STROKE (all types)
What oxygen saturation do you keep a suspected stroke patient at?
90-95%
True or False: You should restrain a patient while they are actively seizing.
FaLsE!! (If you got this wrong I'm concerned)
What is the value of doing a low-grade cranial nerve exam for patients who could have had head/neck trauma, even if they seem relatively okay?
If an abnormal symptom is present, it could indicate damage to the brainstem (like bleeding and/or swelling), which could get worse
Patient presents: (eyes) opening to painful stimuli, (verbally) incomprehensible, and (motor) withdraws to pain. GCS is __?
8
"She's not breathing! Gender: Male"
Andrew
What are the 3 parts of the Cincinnati Stroke scale?
Facial droop, arm drift, and speech
What medications can an EMT Basic in Utah County use while on scene?
Nada
What vital could an EMT Basic take on a patient presenting with possible altered mental status for the first "I" (in AEIOUTIPS)?
Blood glucose
At what GCS is a patient unlikely to be able to protect their own airway?
<8 (+/- 1)
Let's wait until Kevin gets back before you shove stuff down people's throats."
Caelyn
What 3 things are impacted during neurogenic shock, and what are the trends?
Decreased heart rate, blood pressure, and temperature
What is a seizure treatment unique for febrile seizures?
Ensure patients are not excessively dressed or bundled
What is the acronym to remember possible causes of altered mental status and what do each of the letters stand for?
AEIOUTIPS
Alcohol, Environment/electrolytes, Insulin, Overdose (opiates), Uremia (renal failure), Trauma/temperature, Infection, Psychosis/poison, Stroke/shock/seizure
Patient presents: (eyes) open to verbal command, (verbal) confused/disoriented, (motor) purposeful movement to painful stimulus. GCS is ___?
12
"I woke up after 3 hours of sleep last night, so I'm pretty zonked."
"3 whole hours?! That's sleeping in!"
Which two people? (need both names for full points)
Mitchell and Michael
How long does a patient need to hold their arms up with their eyes closed before they fail the arm drift assessment of the Cincinnati Stroke Scale?
10 seconds
What is the condition called when seizures continue every few minutes without the person regaining consciousness or last longer than 30 minutes?
Status epilepticus
What are the four sections of AOx4 and what question could you ask to check for this?
Person (what's your name?)
Place (where are you?)
Time (what day/what month?)
Events (what were you doing leading up to this?)
6
"I got up this morning because I hate myself too much to stay down"
Garrett
What is the youngest age a patient could present with a suspected stroke?
0 (in utero)
Name all the criteria where transporting a seizure patient would be highly recommended (there are 5)
Encourage transport if any apply: (page 697)
Patient is not A&Ox4 and GCS 15
Assessment reveals trauma or complications
It’s the first time they had a seizure
If it has happened before (and they have a diagnosis) was it a usual seizure?
Length, activity, recovery
If the patient isn’t currently being treated with meds and regularly seeing a physician
What are 2 other methods of assessing someone's mental status? (not including AOx4)
Have them count to 30 by 3s, spell a word backwards, show a pen and ask what it is, have the patient repeat a short phrase, etc.
What is decorticate posture and decerebrate posture? Demonstrate both
Decerebrate = wrists pronated/fingers flexed on side
"What route do you give aspirin?"
"PO?"
"Wrong. Rectal - that's why it's called ASprin"
Which 3 people had this interaction? (All 3 need to be included)
Caelyn, Michaelle, Tyler