assessments. Concussions do not show up on X-rays, MRIs, CT scans or EEGs. Approximately 80% of concussions resolve within the first two weeks after injury. Out of the remaining 20%, about 80% of those concussions are healed by a month’s time. For the rare few concussions that persist, a referral to a neurologist is in order. Program Goals • To establish baselines for individual performance on physical and cognitive assessments prior to injury.
• Evaluation for concussion in the event of injury
• Monitoring progress and establishment of appropriate limits on return to activity
• Identification of situations requiring referral to specialists and facilitating access to those services
Baseline Testing Neurocognitive testing is performed as part of concussion management. The testing has an increased value in management when post-injury performance is compared with the individuals own pre-injury performance as opposed to average values of clinical trial test subjects. We utilize ImPACT in the office to conduct the neurocognitive testing portion of concussion management. As part of our concussion management program we encourage our student athletes to obtain a “baseline” test. This is often done in the athletes school and if the school utilizes the ImPACT test for such, we would simply need their “Passport ID” to obtain the full test report. If this is not performed at the athletes school, we can administer the baseline testing in our office. The baseline testing involves measuring visual and verbal memory, reaction time and processing speed through completion of numerous tasks. The purpose is to get an objective measurement of how well and how quickly your child’s brain is managing information.

Remember, baseline testing must be done before a head injury occurs – so a great time to schedule it is before a sports season starts. Testing is available by appointment only Tuesday-Friday from 8am – 5pm. For children 5-11 years of age, the test takes about 20-30 minutes to complete. For children 12 and up, the test takes about 30-45 minutes to complete.
Post-Injury Management In the unfortunate event of a head injury:

• Call us! Most times we can assess the severity of the injury in the office. If the injury occurs after hours, we will speak with you and advise as to whether it is necessary to be seen in an emergency room or wait until the next day.
• The first 48 hours of concussion management is about rest, hydration, and proper nutrition. Screen time needs to be minimized.
• After the first 48 hours, reassessment in office consists of physical and neurocognitive assessment. This visit is extensive and often takes over an hour to complete. Return to activity protocols are established along with follow up.
• Reassessments continue every 1-2 weeks until complete resolution occurs.
Additional Information
There are many concussion resources available on the internet. These are well regarded and reliable sources. Every concussion is different, just as every child is different. The care we provide is based on established guidelines but individualized to your child’s specific needs.
HEADS UP to Youth Sports from the CDC injury center The REAP project of New York BrainLine

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Baby getting listened to PREVENTATIVE HEALTH CARE VISITS Preventative Health Care

Preventative Health Care encompasses a wide variety of services to both promote good health and prevent diseases. We provide preventative health care based on the American Academy of Pediatrics Bright Futures Guidelines for Health Supervision.
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SAME DAY SICK APPOINTMENTS Same Day Sick Appointments

Peds First Pediatrics is available 7 days a week to provide care for when your child is ill. We limit booking for acute illnesses such as fever, ear pain, sore throat to the day you call for the appointment. We kindly request that you call as early in the day as you recognize that you wish to have your child evaluated.
Click here to learn more about our same day sick appointment availability.
breastfeeding baby BREASTFEEDING SUPPORT Breast Feeding Support

We aim to educate families and encourage breastfeeding. We provide access to an International Board Certified Lactation Consultant to support all families that are attempting to breastfeed. Peds First also seeks to identify and assist mothers who are suffering with post-partum depression.
Click here to learn more about our Breastfeeding Support Services.
Helmets and Lacrosse Sticks CONCUSSION MANAGEMENT Concussion Management
Peds First provides evaluations for concussions in the event an injury is sustained. If concussion is of concern, we provide monitoring of symptom progression and establish appropriate limits on return to activity. When available we utilize individualized baseline performance measurements of physical and cognitive skills to assist with post concussion management.
Click here to learn more about Concussion Management.
Support Sign CARE COORDINATION Care Coordination

Our Care Coordination Team is constantly evolving in an attempt to minimize "Gaps in Care." We seek to identify the barriers that families face in receiving proper care and assist them in clearing those barriers.
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Food, Stethoscope and Heart NUTRITION SUPPORT Nutrition Support

