JKO Concussion Training for Medical Personnel

Following diagnosis of concussion, Seaman McKenzie's headaches were aggravated when she tried to increase her levels of physical and cognitive activity. After attempts to manage the headaches with medication and therapy, her medical provider referred her to a neurologist. Why did the medical provider refer the Service Member to a neurologist? Select the correct answer.

Patient treatment is targeted based on her persistent symptom of headache.
Seaman McKenzie may need an exercise and strengthening protocol.
All Service Members who have a concussion will be referred to neurology.
Seaman McKenzie does not have a concussion; she has migraines.

Which of the following are signs that a person may have sustained a concussion? Select ALL that apply.

Leg cramps
Blank or vacant look
Inability to respond appropriately to questions
Drinking excessive amounts of water
Slow labored movements
Lying motionless on the ground
difficulty raising arm above head

not B C E
not b c e

Four Airmen are involved in a football collision during downtime. They all received a blow to the head. Airman A and Airman B appear uninjured. However, Airman C hits the ground hard, quickly becoming dazed and confused. Airman D experiences some dizziness. Which of the Airmen should receive a medical examination? Select the correct answer.

All of the Airmen because they were all involved in a potentially concussive event

None of the Airmen because they were not participating in a training event or mission

Airmen C and D because they were both injured

Airman D because he feels dizzy

While deployed and working out in her free time, Captain Jackson hit her head. She was disoriented right after the event and felt a little nauseous. What could have happened had Captain Jackson sustained a concussion but did not get checked out? Select ALL that apply.

She could be commended for her dedication to mission.
She could affect the ability to accomplish the mission at hand.
She could compromise the safety of other Service Members.
She could make critical mistakes that could impact mission success.

B C D

Match each tool in Column 2 with its description in Column 1.

a) Offers guidance to medical providers on a progressive approach for Service Members who have sustained a concussion to return to duty
b) Multimodal guidance that assists providers in the assessment and diagnosis of concussion

MACE 2 or A PRA

not
a mace
b pra

In order to be diagnosed with a concussion, two criteria must be met. 1) An injury event such as a direct blow or jolt to the head, exposure to a blast, or other head injury and 2) at least one of three other criteria. Which of the following is an accurate description of one of the three other criteria? Select the correct answer.

Headache lasting longer than 1 hour

Post-traumatic amnesia (for example you can't remember anything) greater than 24 hours

An alteration of consciousness (feeling dazed and confused) for less than 24 hours

A loss of consciousness (blacking out) for more than 30 minutes

not d

Which of the following statements is the most accurate? Select the correct answer.

All Service Members who sustain a concussion will experience one or more symptoms.
Some Service Members with a concussion will experience no symptoms.
If a Service Member reports a headache, it is most likely that they recently sustained a head injury.
There are some symptoms that are only associated with concussion.

not d

Captain Rosario has just completed a follow-up visit for a Service Member experiencing headache and tinnitus following an accident in which the Service Member sustained a concussion. Which of the following statements about documenting this patient encounter is correct? Select the correct answer.

It is important for Captain Rosario to document this patient encounter to ensure that the Service Member knows when his follow-up visit is scheduled.
Captain Rosario does not need to document the patient encounter, but he should provide an update to the Service Member's leader.
Since this is a follow-up visit, Captain Rosario does not need to document the patient encounter.
It is important for Captain Rosario to document this patient encounter because information can be used by other healthcare providers during the Service Member's follow-up visits.

In which of the following ways can a concussion impact a Service Member's performance? Select ALL that apply.

The Service Member may feel more hungry than usual.
The Service Member may trip and fall more often.
The Service Member may make mistakes they wouldn't usually make.
The Service Member may feel irritable.

b c d

Captain Hernandez has been progressing through the six stages of a progressive return to activity (PRA). Today he has been told he can return to unrestricted activity. Which stage of the PRA has Captain Hernandez reached?

Stage 2
Stage 4
Stage 6
Stage 5

not b

Lieutenant Colonel Karlsson asked her patient about his medical history and his family's medical history during the MACE 2 assessment. Why is the patient's medical history of interest to Lieutenant Colonel Karlsson? Select ALL that apply.

Recovery time from concussion could be longer if there is a family history of concussion.
Personal and family history may be risk factors for delayed recovery following concussion.
Personal and family history may contribute to which symptom cluster is most prominent after a concussion.
Family medical history is not relevant to the presentation of symptom clusters related to concussion.

not a b

As a medical provider you have a responsibility to identify and treat concussions as soon after the potentially concussive event as possible. Which of the following best explains why this is important? Select the correct answer.

Early treatment can shorten the time it takes for a Service Member to return to duty.

Most Service Members take concussions less seriously if they are not diagnosed immediately after sustaining a concussion.

Concussions are not treatable if not addressed within the first 24 hours.

Symptoms of concussion will be less evident the longer you wait.

Staff Sergeant Morrison hits his head hard on the tailgate of his truck while working in his driveway. He is evaluated for concussion and is told that he did not sustain a concussion. Why did he not sustain a concussion if he received a sharp blow to the head? Select the correct answer.

Concussions usually occur on the battlefield and not in a driveway.
The Service Member was not involved in a blast event.
Not all blows to the head result in a concussion.
The Service Member did not black out.

