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Head Evaluation Process

Head Evaluation Process. Sports Med 2. History. Any loss of consciousness? Note length of time unconscious for Determine level of consciousness (LOC) Alert- awake and responds immediately and appropriately Confused-impaired memory Lethargic- drowsy yet easily aroused

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Head Evaluation Process

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  1. Head Evaluation Process Sports Med 2

  2. History • Any loss of consciousness? • Note length of time unconscious for • Determine level of consciousness (LOC) • Alert- awake and responds immediately and appropriately • Confused-impaired memory • Lethargic- drowsy yet easily aroused • Stuporous-asleep most of the time • Semicomatose-no response to verbal stimuli • Comatose-no response • Headache • Location, type

  3. History • Memory • Anterograde amnesia- length of time from injury until conscious memory returns. Remember on field eval? 1st thing after injury? • Retrograde amnesia- loss of memory of events that occurred before the injury. • Immediate recall- recall 3 to 4 words, ask to repeat words. • Recent memory- repeat 3 words after 5 minutes

  4. History • Questions • Do you know where you are? • What happened to you? • Can you remember the score, or who we played last week? (retrograde amnesia) • Can you remember walking off the field? (antegrade amnesia) • Does your head hurt? • Do you have pain in your neck? • Can you move your hands and feet? • Can you remember if you have ever been knocked out before?

  5. History • Tinnitus • Ringing in ears • Dizziness • Nausea • Vomiting can be a life threatening sign • Vision • See the score board? Blurry vision?

  6. Observation • Obvious deformity • Disoriented? Can they answer history questions? • Blank or vacant stare? Difficulty keeping eyes open? • Slurred or incoherent speech • Delayed verbal and motor responses • Gross disturbance in coordination • Inability to focus, easily distracted • Memory deficit, asking the same question over and over • Length of time athletes affects abnormal • Swelling or bleeding from the scalp • Clear or straw colored fluid in ear canal • Pupils • Are they equal, round and reactive to light (PEARL) • Discoloration

  7. Palpation/Physical Exam Skull deformity Open wounds Palpate both the neck and skull

  8. Special tests • Neurological exam • Cerebral testing • Cognitive function • Cranial nerve testing • Rule out isolated injury • Cerebellar testing • Coordination and motor function • Sensory testing • dermatomes • Reflex testing • Balance Tests • Romberg- stand with eyes closed, single leg and tandem stance, • Balance error scoring system (BESS)

  9. Special Tests • Coordination Tests • Finger to nose • Heel-to-toe walking • Heel to knee test • Cognitive Tests • Count backwards from 100 by 7 • Spelling a word backwards • Naming the months in reverse order • 3 word recall • Neuropsychological assessments

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