ACUTE CONCUSSION ASSESSMENT
| Step |
Rehabilitation stage |
Objective of Stage |
| 1A |
Acute Management |
· Notify coach & medical staff if not present.
· If a Doctor has performed the assessment, please send any reports or imaging. |
| |
|
· |
| 1B |
Acute Assessment |
- 1. If unconscious – assume neck fracture or brain damage and immobilise neck in rigid collar and carry out routine ABC’s.
- If unconscious, direct doctor or hospital consult is needed. Further management will be by hospital or doctor.
- 2. If conscious – determine level of alertness (ie “Glascow Coma Scale”-see below), orientation (place, time, person), extent of amnesia( antrograde vs. retrograde), memory recall(repeat 3 objects 2 mins after assessment) and neurological symptoms with ‘concussion symptom scale’.
|
- When athlete is send to hospital, initial protocol from the hospital should be followed.
Update staff as soon as possible in that case.
- Athlete could be advised to stay in the hospital for some days.
- Further management can start when athlete is out of hospital and clearens from the hospital or doctor is given.
- Diagnosis is either Simple or Complex concussion, and further management is the same by both, but duration is different.
SUBACUTE CONCUSSION GUIDELINE
| Step |
Rehabilitation stage |
Objective of Stage |
| 2A |
Subacute Management |
· Rest: avoid watching TV, using your computer, driving and reading.
· Nutrition: optimal liquid, vitamins and protein intake.
· If there is any deterioration in symptoms, seek medical assessment immediately. |
| |
|
|
| 2B |
Subacute Assessment |
· While symptomatic – fill in the ‘SCAT3 Symptom Evaluation’ scale twice/day and test balance with the ‘BESS’ score. Start this as soon as possible/practical following the concussion. (NB. Can also use SCAT2 app for iPhone, which has the ability to email the results directly and covers both SCAT2 and BESS).
- Patients that are recovering need scores of 0-1 on the “post concussion symptom scale” before progressing rehabilitation.
|
Post Concussion Symptom Scale
The
Post Concussion Symptom Scale is a questionnaire subtracted from the SCAT5. The scale has been shown to have high sensitivity, reliability and validity with monitoring concussion.
| Symptom |
None |
Mild |
Moderate |
Severe |
| Headache |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Nausea |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Vomitting |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Balance Problems/ Dizziness |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Fatigue |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Trouble Falling Asleep |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Sleeping More Than Usual |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Drowsiness |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Sensitivity to Light/ Noise |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Sadness |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Nervousness |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Numbness/Tingling |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Feeling Slowed Down |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Feeling Like “in a fog” |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Difficulty Concentrating |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Difficulty Remembering |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| More Emotional than Usual |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Irritability |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
| Other |
0 |
1 |
2 |
3 |
4 |
5 |
6 |
- SCAT 5: http://www.sportphysio.ca/wp-content/uploads/SCAT-5.pdf
