#### II. Indications

1. Sideline Concussion evaluation in age over 10 years

#### III. Criteria: Orientation (total possible of 5 points)

1. What month is it?
2. What is the date today?
3. What is the day of the week?
4. What year is it?
5. What time is it right now (within one hour)?

#### IV. Criteria: Memory (total possible of 20 points)

1. Primary word list (5)
1. Elbow, Apple, Carpet, Saddle, Bubble
2. Alternative words
1. Candle, paper, sugar, sandwich, wagon
2. Baby, monkey, perfume, sunset, iron
3. Finger, penny, blanket, lemon, Insect
2. Trial 1 (Immediate): Ask patient to remember each of 5 words
1. Instructions
1. I am goimg to test your memory
2. I will read you a list of words, and when I am done, repeat back as many words as you can remember
2. Assign 1 point for each of the 5 words repeated correctly
3. Trial 2 (Immediate): Repeat the same word list
1. Caution to repeat the words even if they've said then on a prior trial
2. Assign 1 point for each of the 5 words repeated correctly
4. Trial 3 (Immediate): Repeat the same word list
1. Assign 1 point for each of the 5 words repeated correctly
5. Delayed Recall (performed 5 minutes later)
1. Assign 1 point for each of the 5 words repeated correctly

#### V. Criteria: Concentration (maximum of 6 points)

1. Instructions - Digits Backwards
1. I am going to read you a string of numbers
2. When I am do, you repeat these numbers backwards (in reverse order)
3. Example
1. If I say 7-1-9
2. You say 9-1-7
2. Digit Recall (one point for each string of numbers correct, total of 5 points possible)
1. Read at one digit per second
2. If first try fails, give one more try with another sequence
3. 4-9-3
1. Alternatives: 6-2-9 or 5-2-6 or 4-1-5
4. 3-8-1-4
1. Alternatives: 3-2-7-9 or 1-7-9-5 or 4-9-6-8
5. 6-2-9-7-1
1. Alternatives: 1-5-2-8-6 or 3-8-5-2-7 or 6-1-8-4-3
6. 7-1-8-4-6-2
1. Alternatives: 5-3-9-1-4-8 or 8-3-1-9-6-4 or 7-2-4-8-5-6
3. Months in reverse order (1 point for the entire sequence)
1. Now tell me the months in the reverse order
3. You'll say December, November...
4. Correct Sequence:
1. December, November, October
2. September, August, July
3. June, May, April
4. March, February, January

#### VII. References

1. McCrea (2001) Clinical Journal of Sports Medicine 11: 176-181