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CRM: Diagnosis
Concussion Recognition & Management
Module 4 Assessment

Diagnosis

doctor shows mother and son file in office
For collegiate athletes, the National Collegiate Athletic Association (NCAA) prefers initial diagnosis as soon after the event as possible, with clinical assessment within 48 to 72 hours. The challenging reality is that in many cases, the young person will show up more than 72 hours after the event, not feeling well but not aware of having suffered a concussion.
Right now, there are well-researched assessment tools that are science-based. Other tools are a result of consensus of best practice. It falls to the licensed health care professional to look at the reliability and validity of potential assessment tools, and from that determine which to use and when to use them.
It’s essential for the licensed health care professional to pull together the data from multiple sources to properly assess the patient, because there is no one perfect assessment tool: there is no "pregnancy test" for concussion that provides a yes-or-no answer.
SCAT, ACE, and Graded Symptom Checklist
Diagnosis is the first stage of assessment. The patient has to meet the criteria for the definition of a concussion in order for a licensed health care professional to make a clinical decision based on the presentation of symptoms after a known or presumed mechanism of injury. (See Module 2 of this course to review the criteria for concussion.)



DIAGNOSTIC ASSESSMENT QUESTIONS





injured brain & Injury Account
Get a detailed description of what exactly happened at the point of injury.
injured brain with symptoms & Symptom Course
Review the physical, emotional, cognitive, & sleep symptoms from Module 3, and note their severity.
  • What events led to the injury?
  • What is the mechanism of the injury?
  • Was there loss of consciousness?
  • Did you experience any amnesia?
  • What are the exact symptoms you experienced at the time of the injury?
  • How have you been feeling?
  • Do you feel like yourself?
  • How is your mood?
  • What have you been doing since your injury?
  • Which of the symptoms you had at the time of the injury are you still experiencing?
  • Are any of the symptoms resolving?
  • Are any getting worse?
  • What symptoms appeared after the injury?
  • Are any of those symptoms getting worse?
  • Are you having headaches?
  • Are you able to fall asleep easily and stay asleep all night?
If a parent or guardian is present, ask the adult the same questions.

Remember: diagnostic assessment is a beginning. At this stage, it is helpful to carry out a brief neurologic assessment including vision tracking, coordination, neck pain, and balance, as well as a brief cognitive status assessment. The SCAT3™ is a useful tool for this type of diagnostic assessment. Other diagnostic tools include:
Module 4 Assessment

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