James Cooper, University of Otago, Wellington, NZ
I'm James, a 26 year old post grad medical student (TI) currently on placement in Hawkes Bay. I chose to complete my elective placement doing Sports Medicine and a research project focussed on Concussion which is being completed under the larger BRAIN study within Wellington.
Concussion Assessment in the Emergency Department- A Feasibility & Pilot Study - BRAIN Study Project
Cooper, J., University of Otago, Wellington, New Zealand Sik, A., University of Otago, Wellington, New Zealand
Introduction: Concussion is a subgroup of mild traumatic brain injury (mTBI) defined as a complex pathophysiological process affecting the brain induced by traumatic biomechanical forces. Concussion is a common emergency department (ED) complaint, but its diagnosis has several inherent challenges. NICE guidelines are used as a clinical decision aid, with the Sports Concussion Assessment Tool (SCAT-5) being recommended for use in suspected concussion within the Wellington ED. This study aims to determine the feasibility of using the SCAT-5 test in an ED setting, and whether reduced forms of the SCAT-5 can be used to predict concussion scores.
Methods: This prospective feasibility pilot study is enrolling patients over 18 years of age with mTBI (GCS 13-15) recorded following injury and a negative CT head (if performed) presenting to the Wellington ED. The SCAT-5 is being completed by research investigators in the ED and subjects are being emailed a symptom survey at days 2, 7, 14 to 28 post injury to monitor clinical symptoms.
Results: Preliminary results after 8 weeks show recruitment of 25 participants, with 22 potential participants declining to participate. Of these enrolled, 14 are subjects with mTBI and 11 are controls who have been recruited from Wellington ED and the universities surgical department. Of the 14 subjects recruited, 6 were unable to undertake the balance assessment due to nausea/dizziness. The assessments were interrupted on 2 occasions by hospital employees involved in the patients care. On average the SCAT-5 took 25.84 minutes to complete on subjects within the ED.
Conclusions: Throughout 8 weeks of recruitment, it appears the length and certain aspects of the assessment may not be feasible within an environment such as the ED. More data should be gathered to confirm this, then efforts should be focussed on reduced versions of the SCAT-5 that are diagnostically useful.