August 30th, 2010
10:19 AM ET

Children's ER visits for concussions double

The number of emergency department visits caused by children's concussions more than doubled in the last 10 years, despite an overall decline in sports participation, according to a new study released Monday.

Using data from a sample of U.S. hospitals that have emergency departments, authors Dr. Lisa Bakhos and her colleagues found that from 2001 to 2005, about 502,000 emergency visits came from concussions in children between the ages of 8 and 13 years of age.

Approximately half of these 500,000 emergency department visits were from concussions related to organized sports, according to the article published in Pediatrics.

The authors ranked the concussion rates as highest in children who played hockey (10 per 10,000 participating children) and football (eight per 10,000 participating children).

Some experts have hypothesized that this increase in injuries may be occurring from more competitiveness in youth sports and intensity in practice. But the higher numbers could be a result of increased awareness and reporting.

Researchers at the Warren Alpert Medical School at Brown University wrote that the concussion in such a young age group could cause injuries in the nervous system, prolonged cognitive disturbances, disturbed skill acquisition, and second-impact syndrome, which is a second concussion that occurs before a first concussion has healed, causing brain swelling and other problems.

Pediatricians are concerned that young athletes may experience more severe long-term developmental and cognitive problems from head injuries than adults.

The authors wrote that more work has to be done to standardize the management of sports-related concussions in children in the medical field. No such guidelines have been established for treating young athletes.

“Additional research to provide guidance in management, prevention strategies, and education for practitioners, coaches and athletes is required,” they concluded.

soundoff (62 Responses)
  1. John

    Increased ER visits does not mean increases injuries, but instead could simply be a case of a higher percentage of people seeking treatment.

    August 30, 2010 at 12:24 | Report abuse | Reply
    • Steve

      Absolutely true. This study provides no useful information because it can't make that distinction.

      August 30, 2010 at 22:24 | Report abuse |
    • stevemiller2

      Another useless grant issued by the gov. Waste of taxes!

      August 31, 2010 at 00:16 | Report abuse |
    • Sean

      Very true, our society is much more aware of head injury problems today then they were 20 years ago. I can count numerous times as a child growing up and a teenager (I am 34 now) that I suffered some sort of head injury through sports or just some sort of accident and nobody back then ever considered taking me to a doctor about it. Unfortunately it took some very high profile deaths for the general public to wake up to the fact that "a little bump on the head" can potentially be very serious.

      August 31, 2010 at 00:17 | Report abuse |
    • timothy

      ... first... this is a retrospective chart review.. which means more than likely they didn't receive any gov't money to do this, all they need is an institutional review board's (IRB) permission (more than likely the hospital's IRB and/or Brown University) and several peons to do the actual data gathering (with enough med students/undergrads/analysts that want their name to be published this can be done in less than a month if its all electronic medical records)... second... they flat out said in the discussion portion that they didn't make any assumptions and that it could be just increased awareness and/or liability issues and/or a real increased amount of concussions in children... third... from what it sounds like this was a pilot study for a larger investigation and to promote more questions in a field that is currently "a hot topic" where NO ONE is sure what is really going on... for christ's sake... read the actual study first before you shoot your mouth

      August 31, 2010 at 01:57 | Report abuse |
    • SurRy

      Head injury research is not a waste of money. More and more research seems to be indicating that head injuries that were once considered "minor" may now lead to later problems. Research and education are not wastes of money.

      August 31, 2010 at 09:24 | Report abuse |
  2. Ken

    Agreed. Especially with all of the increased awareness about concussions – organized/school athletics are probably directing many more borderline cases to urgent care/ER settings to (optimist's view) ensure the safety of the child/teenager or (cynic's view) to provide medical-legal covering of their as$.

    August 30, 2010 at 12:29 | Report abuse | Reply
    • mshrmit

      In Washington State, it's now a law that an athlete cannot return to the field (even practice) after a concussion until a doctor has given written permission.

      August 30, 2010 at 23:39 | Report abuse |
  3. Common Misconception

    I'm pretty sure I accounted for 90% of the adolescent head trauma cases between 1985 and 1995.

    Seriously, I hit my head so much I'm pretty sure I would have been a genius beforehand.

    And yes, all this confirms is that more people are coming in for concussions, not that more are actually happening. In today's increasingly medically litigious society, telling a kid to "Walk it off" is no longer an acceptable way of dealing with a sports injury.

