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ACNC Concussion Symptom Score Sheet free printable template

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How to fill out ACNC Concussion Symptom Score Sheet

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How to fill out ACNC Concussion Symptom Score Sheet

01
Obtain a copy of the ACNC Concussion Symptom Score Sheet.
02
Start by entering the date and the name of the individual being assessed.
03
Familiarize yourself with the list of symptoms provided on the sheet.
04
Ask the individual to rate each symptom based on their current experience, using a scale from 0 (not present) to 6 (severe).
05
Mark the highest score for each symptom on the sheet.
06
Calculate the total score by adding up the individual symptom scores.
07
Document any additional observations or comments regarding the individual's condition.
08
Review the completed score sheet for accuracy.

Who needs ACNC Concussion Symptom Score Sheet?

01
The ACNC Concussion Symptom Score Sheet is needed by athletes who have sustained a concussion, coaches, athletic trainers, healthcare professionals, and parents monitoring a child's recovery.
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Grade 1 adds a dazed feeling lasting less than a minute. In Grade 2 concussion the cloudy senses last longer, and the patient may have dizziness, amnesia, confusion, ringing in the ears, and/or irritability. Loss of consciousness characterizes Grade 3 (for less than a minute), and Grade 4 (for longer than a minute.)
If your child has had a concussion before, the recovery may be slower this time. Your child may have good days when symptoms are mild and bad days when they may be a little worse. This is a normal part of recovery. Your child's doctor will help decide what is safe for them.
Symptoms generally improve over time, and most people with a mild TBI or concussion feel better within a couple of weeks. Symptoms of mild TBI and concussion are different for each person. Symptoms may change during recovery. For example, you may have headaches and feel sick to your stomach earlier on.
Can Symptoms of a Concussion Come and Go? Yes, symptoms of a concussion can come and go. Some patients feel great after their initial recovery. Then a few days or weeks later, those symptoms return with ferocity.
The measure consists of 22 questions that relate to post-concussive symptoms. Survey-takers are asked to rate each symptom ing to a 7-point likert scale ranging from 0-6. Higher scores indicate a higher severity of post-concussive symptoms. The greatest possible score is 132 and the lowest possible score is 0.
Concussion Symptoms Reported. Headache or “pressure” in head. Nausea or vomiting. Balance problems or dizziness, or double or blurry vision. Bothered by light or noise.

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The ACNC Concussion Symptom Score Sheet is a standardized tool used to assess and document the symptoms experienced by an individual following a concussion.
Athletes, coaches, and medical personnel involved in sports activities are required to file the ACNC Concussion Symptom Score Sheet to track concussion symptoms and ensure appropriate management.
To fill out the ACNC Concussion Symptom Score Sheet, individuals should document the symptoms experienced by the athlete, rate their severity, and include any relevant medical history or interventions.
The purpose of the ACNC Concussion Symptom Score Sheet is to provide a systematic approach for monitoring concussion symptoms, facilitating communication among healthcare providers, and guiding the return-to-play protocols.
The ACNC Concussion Symptom Score Sheet must report information such as the list of symptoms, their severity ratings, any prior concussions, and any treatments or interventions administered.
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