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Concussion Care Pathway

Date of last update: May, 2024

Shared Decision-making (SDM)

Clinical Cornerstone:

  • Shared Decision Making (SDM) is a vital component of patient-centered care, especially in managing conditions like concussion, where various symptoms may require various treatment options. This collaborative process involves clinicians, patients, and their families working together, aligning healthcare decisions with the best available evidence, and considering the patient's individual values, preferences, and circumstances.

Steps in Shared Decision Making:

1. Introduce the Decision: Explain the need for a decision regarding concussion management and emphasize the value of the patient's input.

2. Present the Options: Detail the available treatment options, discussing the benefits, risks, and uncertainties of each.

3. Discuss Patient Values and Preferences: Explore what is most important to the patient, including their treatment goals, concerns, lifestyle factors, and cultural or personal beliefs that may influence their decision. Can use patient decision aids if available.

4. Deliberation: Facilitate a discussion where the patient can consider the pros and cons of each option, encouraging them to ask questions and express any concerns. Consider utilizing the “Teach-Back” method to appraise the patient’s level of understanding.

5. Decision: Reach a decision that reflects a consensus between the clinician and the patient, based on evidence and the patient's preferences. Obtain informed consent to proceed with the agreed upon plan.

6. Review and Re-evaluate: Plan for regular follow-ups to assess the effectiveness of the chosen management plan and adjust as necessary.

Conduct patient assessment

Red flags or Orange flags present

Red flags or Orange flags present

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Refer to appropriate emergency or healthcare provider



Acute mTBI

  • Structured patient education

  • Self Care

  • Return to work / school

  • Return to driving

  • Return to sport / activity

Persistent mTBI

  • Monitoring and Reassessment

  • Tailored clinical management of symptoms:

    • Headache
    • Neck Pain
    • Sleep Disturbance
    • Fatigue
    • Emotional / Behavioural
    • Cognitive Disorders
    • Vestibular Disorders

Differential Diagnosis






(Align with patient goals, Criteria for discharge)

Major symptom/sign change

Goals not achieved





Adjust treatment and management plan or refer

References or links to primary sources

  • Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. CDC Heads Up [Internet]. CDC February 2022. Available from:

  • David L. MacIntosh Sports Medicine Clinic, University of Toronto. Post-Concussion Return to Activity Guidelines. EMPWR Our Toolkit [Internet]. EMPWR Foundation 2019. Available from:


Contact information for further inquiries or feedback


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.

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