腦震盪評估完整流程：SCAT-6 工具教學（上）
更新： 2026/7/28｜作者： IOC 國際奧會運動物理治療師 Pazo
重點整理
- 醫療人員專屬：SCAT6 是給醫療人員用的腦震盪評估工具，必須在受傷後三天內完成評估；超過三天或對象是孩童要改用 SCOAT6 或 Child SCOAT6。
- 非醫療人員：請改用腦震盪辨識工具 CRT6，不要直接套用 SCAT6。
- 立即退場：場上出現頸部以上撞傷或嚴重碰撞就要啟動緊急醫療措施，該名個案當天不得再回到場上。
- 十項紅旗現象：任一出現就立即後送（如：頸部疼痛壓痛、抽搐、複視、意識異常、肢體無力、嘔吐、嚴重頭痛、躁動、GCS 小於15、肉眼可見頭骨受傷）。
- 症狀可能延遲：腦傷症狀可能延遲出現，要每隔一段時間重新評估，並採取寧可誤送的低標準——只要稍有懷疑就送醫。
醫療免責聲明：任何疾病或傷害的症狀都因人而異，瞭解症狀的同時，也要知道如何尋求正確的醫療管道。若您的症狀短期內惡化或是長期困擾您，建議直接尋求專業的醫師或是物理治療師進行評估及治療，恢復的速度才會更快哦。
前言
SCAT 工具是由醫療人員共同設計，固定一段時間會更新並發布在 BMJ 上的腦震盪評估工具，作為醫療從業人員，如果會遇到運動時產生的腦震盪狀況，就需要使用 SCAT 進行評估，並根據建議制定後續回場計畫，今天就由 Pazo 帶你一起看看這份評估工具的內容吧！
使用前須知
- 如果遇到運動時出現可能導致腦震盪的傷害，必須在三天內進行評估。
- 如果超過三天未評估或對象是孩童，則需改成使用 SCOAT6 或是 Child SCOAT6。
- 若非醫療人員使用，則建議使用腦震盪辨識工具 CRT6。
- 為了要在遇到事件的第一時間判斷個案的能力變化，在剛開始與個案接觸時，就可以先進行基本評估，以在事件發生當下馬上可以觀察出分數變化。
- SCAT6 由 BMJ 發行，本文僅作基本介紹，詳細使用請參考原始檔案。
第一處置
如果在賽場上看到有嚴重碰撞或是頸部以上的撞傷，就需要馬上啟動緊急醫療措施，若場邊沒有醫療人員可以進行緊急評估，則需馬上進行後送。同一天該個案也不能再回到運動場上競賽。
紅旗現象 (Red Flags)
當第一瞬間發現個案有以下狀況時，建議馬上進行後送：
- 頸部疼痛或壓痛
- 痙攣或抽搐
- 複視
- 失去意識或意識混亂
- 四肢有任一肢以上感覺無力
- 嘔吐
- 嚴重頭痛
- 躁動、易怒或有暴力傾向
- GCS < 15
- 肉眼可見的頭骨受傷
評估流程與後續評估
當紅旗現象評估確定沒有發生，就可以依序進行後續評估，要注意的是，腦部創傷有時不會馬上被發現，因此應該要每間隔一段時間就評估一次，並且以較低標準決定後送，也就是只稍微懷疑有腦震盪就送醫院檢查，以防出現不可挽回的遺憾。
- 第一步：觀察（現場觀察或回放影片觀察）
觀察個案受傷當下的反應，是否著地時直接接觸頭部、著地後有無馬上的動作反應、落地後是否有平衡／動作／意識／視線上的失能、是否有出現痙攣等等。
- 第二步：意識分數評分
由 Glasgow Coma Scale (GCS) 評估分數，若小於 15 分則需後送。
- 第三步：頸部活動評估
評估頸部動作是否有受影響與是否有局部區域性的疼痛，更重要的是觀察是否有四肢肌力與感覺損傷。
- 第四步：手眼協調性
使用鼻尖手指測試（finger-to-nose test）測試協調性，請個案追試測驗者手指測驗眼睛協調。
- 第五步：記憶
這部分可以使用 Maddocks 記憶提問進行。
結語
這一篇文章我們解釋了 SCAT 的基本架構與緊急評估內容，後續在場下的評估會如何進行將在第二部分繼續進行解釋，有興趣的讀者歡迎點此閱讀！
常見問題 FAQ
SCAT-6 是什麼？誰可以使用？
SCAT-6 是由 CISG 發展、發布在 BMJ 上的國際通用腦震盪評估工具。它設計給醫療人員使用；如果使用者不是醫療人員，建議改用腦震盪辨識工具 CRT6。
運動時懷疑腦震盪，多久內要用 SCAT-6 評估？
必須在三天內進行評估。如果超過三天未評估，或評估對象是孩童，就需要改用 SCOAT6 或 Child SCOAT6。建議在剛接觸個案時就先做基本評估，事件發生當下才能比對出分數變化。
出現哪些「紅旗現象」要立刻送醫？
出現以下任一項就建議馬上後送：頸部疼痛或壓痛、痙攣或抽搐、複視、失去意識或意識混亂、任一肢以上感覺無力、嘔吐、嚴重頭痛、躁動易怒或有暴力傾向、GCS 小於15、肉眼可見的頭骨受傷。
被撞到頭後，同一天還能繼續比賽嗎？
不行。賽場上若看到嚴重碰撞或頸部以上的撞傷，要馬上啟動緊急醫療措施；場邊沒有醫療人員就立即後送，該個案同一天也不能再回到運動場上競賽。
腦震盪評估只做一次就夠了嗎？
不夠。腦部創傷有時不會馬上被發現，因此應該每隔一段時間就重新評估一次，並以較低標準決定後送，也就是只要稍微懷疑有腦震盪就送醫檢查，以免出現不可挽回的後果。
Complete Concussion Assessment Process: SCAT-6 Tool (Part 1)
Updated: July 28, 2026 | By: Pazo, IOC Sports Physical Therapist
Key Takeaways
- Medical professionals only: SCAT6 must be completed within 3 days of injury. If >3 days or the patient is a child, use SCOAT6 / Child SCOAT6.
