Get the free concussion symptom score sheet pdf

Concussion Symptom Score Sheet Name Date of injury Circle the number that indicates how much the symptom bothers the patient Symptom Rating Scale Symptom None Mild Mod Severe Headache Nausea Vomiting Balance problems Dizzy Fatigue or tired Trouble falling asleep Sleeping more than usual Sleeping less than usual Drowsy feeling sleepy Eyes sensitive to light Visual problems Bothered by noise Irritable Sad Nervous Feeling more emotional Numbness or tingling Feeling slowed down Feeling mentally...

How to fill out concussion symptom score sheet

How to fill out concussion symptom score sheet:

1. Start by entering the necessary personal information, such as name, date of birth, and contact information.
2. Next, indicate the date of the concussion incident or injury.
3. Read through the list of symptoms on the score sheet and mark the severity of each symptom experienced. Use a scale provided on the form, such as 0-6 or 1-10, to rate the severity.
4. Include any additional notes or comments in the designated section, if necessary.
5. Finally, sign and date the score sheet to confirm the accuracy of the information provided.

Who needs concussion symptom score sheet:

1. Athletes who have experienced a concussion during sporting activities and need to track their symptoms.
2. Medical professionals who are evaluating and monitoring patients with concussion or traumatic brain injury.
3. Parents or caregivers of individuals who have suffered a concussion and are responsible for monitoring their symptoms.

Video instructions and help with filling out and completing concussion symptom score sheet pdf

Instructions and Help about concussion symptom score sheet

— Concussions a type of brain injury frequently that doesn't show up on any CAT scan or MRI It's often experienced after or during a sports injury or fall where you hit your head The frequent symptoms WEEE would be dizziness a persistent severe headache fatigue trouble with your balance and sensitivity to light Occasionally these symptoms can be more severe and be the sign of something even more significant inside the brain such as bleeding in or around the brain or a skull fracture Those symptoms would be loss of consciousness even if its very short confusion amnesia to the events or around the event throwing up seizures elderly folks or as well as those on blood thinners frequently will have these injuries even with minor head injuries

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What is concussion symptom score sheet?

A concussion symptom score sheet is a tool used to assess and record the symptoms experienced by an individual after a concussion. It typically includes a list of common symptoms and a rating scale to indicate their severity.

Who is required to file concussion symptom score sheet?

Athletes, coaches, and medical personnel are often required to file a concussion symptom score sheet after a suspected concussion. This may also include parents or guardians when it involves minors.

How to fill out concussion symptom score sheet?

To fill out a concussion symptom score sheet, individuals should review the list of symptoms, rate each symptom based on severity (usually on a scale of 0 to 6), and provide any additional comments or information related to the injury.

What is the purpose of concussion symptom score sheet?

The purpose of the concussion symptom score sheet is to help healthcare providers and coaches monitor the symptoms and recovery progress of an individual who has experienced a concussion. It assists in making informed decisions about return-to-play protocols.

What information must be reported on concussion symptom score sheet?

The concussion symptom score sheet must report the date of the assessment, the individual's name, the specific symptoms experienced, their severity ratings, and any additional comments or relevant medical history.