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

Referral criteria include: symptoms not resolving within expected timeframes, worsening trajectory, multiple prior concussions, abnormal imaging or neurological exam, pre-existing mental health conditions complicating recovery, or significant duty impairment.

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

Cognitive rehabilitation may include progressive cognitive loading (reading, problem-solving), compensatory strategies (note-taking, checklists), targeted attention/memory training, and education about normal recovery expectations.

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

Combat concussion management requires balancing tactical needs with medical care: conducting rapid assessment, ensuring the service member is in a safe location, monitoring for deterioration, making evacuation decisions, and documenting everything.

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

Research shows that service members with concussion history are more susceptible to subsequent concussions, experience longer recovery periods, and may develop persistent symptoms at lower injury thresholds, requiring more conservative management.

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

Comprehensive documentation tracks the entire recovery: initial assessment, serial symptom monitoring, repeat cognitive testing, progressive activity tolerance, and final clearance. This record supports medical decisions and disability claims if needed.

MACE - Military Acute Concussion Evaluation Practice Test

MACE - Military Acute Concussion Evaluation Practice Test

MACE Return-to-Duty & Recovery Protocols 2