Red flags & when to go in person for Post-Concussion Symptoms - Triage

Audience: pediatric

After a concussion, children may experience symptoms like headaches, dizziness, or difficulty concentrating. Most post-concussion symptoms improve with rest and time. However, some signs suggest a more serious problem that needs immediate medical attention. Telemedicine can help assess mild symptoms and guide families on care and monitoring. It is important to know when to seek in-person care, especially if symptoms worsen or new problems appear. This guide helps parents and caregivers recognize red flags, understand what telemedicine can and cannot do, and prepare for a telehealth visit. Remember, this information is educational and not a substitute for professional medical evaluation.

Red flags — go in person / ER

• Severe or worsening headache not relieved by medication — go to emergency care immediately.
• Repeated vomiting or inability to keep fluids down — seek urgent in-person evaluation.
• Seizures, weakness, confusion, or difficulty waking up — call emergency services without delay.

What telemedicine can do

• Initial assessment of mild post-concussion symptoms.
• Providing guidance on rest and symptom monitoring.
• Answering questions about concussion care and recovery.
• Determining if symptoms require urgent in-person evaluation.

What telemedicine cannot do

• Emergency situations such as seizures or severe neurological changes.
• Performing physical examinations that require hands-on assessment.
• Imaging tests like CT scans or MRIs.
• Administering treatments or medications that require in-person visits.

What are Post-Concussion Symptoms?

Post-concussion symptoms are changes that happen after a child hits their head or experiences a sudden jolt. These can include headaches, feeling dizzy, trouble sleeping, mood changes, or difficulty paying attention. Symptoms usually start within hours or days after the injury and often improve over time with rest.

When to Use Telemedicine for Post-Concussion Symptoms

Telemedicine can be helpful for checking mild symptoms, answering questions, and deciding if further care is needed. A healthcare provider can assess your child's symptoms through a video call and provide advice on rest, gradual return to activities, and warning signs to watch for.

Red Flags: When to Go In Person Immediately

Certain signs mean your child needs urgent in-person care. These include:

If any of these occur, seek emergency care right away.

Preparing for a Telemedicine Visit

Before your tele-visit, gather important information:

This helps the provider give the best advice.

After the Telemedicine Visit: What to Do Next

Follow the provider's recommendations carefully. This may include:

Keep a symptom diary to track progress.

How to prepare for your tele-visit

• Know the exact time and cause of the head injury.
• List all symptoms your child is experiencing and when they started.
• Have a quiet, well-lit space with a working camera and microphone for the tele-visit.
• Prepare any questions or concerns to discuss with the provider.
• Have a trusted adult available to assist your child during the visit if needed.

After your tele-visit

• Follow the healthcare provider's advice on rest and gradual return to activities.
• Monitor your child's symptoms daily and note any changes.
• Keep your child hydrated and ensure proper nutrition.
• Avoid activities that risk another head injury until cleared by a provider.
• Seek in-person care immediately if any red flags develop.

FAQs

Can telemedicine diagnose a concussion?

Telemedicine can help assess symptoms and guide care but cannot replace a full in-person evaluation needed to diagnose a concussion definitively.

How long do post-concussion symptoms usually last?

Symptoms often improve within days to weeks, but some children may experience symptoms for several months. Recovery varies by individual.

When should my child return to school or sports?

Return to school and sports should be gradual and guided by a healthcare provider. Typically, children rest until symptoms improve, then slowly resume activities.

Is it safe to use telemedicine for follow-up after a concussion?

Yes, telemedicine can be useful for follow-up visits to monitor recovery and provide ongoing advice, as long as no urgent symptoms are present.

What should I do if my child’s symptoms get worse after the tele-visit?

If symptoms worsen or new red flags appear, seek in-person medical care immediately, even if it means going to an emergency department.

Sources

1. Concussion in Children and Teens — MedlinePlus, U.S. National Library of Medicine.
2. Traumatic Brain Injury & Concussion — Centers for Disease Control and Prevention (CDC).
3. Concussion: Symptoms, Diagnosis, and Treatment — Mayo Clinic.
4. Post-Concussion Syndrome — Merck Manuals: Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical evaluation or emergency care. If your child shows any red flag symptoms or if you are concerned about their health, seek immediate medical attention.