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;
-
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.
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
Differential Diagnosis
Clinical Cornerstone:
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The majority of traumatic brain injuries are considered “mild”. 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. Clinical reasoning is needed to increase confidence in a diagnosis of concussion and decrease the likelihood that more serious conditions or conditions with similar symptoms are present. A comprehensive diagnostic strategy integrates clinical findings with patient narratives and risk factor evaluations for a complete understanding of the patient's condition.
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Diagnosis may be complicated by comorbid conditions that mimic concussion symptoms (e.g. anxiety, migraine, etc.).
Physical Disorders (Headache, Non-specific neck pain)
Migraine:
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Commonly disabling. More prevalent in women.
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Without aura (commonly lasting 4-72 hours, unilateral, pulsing, sensitive to light/sound, nausea).
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With aura (commonly moderate-to-severe, brief episode of neurological symptoms (visual, speech or sensory disturbances) which last less than 60 minutes and precede the headache).
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Cervicogenic Headache:
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Moderate intensity headache. Does not throb.
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Unilateral from nuchal-area to oculo-frontal area.
Tension-type Headache:
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May be associated with sensitivity to light/sound.
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Headaches vary in intensity from mild to moderate.
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Not associated with nausea or vomiting.
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Does not worsen with physical activity.
Trigeminal Neualgia:
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May cause tinnitus.
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May cause dizziness/vertigo.
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Superficial pain on one side of face.
Non-specific Neck Pain:
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May cause neck stiffness, or irritation of neck area with certain movements.
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May be sharp, dull, shooting, or ache.
Anxiety
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May be associated with sleep disturbance or fatigue.
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May be associated with irritability or emotional lability.
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May be associated with focus/concentration difficulties.
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May be associated with dizziness.
Depression:
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May be associated with irritability.
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May be associated with sleep disturbance or fatigue.
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May be associated with decrease cognitive flexibility or verbal recall.
Post-Traumatic Stress:
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May be associated with sleep disturbance or fatigue.
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May be associated with irritability or emotional lability.
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May be associated with focus/concentration difficulties.
Other Disorders
Stroke
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May be associated with severe neck pain and/or headache.
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May be associated with dizziness or difficulty walking.
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May be associated with nausea.
Moderate/Severe TBI:
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May be associated with loss of consciousness > 30 minutes.
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May be associated with post-traumatic amnesia >24 hours.
Intracranial Hemorrhage:
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May be associated sudden and intense onset headache (thunderclap headache).
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May be associated with repetitive vomiting.
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May be associated with falls due to imbalance.
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May be associated with extreme drowsiness.
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May be associated with unusual confusion or irritability or behaviors.
Documentation: Record all findings in the patient record.
Conduct patient assessment
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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.