Trauma casualties with suspected head injury/TBI due to mechanism, obvious wounds, or proximity to blast event (within 50 meters) should be referred to medical personnel as soon as possible for Military Acute Concussive Evaluation 2 (MACE 2). This evaluation is most effective when done as soon as possible after the injury.

If ANY of the following RED FLAG signs and symptoms are present, MACE 2 should be deferred and urgent evacuation to a higher level of medical care considered:

- Deteriorating level of consciousness
- Double vision
- Increased restlessness; combative or agitated behavior
- Repeat vomiting
- Results from a structural brain injury detection device (if available)
- Seizures
- Weakness or tingling in the arms or legs
- Severe or worsening headache