    August 30, 2010 at 12:33 | Report abuse | Reply
  4. C A

    I think that people in general, doctors, parents and coaches, recognize it's not appropriate to ignore a head injury. When I was in my teens I had my horse land on me or roll over me in jumping accidents on four separate occasions and each time I smacked my head on the ground or on a wooden pole from obstacles. My parents took me to the doctors on two of those occasions, but on the other two they thought it "wasn't bad enough." I'm glad there's more awareness now, and I consider myself lucky when I reflect back on it.

    August 30, 2010 at 12:47 | Report abuse | Reply
    • Diane

      Having taken a few spectacular falls off horses myself, I agree that we are both lucky that no serious damage was done. I did not seek any kind of medical attention even when I landed on my head and neck.

      August 31, 2010 at 09:58 | Report abuse |
  5. Poppy

    I think this also speaks to how weak our children have become. We have stopped evolving and its a shame that the weak are allowed to reproduce.

    August 30, 2010 at 13:36 | Report abuse | Reply
    • Michael

      Sounds harsh but on the whole its true. Even worse the lowest quotient of IQs has 5 times more babies and is paid by the government to do so.

      August 30, 2010 at 23:27 | Report abuse |
    • Spijder

      It does not point to physical weakness, but rather as many comments have pointed out, people being more apt to get head injuries looked at by a doctor. Increased awareness or concern doesn't automatically indicate (or lead to) the conclusion that current generations are less physically resilient than previously. You would have to look at bone-density or actual death rate versus impact force studies to even start thinking along those lines.

      August 31, 2010 at 08:17 | Report abuse |
    • Dave

      With that kind of thinking, I think they should study how many time you hit YOUR head as a child. Dumbass.

      August 31, 2010 at 09:47 | Report abuse |
    • Poppy

      realisitcally there needs to be a testing program in place so that children that will be allowed to reproduce can be identified as young as grade school. We can then sterilize the rest so that existing children can live out their lives as best they can but wont pollute the gene pool. Imagine how great life would be in our country if we only allowed the good people to reproduce. There is maybe 20% of the population that should be allowed to do this. If we always only take the top 20% even a few generations from now would see big changes

      August 31, 2010 at 15:38 | Report abuse |
    • Kathy

      I think it shows how weak the male children have become but most of these injuries are in males are they not? One reason is that males engage in more risky behavior than do girls. That is why almost everyone who wins the Darwin Award is male.

      September 1, 2010 at 02:47 | Report abuse |
  6. Ralph Gentry

    No more footbaw for 12 year olds. Way to much contact for non-contact sports like soccer and golf. Kids need to stop using their bodies as battering rams. Got to wonder if we took away all those huge pads and helmets if injouries would be more or less.

    August 30, 2010 at 14:50 | Report abuse | Reply
    • Steve

      Soccer is NOT a non-contact sport. Any idiot watching a soccer match on TV can see that.

      August 30, 2010 at 22:26 | Report abuse |
    • JC

      Football and Hockey are considered collision sports, whereas soccer and basketball are considered contact. Incidentally, some studies indicate soccer may have the highest rate of reported concussions. There is a lot of incidental head trauma mixed with intentional (heading the ball at high velocity). That being said, reporting is also an issue imo in that many collision sports players will neglect head trauma and play on.

      August 30, 2010 at 23:32 | Report abuse |
    • WTF?

      Soccer a NON contact sport? What the ???? That is a very contact sport. My son's orthopaedic surgeon said he says more injuries from soccer than any other sport. Typical football mentality. Kids are weak, they need to play when they are injured, etc. You are a wimp if you play soccer. GET OVER IT ALREADY!

      August 31, 2010 at 09:02 | Report abuse |
  7. Lynn

    My son plays baseball and I hear the coaches telling the kids to walk it off all the time. Some of the kids look really injured sometimes. Then on the other hand, parents bring kids to the emergency room for the sniffles. My son hurt his ankle really bad during a game and could barely walk but he had to go up to bat because of the rules that they have. He made it to 2nd base and looked funny running but as a mother I would think the coach would'nt have allowed him to run. Sometimes winning the game is more important to the coaches than the childs welfare.

    August 30, 2010 at 23:30 | Report abuse | Reply
    • JC

      Did your child end up having an injury that was complicated by their participation?

      August 30, 2010 at 23:37 | Report abuse |
    • Kh

      It's not just coaches. I once saw parents tell their kid to "walk it off " after their son was injured during football practice. He had a broken wrist. Then the biggest concern the mother seemed to have had was when he could get his cast off, so he could play football again. Healthy competition is good. Parents using their kids and being callous about real injuries for their own ego satisfaction is not good.

