Do You Have a Concussion?

Directions: For accuracy, this test should be proctored by someone other than the individual with a head injury and possible concussion. If the individual has taken the baseline test, information such as their full name, birthdate, and whether or not they have previously had a concussion should be available. Only administer this test to someone who is conscious and responsive. If the individual is not conscious or responsive get them medical care immediately!!!

Begin

Post-Injury Concussion Test

Do You Have a Concussion?

Ask the following question: What is your name?

Can the injured individual answer this question correctly?

Yes No

Post-Injury Concussion Test

Do You Have a Concussion?

Ask the following question: When is your birth date?

Can the injured individual answer this question correctly?

Yes No

Post-Injury Concussion Test

Do You Have a Concussion?

Ask the following question: What year is it?

Did the individual answer this question correctly?

Yes No

Post-Injury Concussion Test

Do You Have a Concussion?

Ask the following question: Who is the President?

Did the individual answer this question correctly?

Yes No

Post-Injury Concussion Test

Do You Have a Concussion?

Ask the following question: Do you have a headache right now?

What was their answer?

Yes No

Post-Injury Concussion Test

Do You Have a Concussion?

Ask the following question: Are you experiencing any blurry vision, spotting in your vision, double vision, and/or loss of vision?

If the individual is experiencing any one or combination of these eye problems click yes, if not, than click no.

Yes No

Post-Injury Concussion Test

Do You Have a Concussion?

Ask the following question: Do you feel dizzy or lightheaded?

What was their answer?

Yes No

Post-Injury Concussion Test

Do You Have a Concussion?

Ask the following question: Can you get up and walk normally? Have the person walk about 5-10 steps (if they can) and check for any unsteadiness. If they cannot get up do not press them to do it and simply click the Cannot walk steadily or cannot get up button.

Cannot walk steadily or cannot get up. Is walking steadily.

Post-Injury Concussion Test

Do You Have a Concussion?

Ask the following question: Are you nauseous?

What was their answer?

Yes No

Post-Injury Concussion Test

Do You Have a Concussion?

Ask the following question: Do you remember how you hit your head?

What was their answer?

Yes No

Post-Injury Concussion Test

Do You a Concussion?

Click the Results button to find out the probability that the injured individual is afflicted with a concussion. This will be given as a percentage and interpret the results as such:

If the afflicted has a score at or above a 40% probability of a concussion, they need to seek out proffessional help from a licensed physician immediately.

If the afflicted has a score at or between 15-39% probability of a concussion, than the individual needs to consult a licensed physician within the next 72 hours.

If the afflicted has a score anywhere under 15% of a probability of a concussion, rest and abstaining from any strenous physical activity for the next few days is necessary. Also, to be on the lookout for any out of the normal symptoms over the next few days to determine their need to consult a physician.

Results

Post-Injury Concussion Test