Concussion: University of Pittsburgh sideline mental status examination card

Orientation questions
        What stadium is this?
         What city is this?
         Who is opposing team ?
          What month is it?
           What day is it?

Post-traumatic amnesia
            Remember three words:  girl , dog and green (ask player to repeat them)

Retrograde amnesia
           Ask "What happened in prior half"
           "What happened before you were hit"
          "What was the score before the hit"
          "Do you remember the hit"

Concentration
          ask the player to say the days of the week backwards, starting from today
          ask the player to say the following numbers backwards:  63, 419

Memory
          ask the player to recall the three words given earlier


Vienna conference return to play recommendations1.   Remove from game if any signs of concussion- any items missed on sideline exam
2.   No return to play in current game
3.   Medical evaluation after injury   a. rule out serious focal injury     b. neuropsychologic evaluation
4.   Stepwise return to play    a.  rest till asymptomatic      b.   light aerobic      c.  sport specific training     d.  noncontact practice      e. full contact practice     f. return to play