MACE Return-to-Duty & Recovery Protocols 2

Question 1

What factors indicate a service member may need referral to a TBI specialist?

Accepted Answer

Symptoms persisting beyond 7-14 days, worsening symptoms, history of multiple concussions, abnormal neurological findings, or significant functional impairment

Answer

All concussions require specialist referral

Answer

No concussions require specialist referral

Answer

Only loss of consciousness requires referral

Question 2

What cognitive rehabilitation strategies are used for concussion recovery?

Accepted Answer

Graduated cognitive loading, compensatory strategy training, attention and memory exercises, and psychoeducation about expected recovery

Answer

No cognitive rehabilitation exists for concussion

Answer

Only medication is used

Answer

Cognitive rehabilitation is only for severe TBI

Question 3

How should a medic or corpsman manage a concussed service member in a combat environment?

Accepted Answer

Conduct MACE assessment, ensure safety from further injury, monitor for red flag symptoms, evacuate if indicated, and document all findings

Answer

Ignore the concussion and continue the mission

Answer

Administer pain medication and return to duty

Answer

Only evacuate for loss of consciousness

Question 4

What is the significance of previous concussion history in managing new concussions?

Accepted Answer

Prior concussions increase vulnerability to subsequent injury, prolong recovery times, and lower the threshold for symptom development

Answer

Previous concussions have no effect on new injuries

Answer

Multiple concussions actually make the brain more resilient

Answer

History is only relevant for athletes, not military

Question 5

What documentation is required throughout the concussion recovery process?

Accepted Answer

Initial MACE scores, serial symptom checklists, follow-up MACE scores, activity progression notes, and final return-to-duty clearance documentation

Answer

Only the initial assessment needs documentation

Answer

Documentation is optional during recovery

Answer

Only the final clearance needs to be documented

Question 6

What role does sleep play in concussion recovery protocols?

Accepted Answer

Adequate, quality sleep is essential for brain healing and is actively managed through sleep hygiene education and environmental modifications

Answer

Sleep should be limited after concussion

Answer

Sleep has no impact on recovery

Answer

Service members should sleep as little as possible to stay alert