Taking a Page Out of the Military’s and NFL’s Concussion Care Playbook
In 2009, former Vice Chief of Staff of the U.S. Army, General Peter Chiarelli (Ret.), led the Department of Defense (DoD) efforts on
the invisible wounds of war” – traumatic brain injury (TBI), post-traumatic stress (PTS), and suicide prevention. He championed a
battlefield-to-bed side protocol to identify service members with suspected brain trauma and provide expert medical care. The National Football League (NFL) and Centers for Disease Control (CDC) have also convened experts to address concerns about sports-related concussions. Both organizations have developed best practice protocols to ensure appropriate screening and evidence-informed guidance for return-to-play or –duty decisions.
It is time to turn our attention to the “fight at home,” to bring evidence-informed concussion screening, patient discharge information, and follow up referrals to the more than 2.5 million Americans who go to emergency departments (EDs) or other urgent care centers every year. Children and adults who play sports, ride bicycles and engage in other recreational activities, or who fall or have accidents resulting in brain trauma, should all receive the benefits afforded to NFL players and service members.
However, EDs face unique challenges because many of their patients have life-threatening injuries, and the financial, social and family support available to them after discharge varies
widely. Therefore, we have adapted the screening protocols and concussion management
guidelines used by the DoD, NFL and CDC so that they are relevant to both children and
adults, are simple and rapid to administer, and are integrated into electronic health systems.
Our goal is to improve outcomes for concussion by detecting it early with a standardized
screening tool, providing evidence-informed guidance, and creating a national registry for
further improvements in the future.