      August 31, 2010 at 07:30 | Report abuse |
  8. Josephson

    This is 100% because of gym teachers wanting to avoid litigation. Unfortunately this could be taken care of by watching the kid for a few hours, making sure he feels better, and taking him to the ER if he keeps getting confused, worsening headaches, has nausea, vomiting. This used to be known as common sense. Now, because of lawyers, we can take away the ER's resources from real emergencies and all our children can get a healthy dose of radiation to the head from a CAT scan.

    August 31, 2010 at 00:50 | Report abuse | Reply
  9. chris

    The media blows out cases of talk and die syndrome, where someone hits their head and later dies of the complications of impact. The person appears fine but impact caused internal bleeding. So every parent has to take their 'angel' to the ER every single time their kid gets his or her head tapped during a game of duck/duck/goose.

    August 31, 2010 at 00:53 | Report abuse | Reply
  10. Alvin

    There was an article in medgadget a few weeks ago just talking about this! The article talks about a company Brainscope that seems to determine the severity of a concussion using some brain wave eeg. I guess you could use that to determine if it's safe to play again.


    August 31, 2010 at 01:58 | Report abuse | Reply
  11. hoss

    kids also need to learn competition....life isn't fair and nobody gives you anything.If the guy next to you works harder than you, the boss won't be telling you "it;s ok, you really tried" he'll be telling you to pound sand. Kids don't understand work ethic anymore...mine included. At least sport is giving them a taste of what's to come

    August 31, 2010 at 01:58 | Report abuse | Reply
    • Kh

      Unless they play sports for a living, how is that giving them a taste of what's to come for competition in the job market? I guess school is not necessary and just to fill up time?

      August 31, 2010 at 07:33 | Report abuse |
    • Poppy

      I agree. There has to be real consequences for failure in sports. Children are too soft they need to be punished.

      August 31, 2010 at 15:27 | Report abuse |
  12. tracy

    after the high profile death of Natasha Richardson, as an ER nurse I saw more people bring their kids in DEMANDING CT scans for little bumps on the head. It's a lot of radiation, but parents don't think ahead to their kids' higher risk of cancer later. and after 10 years I swear I've only seen like 5 bleeds. people need to be educated as to the SYMPTOMS that indicate more than just a concussion

    August 31, 2010 at 05:09 | Report abuse | Reply
    • Mercedes S.

      Sounds like you blame Natasha Richardson. I'm glad her "high profle death" (?) caused parents to take their kids' head injuries seriously.

      August 31, 2010 at 06:04 | Report abuse |
  13. Jennifer

    The numbers that got my attention was 10 in 10,000 this is not a major issue. Yes it requires attention but I think coachs and other trained people should be the ones making the call. I found that the children are playing rougher and tranning harder at youger ages raised more red flags. They are 8-13 they should be playing for the love of the game.

    August 31, 2010 at 08:39 | Report abuse | Reply
  14. El Kababa

    When any scientific study is summarized on the internet, there are two comments that appear much more frequently than any others.

    1. "Well, duh! Everyone knows that. There was no reason to do a scientific study. My second cousin had a concussion while on his skateboard and my brother had one when he fell off a fence. I could have told you that concussions were up."

    These are the people who were shooting spitwads at the smart kids in science class instead of paying attention in class. They are still doing it.

    2. "More of my hard earned tax money gone to waste! When oh when will the federal government stop wasting the money that they steal from my paycheck? No one has had a concussion in MY family! Besides, I heard that Obummer had french fries for lunch yesterday. I guess it's no coincidence that France is a socialist country is it? What's wrong with good old Ameican fries? They were good enough for Ronald Reagan ..."

    These are the pod people. They are aliens from another planet who have taken the place of a human being. Their goal is to end all intelligence on earth.

    August 31, 2010 at 08:44 | Report abuse | Reply
  15. Someone

    People just understand concussions more. The one stat in this article that scares me is that hockey is the highest. Can we not return to a time when it was skill that won and just get rid of all the violence in it.

    August 31, 2010 at 08:46 | Report abuse | Reply
    • El Kababa

      Every former football player I know has an injury to prove it. I don't know any former hockey players. It's not very popular in the southwest where I live. It is tantamount to child abuse to let your kid play football.

      Also, I can't help but wince at modern cheerleading choreography, which calls for tossing petite girls high into the air and trying to catch them. Are no parents watching this?

      August 31, 2010 at 09:08 | Report abuse |
  16. Kit

    If I had to guess it is most likely that people are simply more aware. Head injuries really aren't something you want to fuss with anyways. They should be looked at, do they always require a CT? No. But they should be looked at. Sometimes they can have lasting effects and the more concussions you have the more likely you are to get another in the future. You should especially get them looked at if you black out.

