Introduction: In 2012, Florida passed legislation, in attempts to protect concussed youth athletes from second impact syndrome, requiring physician clearance licensed allopathic or osteopathic physicians for return to play. Studies have shown the majority of physicians clearing concussed youth athletes for return to play include physicians from the specialties of pediatrics, emergency medicine, family medicine, neurology, and orthopedics. Because of evolving research on concussion management and return to play protocol, it is vital that physicians clearing concussed youth athletes to return to play follow published guidelines. This study aimed to determine whether Florida physicians in the previously mentioned specialties adhere to published guidelines during their concussion management and return to play clearance protocol for youth athletes.

Methods: This cross-sectional study utilized a 22-question, researcher-developed survey, which was sent to active physicians board-certified by the Florida Board of Medicine practicing in pediatrics, emergency medicine, family medicine, neurology, and orthopedics. The survey determined the physician management and return to play clearance protocol given to concussed youth athletes. Survey results were reported as frequencies and percentages, and were compared between medical specialties and physician experience.

Results: Of the 388 respondent physicians that actively manage youth concussions in Florida, 94 (24.2%) of them reported not using any published guidelines or set of criteria to guide their clinical management and return to play protocol clearance of the concussed youth athletes. Additionally, 187 (48.2%) of the 388 physicians managing concussed youth athletes reported not feeling as though they have adequate training to prescribe a return to play protocol for a concussed youth athlete.

Conclusions: This study demonstrated that the implementation of recent legislation on concussion management does not translate into improved patient care. Inadequate management of concussed youth athletes has the potential to lead to greater incidence of second impact syndrome and neurosurgical emergencies.

Patient Care: Identify flaws in current legislation putting concussed youth at risk for chronic or permanent injury. Make recommendations to improve concussion management legislation.

Learning Objectives: 1. Demonstrate that a subset of physicians managing concussed youth athletes in Florida are not using any published guidelines or established set of criteria to guide their management and return to play protocol clearance. 2. Demonstrate that many physicians managing concussed youth athletes feel inadequately trained to prescribe a return to play protocol for concussed youth athletes. 3. Demonstrate that regardless of medical specialty or experience, many physicians managing concussions feel unequipped to clear youth athletes for return to play.

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