Concussion Symptom Score Sheet Pdf

Concussion Symptom Score Sheet Pdf Concussion Symptom Score Sheet Created Date 5 19 2015 1 55 03 PM

Please rate your symptoms as you have felt over the past 2 3 days according to the scale below 0 6 by circling the ONE number that represents your status best Do the symptoms get worse with physical activity Do the symptoms get worse with mental activity Stanford Children s Health Christine R Boyd MD Pediatric Sports Medicine

Concussion Symptom Score Sheet Pdf

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Individual item scores reflect the presence and severity of post concussive symptoms Post concussive symptoms as measured by the RPQ may arise for different reasons subsequent to although not necessarily directly because of a traumatic brain injury Post Concussion Symptom Scale Mild Moderate Severe Please use the following scale to rate each symptom

Each stage should be performed symptom free before progression to the next stage This athlete has successfully completed the RTP protocol as outlined above Symptoms Get Worse Decreasing Consciousness Increasing Sleepiness Seizure Vomiting Trouble Recognizing People or Places Neck Pain Weakness in Arms or Legs Slurred Speech Concussion history Assess the number and date s of prior concussions the duration of symptoms for each injury and whether less biomechanical force resulted in re injury Research indicates that cognitive and symptom effects of concussion may be cumulative

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A concussion is an injury to the brain as a result of a force or jolt applied directly or indirectly to the head which produces a range of possible symptoms and may or may not involve a loss of consciousness Assess the number and date s of prior concussions the duration of symptoms for each injury and whether less biomechanical force resulted in re injury Research indicates that cognitive and symptom effects of concussion may be cumulative especially if there is minimal duration

To better track the concussion recovery please complete this log daily using the following scale Please use only one number for each symptom It is important that you document the information and bring this form with you to your next scheduled appointment Use of the Post Concussion Symptom Scale The athlete should fill out the form on his or her own in give a subjective value for each symptom This form can be used with each encounter to track the athlete s progress towards the resolution of symptoms Many athletes may have some of

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How To Test For A Concussion
Concussion Symptom Score Sheet University Hospitals

https://www.uhhospitals.org/-/media/Files/Services/Sports …
Concussion Symptom Score Sheet Created Date 5 19 2015 1 55 03 PM

Comparison Of Symptom Charts Used For Concussion Assessments Download
Microsoft Word Post Concussion Symptom Scale docx

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Please rate your symptoms as you have felt over the past 2 3 days according to the scale below 0 6 by circling the ONE number that represents your status best


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Concussion Symptom Score Sheet Pdf - Concussion history Assess the number and date s of prior concussions the duration of symptoms for each injury and whether less biomechanical force resulted in re injury Research indicates that cognitive and symptom effects of concussion may be cumulative