The old adage states “You are what you eat.” To a large extent, this is accurate – optimal nutrition is one factor to help you live a longer and healthier life. However, what is optimal depends on the individual, and this is the focus of our nutrition department.
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Chest x-ray ASTHMA MANAGEMENT Asthma Management

Asthma is a chronic inflammatory condition affecting the smaller airways in the lungs of nearly 1 in 10 children. We actively seek to identify children that are at risk for having asthma so that we may provide the proper education, monitoring, and therapy as needed to minimize both short and long term consequences of poorly controlled asthma.
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Unhappy to Smiley Face MENTAL HEALTH SERVICES MENTAL HEALTH SERVICES

A 2018 study in The Journal of Pediatrics demonstrated that among children ages 3 to 17 years, about 3% suffer from depression and 7% from anxiety. Of great concern is that more than 1 in 5 of these children went untreated for their condition. We seek to identify those children at risk for mental health conditions so that we can provide assistance where appropriate.
Click here to learn about our Mental Health Services.
Kids writing ADHD MANAGEMENT ADHD Management

ADHD is a common condition that affects children more than just academically. It can cause difficulty in all avenues of life, and when severe can contribute to the development of other mental health concerns such as depression and low self esteem. We seek to identify and manage this condition to maximize the success of those affected.
Click here to learn more about our ADHD Management services.

Concussion Basics

A concussion is a mild traumatic brain injury.  It commonly occurs due to a sports injury or an accident.  Concussions are diagnosed by performing a series of physical and cognitive (thinking) assessments.  Concussions do not show up on X-rays, MRIs, CT scans or EEGs.  Approximately 80% of concussions resolve within the first two weeks after injury.  Out of the remaining 20%, about 80% of those concussions are healed by a month’s time. For the rare few concussions that persist, a referral to a neurologist is in order.

Program Goals

  • To establish baselines for individual performance on physical and cognitive assessments prior to injury.
  • Evaluation for concussion in the event of injury
  • Monitoring progress and establishment of appropriate limits on return to activity
  • Identification of situations requiring referral to specialists and facilitating access to those services

Baseline Testing

Neurocognitive testing is performed as part of concussion management.  The testing has an increased value in management when post-injury performance is compared with the individuals own pre-injury performance as opposed to average values of clinical trial test subjects.  We utilize ImPACT in the office to conduct the neurocognitive testing portion of concussion management.  As part of our concussion management program we encourage our student athletes to obtain a “baseline” test.  This is often done in the athletes school and if the school utilizes the ImPACT test for such, we would simply need their “Passport ID” to obtain the full test report.  If this is not performed at the athletes school, we can administer the baseline testing in our office.  The baseline testing involves measuring visual and verbal memory, reaction time and processing speed through completion of numerous tasks.  The purpose is to get an objective measurement of how well and how quickly your child’s brain is managing information.

Remember, baseline testing must be done before a head injury occurs – so a great time to schedule it is before a sports season starts.  Testing is available by appointment only Tuesday-Friday from 8am – 5pm.  For children 5-11 years of age, the test takes about 20-30 minutes to complete. For children 12 and up, the test takes about 30-45 minutes to complete.

Post-Injury Management

In the unfortunate event of a head injury:

  • Call us!  Most times we can assess the severity of the injury in the office.  If the injury occurs after hours, we will speak with you and advise as to whether it is necessary to be seen in an emergency room or wait until the next day.
  • The first 48 hours of concussion management is about rest, hydration, and proper nutrition.  Screen time needs to be minimized.
  • After the first 48 hours, reassessment in office consists of physical and neurocognitive assessment.  This visit is extensive and often takes over an hour to complete.  Return to activity protocols are established along with follow up.
  • Reassessments continue every 1-2 weeks until complete resolution occurs.

Additional Information

There are many concussion resources available on the internet.  These are well regarded and reliable sources.  Every concussion is different, just as every child is different. The care we provide is based on established guidelines but individualized to your child’s specific needs.