Do I Have a Concussion Quiz

Questions: 15 · 10 minutes
1. How would you describe any neck symptoms since the event?
I have no new neck discomfort or movement problem.
I have persistent neck pain or noticeably restricted movement.
I have severe neck pain, new limb symptoms with neck pain, or cannot safely move my neck.
My neck feels mildly sore or stiff.
2. Which description best matches the recent event that prompted this quiz?
I have not had a recent hit, fall, collision, or forceful jolt.
A forceful hit or jolt occurred and I immediately felt altered, dazed, or unsteady.
I had a light bump or jolt without an immediate noticeable change.
It involved a high-speed crash, a fall from significant height, or another high-force impact.
3. What physical sign is present around the head, eyes, ears, or nose?
There is a tender spot or small bump without an open wound.
There is clear fluid or unexplained blood from an ear or nose, bruising behind the ears or around both eyes, or a visible skull dent.
I see no new swelling, wound, fluid, or unusual bruising.
There is a large swelling or a cut that may need professional treatment.
4. How are thinking and concentration going during ordinary tasks?
I cannot follow simple conversation, do not recognize familiar people or places, or am markedly confused.
My thinking and concentration feel normal for me.
I feel somewhat slowed, foggy, or more distractible than usual.
I struggle to remember instructions, follow conversation, or complete familiar tasks.
5. Which statement best describes strength, sensation, and coordination in your limbs?
I have clear weakness or numbness on one side, cannot coordinate a limb, or cannot stand safely.
My strength, sensation, and coordination feel normal.
I feel mildly clumsy or have brief tingling that is new.
I have persistent tingling, notable clumsiness, or reduced strength that affects a task.
6. How has alertness changed since the possible injury?
I am a little more tired than usual but wake and respond normally.
My alertness is normal for the time of day.
I cannot be awakened normally, had a seizure, or repeatedly lose consciousness.
I am unusually drowsy, difficult to keep awake, or responding much more slowly.
7. How clearly do you remember the period just before and after the event?
I felt briefly dazed, but the sequence of events is mostly clear.
I remember the period clearly and noticed no confusion.
I remain confused, cannot account for a substantial period, or cannot reliably describe what happened.
There is a definite short gap or parts of the event are missing.
8. What best describes any loss of consciousness after the impact or jolt?
A brief loss of consciousness was witnessed or strongly suspected, and I am now fully awake.
I definitely remained conscious throughout.
I am unsure whether I briefly lost consciousness.
I was unconscious for more than a brief moment, lost consciousness repeatedly, or am not fully alert now.
9. How have nausea and vomiting affected you?
I have vomited repeatedly or cannot keep fluids down.
I have mild, occasional nausea without vomiting.
I have had no new nausea or vomiting.
I have strong or persistent nausea, or I vomited once.
10. What change, if any, has someone noticed in your speech or behavior?
My speech and behavior seem usual for me.
I am mildly irritable, emotional, or quieter than usual.
My responses are noticeably slowed, disorganized, or out of character.
My speech is slurred, confusion is increasing, or I am behaving in a profoundly unusual way.
11. Since the event, what has your headache been like?
I have not developed a new or unusual headache.
I have a mild headache that comes and goes.
I have a persistent or moderately strong headache that limits activity.
The headache is severe, rapidly worsening, or unlike any headache I normally experience.
12. What visual or sensory change have you noticed?
Light or ordinary noise bothers me more than usual.
I have double vision, sudden major visual loss, or a clearly unequal pupil size.
My vision and sensitivity to light or sound feel normal.
I have persistent blurred vision or substantial sensitivity that limits activity.
13. How have symptoms changed during the hours since the event?
No relevant symptoms have developed.
Symptoms are rapidly worsening, or a new emergency warning sign has appeared.
Mild symptoms developed but have been steadily easing.
Symptoms persist, fluctuate, or new non-emergency symptoms are appearing.
14. When you stand or walk, what do you notice?
I feel dizzy or unsteady enough that I need to move cautiously.
My balance and sense of motion feel normal.
I have brief lightheadedness or mild motion sensitivity.
I cannot walk safely without support, keep falling, or have intense spinning sensations.
15. What happened when you tried to continue your activity immediately afterward?
I collapsed, could not get back up, or could not safely support myself.
I continued but felt briefly stunned or unlike myself.
I continued normally without any immediate change.
I had to stop because of dizziness, confusion, pain, or poor coordination.
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