- Non-medical personnel: Use the CRT6 instead. Do not use SCAT6 directly.
- Immediate removal: Any head/neck trauma requires emergency protocols. The athlete must not return to play on the same day.
- 10 Red Flags: Immediate hospital transport if ANY occur (e.g., neck pain, seizures, double vision, GCS < 15).
- Delayed symptoms: Reassess periodically and err on the side of caution—send to hospital if there's any suspicion.
Medical Disclaimer: Symptoms vary from person to person. If symptoms worsen rapidly or persist, consult a physician or physical therapist for proper evaluation to speed up recovery.
Foreword
The Sport Concussion Assessment Tool (SCAT) is designed by medical professionals, updated periodically, and published in the British Journal of Sports Medicine (BMJ). Healthcare providers use it to assess concussions and formulate return-to-play plans. Today, Pazo walks you through the contents of this assessment tool!
Before Using SCAT6
- Assessments must be completed within 3 days.
- If >3 days or the patient is a child, use SCOAT6 / Child SCOAT6.
- Non-medical professionals should use the CRT6 (Concussion Recognition Tool 6) instead.
- Perform a baseline evaluation immediately upon contact to observe any changes in scores.
- SCAT6 is published by BMJ. Please refer to the original document for detailed usage.
Immediate Management
Activate emergency protocols immediately for severe collisions or trauma above the neck. The athlete cannot return to play on the same day.
Red Flags (Immediate Transport Required)
Arrange emergency transport if you observe:
- Neck pain or tenderness
- Seizure or convulsion
- Double vision
- Loss of consciousness / altered mental state
- Weakness or tingling/burning in limbs
- Vomiting
- Severe or increasing headache
- Agitated or combative behavior
- GCS < 15
- Visible skull deformity
Assessment Flow
Once Red Flags are ruled out, proceed with the follow-up assessment. Since brain trauma symptoms are not always immediately apparent, you should reassess the athlete at regular intervals and apply a low threshold for medical transport.
- Step 1: Observable Signs
Observe the athlete's reaction at the time of injury: immediate motor response, balance, movement, and consciousness.
- Step 2: GCS Assessment
If the GCS score is less than 15, transport immediately.
- Step 3: Cervical Spine Assessment
Assess impaired movement, localized pain, and loss of limb strength or sensation.
- Step 4: Coordination Screen
Test coordination using the finger-to-nose test.
- Step 5: Memory
Memory is assessed using the standardized Maddocks questions.
Conclusion
In this article, we explained the basic structure and emergency assessment components of the SCAT6. How the off-field assessment is conducted will be covered in Part 2. Stay tuned!
Frequently Asked Questions (FAQ)
What is the SCAT-6 and who can use it?
The SCAT-6 is an internationally recognized concussion assessment tool published in the BMJ. It is specifically designed for use by medical professionals. If you are not a medical professional, it is recommended to use the CRT6 instead.
How soon should SCAT-6 be used if a concussion is suspected?
It must be conducted within 3 days. If it has been more than 3 days, or if the patient is a child, use the SCOAT6 or Child SCOAT6 instead. Conduct a basic evaluation immediately upon contact to track score changes.
What "Red Flags" require immediate medical transport?
If any of the following occur, immediate transport is advised: neck pain/tenderness, seizures/convulsions, double vision, loss of consciousness, limb weakness, vomiting, severe headache, agitation/combativeness, GCS < 15, or visible skull deformity.
Can an athlete return to play on the same day after a head hit?
No. If there is a severe collision or a hit to the head/neck, emergency protocols must be triggered. They absolutely cannot return to the game on the same day.
Is a single concussion assessment enough?
No. Brain trauma symptoms sometimes do not appear immediately. Therefore, you should reassess the athlete periodically and maintain a low threshold for hospital transport—if there's even a slight suspicion of a concussion, send them in for a check to avoid irreversible consequences.