    All sports are dangerous. I've figure skated as well as horse back ridden and I've seen nasty injuries in both sports. Cheerleading, football, american football, for goodness sakes tennis can be dangerous. That doesn't mean kids shouldn't PLAY the sports. I once got a concussion from sledding down a hill, a friend of mine went blind from a swimming accident. I mean, come on. Stuff happens. Can't hide in a box.

    I definitely think the increased rate has to do with parents being more aware though.

    August 31, 2010 at 09:36 | Report abuse | Reply
  17. atrack

    The Illninois high school association is now requiring all athletes that suffer concussion symptoms to be evaluated by a certified athetic trainer or physician before allowing them to return to play. Also the NCAA as mandated that athletes suffering a concussion not be allowed to return to play that day and must follow a concussion protocol for return to play. The problem, especially at the high school level and below is that many schools and programs lack the resources such as having an athletic trainer available to evaluate the injury on the sideline. Another problem is that over 60% of injuries happen in practice where the coach is the only person available, in many cases, to make medical judgements on injured athletes. It used to be that people thought that being knocked out made a concussion serious. Research has shown this not to be true. Many severe concussions can occur without the athlete losing consciousness.

    August 31, 2010 at 09:52 | Report abuse | Reply
  18. Klauck

    I'm sorry but with kids/sports being the way they are now I can see the reason behind the increase in concussions. Kids will be kids and depending on how one another is raised determines the will and dedication to what they do and the effort they put forth. My opinion personnel opinion is that the harder they work and play the better! Not incouraging kids to hurt one another but put fourth the effort, you never know what could happen!!!!

    August 31, 2010 at 09:53 | Report abuse | Reply
  19. e gronager

    Well, this will be very tongue in cheek as my son does play football... Parents are arrested for the shaken baby syndrome behavior but, it is perfectly acceptable to trot junior, who's brain is not developed until the mid twenties, out to the football field six days a week and allow children of the same age to smash each other in the name of good fun and sportsmanship with total impunity. Take note of what Chris Henry's autopsied brain looked like at the age of 26... just sayin"

    August 31, 2010 at 09:55 | Report abuse | Reply
  20. Sue

    Is it just me, or is something missing from this article? IIt says "more than doubled in the last 10 years, but gives only one set of numbers, from a 4-year period.

    August 31, 2010 at 10:00 | Report abuse | Reply
  21. Grego

    Also, more schools are being cautious about lawsuits these day. None of them want to get sued.

    September 1, 2010 at 04:25 | Report abuse | Reply
  22. Dr. Leon David Peris

    Bill Clinton has a abnormal frontal Lobe and is devoid of Morals!

    September 2, 2010 at 12:38 | Report abuse | Reply
  23. Sharon Orleans

    Steroid use is out of control, so where is Alan Greenspan to tell us all is well?

    September 2, 2010 at 12:39 | Report abuse | Reply
  24. Dr. Leon Peris

    We can cure ADHD with Annabolic steroids. The doctors at Pa. Hospital ruined more lives by sloppy surgical

    September 2, 2010 at 22:42 | Report abuse | Reply
  25. Dr. Leon David Peris

    God is Dead. Evolution and Science is all there is.

    September 2, 2010 at 22:43 | Report abuse | Reply
  26. Dr. Leon David Peris

    The frontal brain cavity (Stanis Lobe) can be activated with Electric Shock.

    September 2, 2010 at 22:44 | Report abuse | Reply
  27. Dr. Leon David Peris

    GOD is a Tool ofthe Rich to keep the masses inline!

    September 2, 2010 at 22:45 | Report abuse | Reply
  28. Dr. Leon David Peris

    Fenton Stanic is not GOD, only his lost son

    September 2, 2010 at 22:46 | Report abuse | Reply
  29. Big Belly Scharfberg

    Drugs are dangerous, my son died of them!

    September 3, 2010 at 14:07 | Report abuse | Reply
  30. Jerry Scharfberg

    Drugs are no laughing matter!

    September 3, 2010 at 14:08 | Report abuse | Reply
  31. Jerry Scharfberg

    Drugs are not Kool!

    September 3, 2010 at 14:09 | Report abuse | Reply
  32. how much for whiplash

    how much for whiplashVery true, i think today kids are participating in games in early ages and this results in serious injury.
    But the one thing in this article that scares me is that hockey is the highest. Can we not return to a time when it was skill that won and just get rid of all the violence in it.

    September 6, 2010 at 08:30 | Report abuse | Reply
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