CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
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understanding how clinical practice guidelines are developed;
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discussing best practices and guidelines with colleagues;
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having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
Concussion Care Pathway
Date of last update: May, 2024
Diagnosis
Clinical Cornerstone:
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The majority of traumatic brain injuries are considered “mild”. Nearly one in two people will experience a mild traumatic brain injury in their lifetime. Concussion is considered a concussion.
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Diagnosing a concussion requires a patient-centered approach that integrates physical and psychological aspects of the patient’s symptoms.
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Diagnosis may be complicated by comorbid conditions that mimic concussion symptoms (e.g. anxiety, migraine, etc.). Clinical reasoning is needed to increase confidence in a diagnosis of concussion, and to decrease confidence that more serious conditions, more serious TBI, or conditions with similar symptoms are present. A comprehensive diagnostic strategy integrates clinical findings with patient narratives and risk factor evaluations for a fulsome understanding of the patient's condition.
Concussion
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One or more conditions need to be met for the diagnosis of concussion once a plausible mechanism of injury has been established and suspicion for other causes of the patient’s symptoms has decreased
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one or more clinical signs; altered mental status, loss of consciousness (<30 minutes), amnesia (<24 hours), neurological signs (seizure, coordination, etc.).
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two or more new or worsened clinical symptoms; subjective alteration of mental status (feeling dazed or confused), physical symptoms (headache, nausea, dizzy or sensitive to light/sound), cognitive symptoms (feeling run down, fatigue or foggy/processing-speed), emotional symptoms (lability, impulsivity).
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unambiguous imaging evidence of neurotrauma.
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Other common symptoms include:
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sleep disturbance
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visual disturbance
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hearing difficulties, tinnitus
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difficulties with memory/retrograde amnesia/anterograde amnesia
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difficulties with focus/concentration
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difficulties with judgement/executive-function
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depression or anxiety
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loss or decreased levels of consciousness <30 minutes
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The need for neuro-imaging can be determined using the Canadian CT Head Rule.
Documentation: Record all findings in the patient record.
Conduct patient assessment
click to learn more
Red flags or Orange flags present
Red flags or Orange flags present
Refer to appropriate emergency or healthcare provider
No
Yes
Acute mTBI
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Structured patient education
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Self Care
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Return to work / school
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Return to driving
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Return to sport / activity
Persistent mTBI
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Monitoring and Reassessment
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Tailored clinical management of symptoms:
- Headache
- Neck Pain
- Sleep Disturbance
- Fatigue
- Emotional / Behavioural
- Cognitive Disorders
- Vestibular Disorders
Treatment and management details
Report of findings, Shared decision-making, Initial management, Persistent systems
Differential Diagnosis
Diagnosis
Follow-up
(Align with patient goals, Criteria for discharge)
Major symptom/sign change
Goals not achieved
Discharge
No
Yes
Re-evaluate
Adjust treatment and management plan or refer
References or links to primary sources
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Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. CDC Heads Up [Internet]. CDC February 2022. Available from: https://www.cdc.gov/headsup/index.html.
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David L. MacIntosh Sports Medicine Clinic, University of Toronto. Post-Concussion Return to Activity Guidelines. EMPWR Our Toolkit [Internet]. EMPWR Foundation 2019. Available from: https://empwr.ca/our-toolkit.
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Ontario Psychological Association. OPA Guidelines for Best Practices in the Assessment of Concussions and Related Symptoms [Internet]. OPA July 2016. Available from: https://www.psych.on.ca/getmedia/b7ada02e-76ca-4a5c-891a-bc610c81a213/OPAConcussionGuidelinesFINAL2018.pdf.
Contact information for further inquiries or feedback
carolina.cancelliere@ontariotechu.ca
Disclaimer:
These care pathways are intended to provide information to practitioners who provide care to people with musculoskeletal conditions. The care pathways on this website are 'living' documents, reflecting the state of clinical practice and research evidence to our best knowledge at the time of development. As knowledge and healthcare practices evolve, these pathways may be updated to ensure they remain current and evidence driven. These pathways are not intended to replace advice from a qualified healthcare provider.