Stroke
What is BEFAST?
B = balance ; sudden loss
E = eyes ; blurry vision
F = face ; drooping smile
A = arms ; one arm drops when raised
S = speech ; can't repeat a simple sentence back
T = time ; what time did symptoms start
- within 4.5 hours administer TPA
Which type of seizure is a true medical emergency?
status epilepticus: a seizure that lasts longer than 5 minutes or they don't regain consciousness
What is the test for diabetes?
hemoglobin A1C - identifies the concentration of glucose in plasma overtime
What is the organ responsible for insulin and glucagon secretion?
pancreas
True or false: altered mental status and LOC are the same thing
false - altered mental status is defined as being alert, but not knowing what is going on
What is a transient ischemic attach?
mini stroke (10x more likely to have a major stroke within 2-5 years)
brief episode of neurological dysfunction caused by a focal brain, spinal, or retinal ischemia without acute damage
what is osmotic demyelination syndrome?
neurological damage to the brainstem (sheath) from hyponeutremia
What is the A1C reading for pre-diabetes and diabetes?
pre-diabetes = over 5.5
diabetes = over 6.5
What is hypoglycemia?
low blood sugar with too much insulin
insulin shock
serum glucose <60
What is hyperglycemia?
increased sugar & decreased insulin
serum glucose > 180
can lead to diabetic ketoacidosis which is when the body does not have enough insulin to break down sugar
- causes ketones to build up and increase acids
What is the difference between an ischemic stroke and a hemorrhagic stroke?
ischemic = lack of O2; clot blocks blood flow to the brain - gradual onset; overall more favorable recovery if caught in time
hemorrhagic stroke = weakness / rupture in artery (brain bleed) - sudden onset and may initially recover faster
Name 3 types of seizures.
generalized tonic-clonic (grand mal)
partial / focal onset
absence febrile
status epilepticus
What is a normal fasting blood glucose level? What is a normal level after eating?
fasting = 60-80
2-3 hours after eating = 100-140
What are three symptoms of hypoglycemia?
hunger, weakness, shakiness, shallow breathing, heart palpitations, anxiety, behavioral changes, tachycardia, hyperventilation, nausea, hypothermia, diaphoresis/cold sweat, sudden onset, tremors, diabetic coma
What are three symptoms of hyperglycemia?
fruity odor in breath, drowsy, slurred speech, dehydrated, weakness, gradual onset, altered vision, frequent urination, hyperventilation, hypotension, cardiac arrhythmia, stupor, possible coma
How do you treat a stroke?
maintain open airway, administer O2, lie patient on side and clear mouth, raise head and shoulders to relieve intercranial pressure, no food or liquids, handle gently, refer to Dr
When would you need immediate advanced care for a seizure?
if it lasts longer than 5 minutes
if they occur in a cluster
presentation changes
if they get an injury from the seizure
if they experience a seizure without a known disorder
if the seizure occurs in water
if they do not regain consciousness
Explain the difference between type 1 and type 2 diabetes.
Type 1 = an auto immune disorder where the body cannot produce enough insulin and is therefore insulin dependent. it is most often a juvenile onset and is not preventable.
Type 2 (90%) = the body has an inability to use insulin effectively because of resistance to insulin as well as a decrease production of insulin. Type 2 is non-insulin dependent and is usually an adult onset and is preventable. 85% of people with type 2 are overweight.
You have an athlete with a history of diabetes walk up to at practice. They are shaky, nauseas, and tachycardic. You ask when the last time they ate was and they said an hour ago. You take their blood glucose and it is 55. What do you do?
their symptoms and blood glucose tell me that they are hypoglycemic. Therefore, I would give them 10-15 grams of fast acting carbs like honey, sugar, candy, etc.
You have an athlete with a history of diabetes walk up to at practice. They are weak, drowsy, and have a low BP. You take their blood glucose and it is 300. What do you do?
I would administer insulin and assess their urine for ketones since their serum glucose is above 300.
What are symptoms of stroke?
unilateral paralysis or weakness, slurred or difficulty talking, unequal pupils, blurred vision, incontinence, altered mental status, look ill, loss of balance or trouble walking
How would you treat someone experiencing a seizure?
protect the patient from injury and manage airway
move objects away from patient
TIME SEIZURE LENGTH
place patient in recovery position afterwards
do initial and secondary assessment after seizure
offer comfort and stay with them until fully conscious
What cells are responsible for glucagon production and which are responsible for insulin secretion?
glucagon = alpha cells
insulin = beta cells
When would you have to monitor blood sugar levels more frequently at practice?
if the temperature is below 36 or above 86
What causes variation in blood serum levels?
individual patient
activity type (aerobic, anerobic, strenuous)
activity timing (after meals or insulin)
activity duration
environment conditions (temp, altitude, humidity)
patient fitness