While evaluating a Service Member for concussion, the medical provider learns that the Service Member has a headache and that she also has a history of migraines. Why is the Service Member's medical history of migraines relevant to her headache today? Select ALL that apply.

This information may help guide prioritization of treatments and further assessments.
The headache is probably not the result of the concussion.
Her recovery time from concussion could be longer because of the history of migraines.
This patient could be at a greater risk of sustaining another concussion.

a c

Which of the following is a symptom of concussion? Select the correct answer.

Irritability
Cough
Increased appetite
Diarrhea

Lieutenant Walsh was diagnosed with a concussion a week ago. He has been progressing through a progressive return to activity (PRA) and increasing his activity levels each day. He has been back in his office for the last few days with a reduced shift time. Today he reported that he felt fine and has no symptoms of concussion. Which of the following will the medical provider recommend? Select the correct answer.

Start engaging in some light physical and cognitive activity as tolerated.
Start engaging in some light aerobic exercise, and more complex cognitive tasks.
Take it easy for the next twenty-four-hours. Get some rest and limit your activity to cognitively familiar activities.
You can return to pre-injury activity.

not a

Which of the following best describes the role of the MACE 2 and a progressive return to activity (PRA) in the treatment and management of concussion? Select the correct answer.

They assist with the treatment of concussion symptoms.
The MACE 2 outlines the activities that are recommended when a patient is moving through the stages in a progressive return to activity.
The MACE 2 and a PRA integrate advances in clinical management to aid with concussion diagnosis, treatment, and return to duty determinations.
They are driven by clinical management of concussion guidelines which help determine when a patient may be ready to move to subsequent stages in the progressive return to activity.

not d

Which of the following best describes the relationship between the MACE 2 and a progressive return to activity (PRA)? Select the correct answer.

The MACE 2 provides guidance to medical providers on a progressive approach to returning Service Members to duty following a concussion.
The MACE 2 and a PRA integrate advances in clinical management to aid with concussion diagnosis, treatment, and return to duty determinations.
The MACE 2 outlines the activities that are recommended when a patient is moving through the stages in a progressive return to activity.
A PRA assists providers in the assessment of concussion following initial diagnosis using the MACE 2.

Senior Airman Patrick was diagnosed with a concussion a few days ago. His symptoms were headache and nausea. He has been progressing through a progressive return to activity and increasing his activity levels each day. Today his medical provider recommended engaging in some light aerobic exercise and more complex cognitive tasks. Senior Airman Patrick went for a short run. Following the run, his headache returned. Which of the following will the medical provider recommend? Select the correct answer.

Start engaging in some light aerobic exercise, and more complex cognitive tasks.
Take it easy for the next twenty-four-hours. Get some rest and limit your activity to cognitively familiar activities.
Since only your headache returned but you are not nauseous, you can return to work on lighter duty.
Start engaging in some light physical and cognitive activity as tolerated.

Which of the following are signs that a person may have sustained a concussion? Select ALL that apply.

Heavy breathing
Stumbling
Difficultly bending
Confusion
Facial injury after head trauma
Broken arm

not b c d

Not all blows to the head result in a concussion.

Which of the following statements about concussion are correct? Select ALL that apply.

Being involved in a vehicle crash is one of the common causes of concussion.

Being near a blast does not always result in a concussion.

Which of the following are signs that a person may have sustained a concussion? Select ALL that apply.

Slow to get up after a direct or indirect blow to the head

Blank or vacant look

Lying motionless on the ground

Disorientation

Which of the following best describes the role of the MACE 2 and a PRA in the treatment and management of concussion? Select the correct answer.

It is important for Captain Rosario to document this patient encounter because information can be used by other healthcare providers during the Service Member's follow-up visits.

Which of the following are associated with sustaining multiple concussions? Select ALL that apply

You may experience more severe symptoms with multiple concussions.

You will be at greater risk of sustaining another concussion after the first concussion.

Recovery may take longer for a second or third concussion.

After being involved in an accident during a training event, Corporal Morales hit her head and was dazed and confused for a couple of seconds. Corporal Morales brushed off her injury and was reluctant to go to the medical center to get checked out. If Corporal Morales did not get checked out and had sustained a concussion, which of the following could happen? Select ALL that apply

Corporal Morales would be putting her unit and the mission in danger.

Corporal Morales would be at risk for worsening or lingering concussion symptoms

During a follow-up appointment for concussion, Sergeant Harris reports that he has a constant headache and feels nauseous. The medical provider asks Sergeant Harris how he has been sleeping. Why is the Service Member's sleep of interest to the Medical Provider? Select the correct answer.

Sleep disturbances can exacerbate or modify symptom presentation.

Chief Petty Officer Jackson was diagnosed with a concussion 24 hours ago. Today she has returned for a follow-up examination with her medical provider. Chief Petty Officer Jackson's symptoms were dizziness and nausea. Today the Service Member reports that her symptoms have resolved. Which of the following will the medical provider recommend to return Chief Petty Officer Jackson to pre-concussion activity?

Start engaging in some light physical and cognitive activity as tolerated.

Which of the following are symptoms of concussion? Select ALL that apply.

Memory difficulty

Visual disturbances

Balance difficulty