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  • Ca Child And Adolescent Neurology Consultants Acute Concussion Evaluation (ace) Form

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An initial score of less than 5 is associated with an 80 percent chance of a lasting vegetative state or death. An initial score of greater than 11 is associated with a 90 percent chance of complete recovery (Teasdale and Jennett, 1974).

The evaluation includes a clinical exam, self-reported symptom checklist, postural assessment, and neurocognitive testing [8-10].

Healthcare providers use the acute concussion evaluation (ACE) tool. It includes questions about the presence of concussion characteristics, a checklist of 22 concussion symptoms and risk factors that might lengthen recovery. The form collects specific information, including: Concussion cause.

Sport Concussion Assessment Tool (SCAT5) Red flags. Memory assessment – Maddocks Questions. Glasgow Coma Scale (GCS) examination. Cervical spine assessment. Symptom evaluation. Cognitive screening. Neurological screening. Balance examination.

B. Symptom Check List* Since the injury, has the person experienced any of these symptoms any more than usual today or in the past day? Indicate presence of each symptom (0=No, 1=Yes).

Grade 1 Concussion – Mild Concussion. Grade 2 Concussion – Moderate Concussion. Grade 3 Concussion – Severe Concussion.

The ACE is intended to provide an evidence-based clinical protocol to conduct an initial evaluation and diagnosis of patients (both children and adults) with known or suspected MTBI.

The ACE — the easy name for the Acute Concussion Evaluation — is an innovative assessment tool that can be used for the initial evaluation and diagnosis of people who have a known or suspected concussion or mild TBI.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232