The life of Brain
Describe the anatomy, physiology, and
functions of the brain and spinal cord.
(pp 724–726)
List three conditions with symptoms that
mimic stroke and the assessment techniques
EMTs may use to identify them.
(p 731)
Explain the postictal state and the specific
patient care interventions that may be
necessary.
(p 735)
Explain the primary assessment of a patient
who is experiencing a neurologic emergency
and the necessary interventions that may be
required to address all life threats.
(pp 738–739)
Explain the concept of a stroke alert and the
important time frame for the most successful
treatment outcome for a patient who is
suspected of having a stroke.
(pp 745–746)
Discuss the different types of headaches, the
possible causes of each, and how to distinguish
a harmless headache from a potentially life-
threatening condition.
(pp 726–727)
Define a general seizure, focal-onset seizure,
and status epilepticus; include how they differ
from each other and their effects on patients.
(pp 732–733)
Define altered mental status; include possible
causes and the patient assessment considera-
tions that apply to each.
(pp 735–737, 749)
Describe the process of history taking for
a patient who is experiencing a neurologic
emergency and how this process varies
depending on the nature of the patient’s illness.
(pp 739–741)
List the key information EMTs must obtain
and document for a stroke patient during
assessment and reassessment.
(pp 741–745)
Explain the various ways blood flow to
the brain may be interrupted and cause a
cerebrovascular accident.
(pp 727–728)
Describe how the different stages of a seizure
are characterized.
(p 733)
Discuss scene safety considerations when
responding to a patient with a neurologic
emergency.
(pp 737–738)
Explain the secondary assessment of a patient
who is experiencing a neurologic emergency.
(pp 741–744)
Explain the care, treatment, and transport of
patients who are experiencing headaches,
stroke, seizure, and altered mental status.
(pp 745–749)
Discuss the causes, similarities, and differences
of an ischemic stroke, hemorrhagic stroke, and
transient ischemic attack.
(pp 728–730)
Discuss the importance for EMTs to recognize
when a seizure is occurring or whether one has
already occurred in a patient.
(pp 734–735)
Explain the special considerations required for
pediatric patients who exhibit altered mental
status.
(p 737)
Explain how to use stroke assessment tools
to rapidly identify a stroke patient; include two
commonly used tools.
(pp 741–744)
Explain the special considerations required
for geriatric patients who are experiencing a
neurologic emergency.
(p 747)
List the general signs and symptoms of stroke
and how those symptoms manifest if the
left hemisphere of the brain is affected and if
the right hemisphere of the brain is affected.
(pp 730–731)
A 68-year-old male presents with sudden onset slurred speech and right-sided facial droop. His wife states symptoms began 20 minutes ago. He is conscious and breathing normally.
What is your priority action?
A. Administer aspirin
B. Perform a Cincinnati Prehospital Stroke Scale
C. Give oxygen via nonrebreather
D. Transport without assessment
Correct Answer: B
Rationale:
You need to identify a stroke quickly using a validated tool like the Cincinnati Stroke Scale (facial droop, arm drift, speech). Early recognition activates stroke care pathways. Aspirin is not given in suspected stroke prehospital because it could be a hemorrhagic stroke.
A 72-year-old female has left arm weakness and confusion. Symptoms started 1 hour ago. Blood glucose is 110 mg/dL. Vital signs are stable.
What is the most appropriate destination decision?
A. Closest hospital regardless of capability
B. Delay transport for detailed neurological exam
C. Transport to a stroke center if available
D. Administer glucose and reassess
Correct Answer: C
Rationale:
Stroke is time-critical (“time is brain”). Patients within the treatment window should go to a designated stroke centerfor possible thrombolytics or intervention. Glucose is normal, so no need to treat hypoglycemia.
You respond to a 60-year-old diabetic with altered mental status and right-sided weakness. Blood glucose reads 42 mg/dL.
What should you do first?
A. Activate stroke alert
B. Administer oral glucose or IV dextrose
C. Perform a full stroke scale
D. Transport immediately
Correct Answer: B
Rationale:
Hypoglycemia can mimic stroke symptoms. Always check glucose early. Correcting low blood sugar may completely resolve symptoms, avoiding a false stroke activation.
Demonstrate how to use a stroke assessment
tool such as the Cincinnati Prehospital Stroke
Scale, 3-Item Stroke Severity Scale (LAG),
or BE-FAST mnemonic to test a patient for
aphasia, facial weakness, and motor weakness.
(pp 741–745)