Be fix-it-felix
You respond to a 45-year-old male found acting confused and slurring his words at a bus stop. He is sweaty and trembling.
What is the first diagnostic assessment you should perform?
What is blood glucose test (to rule out hypoglycemia, the great neurologic mimicker).
This type of generalized seizure is characterized by a sudden loss of consciousness followed by alternating phases of rigid muscle tensing and rhythmic, violent jerking of the extremities.
What is a Tonic-Clonic seizure? (Grand Mal is also acceptable, though "Tonic-Clonic" is preferred
Even if a patient is completely unresponsive, flaccid, and shows no signs of life, this is the lowest possible mathematical score they can receive on the GCS scale.
What is a 3?
This dual-injury mechanism occurs when the brain strikes the front of the skull, then bounces back to hit the opposite side, common in high-speed rear-end collisions.
What is a coup-contrecoup injury?
This phenomenon occurs when a patient experiences a brief "lucid interval" of normal behavior before a rapidly expanding arterial blood clot severely compresses brain tissue.
What is an epidural hematoma?
A 62-year-old female suddenly experiences left-sided facial droop and right arm weakness while eating dinner. Her symptoms completely disappear 15 minutes later before your arrival.
What neurological event did this patient most likely experience?
What is Transient Ischemic Attack (TIA).
Common in children, this seizure type involves a sudden, brief lapse of consciousness where the patient appears to be "blankly staring" or day-dreaming, typically lasting only a few seconds with no postictal confusion.
What is an Absence seizure? (Petit Mal is also acceptable).
Any GSC below this level would categorize your patient as comatose, what number would this be.
What is "Less than 8," (or a GCS of 8)?
During a motor vehicle accident, this sudden, temporary loss of spinal reflex activity occurs immediately following a severe spinal cord injury, causing flaccid paralysis and a loss of sensation below the level of the injury.
What is neurogenic shock?
This life-threatening condition occurs within 24 to 48 hours of trauma when fluid buildup increases pressure inside the rigid, unyielding human skull.
What is cerebral edema (or increased intracranial pressure)?
You respond to a 16-year-old female who was playing basketball, she was elbowed in the head and fell to the ground. She states she didn't lose consciousness, her head hurts, and is sensitive to light. Pt is A&Ox4.
What is your diagnoses for her injury?
What is Concussion
During this specific type of seizure, the abnormal electrical activity is localized to one hemisphere of the brain, causing isolated symptoms like localized twitching or sensory changes, while the patient remains fully alert and oriented.
What is a Focal Aware seizure? (Simple Partial seizure is also acceptable).
If a head-injury patient only opens their eyes when you apply a painful stimulus like a trapezius squeeze, they receive this specific score for Eye Opening.
What is a 2?
A linear fracture to the temporal bone frequently disrupts the middle meningeal artery, leading to this rapidly expanding, life-threatening intracranial bleed.
What is an epidural hematoma?
Accompanied by systemic issues like broken ribs or a collapsed lung, this secondary insult occurs when the brain is starved of oxygen despite surviving the initial impact.
What is hypoxia (or ischemic brain injury)?
You arrive to find a 22-year-old male lying on the floor. Witnesses say he just finished a 2-minute episode of full-body muscle jerking. He is currently unresponsive to verbal commands and breathing deeply.
What is the medical term for this patient’s current altered neurological state?
What is postictal state (or postictal phase).
This life-threatening neurological emergency is defined as a continuous seizure lasting longer than 5 minutes, or consecutive seizures occurring without the patient regaining full consciousness in between.
What is Status Epilepticus?
When checking Verbal response, a patient who speaks in full, coherent sentences but incorrectly states that the current year is 1995 earns this point value.
What is a 4?
This type of traumatic brain injury is caused by a mechanism of rapid acceleration or deceleration that disrupts neurologic function, sometimes losing consciousness, often presenting with temporary confusion, amnesia, or dizziness without showing physical damage on standard imaging.
What is a concussion?
To rapidly identify a stroke in the field, EMTs assess for abnormal speech, an asymmetrical smile, and this motor sign where one arm involuntarily drifts downward.
What is arm drift?
A 50-year-old male reports a sudden, excruciating headache that he rates a "10 out of 10," You note he has a stiff neck and is suddenly vomiting.
What specific life-threatening presentation does this suggest?
What is subarachnoid hemorrhage (SAH).
This type of seizure is prescribed medication?
What is Epileptic seizures
Using your stroke scale to assess this patient: A 67-year-old patient suddenly develops slurred, slow speech and confusion. They have equal grip strength, no facial droop, no arm drift, and no vision changes, think of your stroke scale. What is most likely the cause of this?
Hypoglycemia - they passed the stroke scale.
This physiological response—characterized by bradycardia, bradypnea, and hypertension—occurs when severe head trauma causes a drastic spike in intracranial pressure.
What is Cushing’s triad?
Unlike standard hemorrhagic shock, an EMT can suspect neurogenic shock from a high spinal injury if the hypotensive patient presents with this unusually low vital sign.
What is bradycardia (or a slow heart rate)?