Highlander Help

EMT NOTES

Neurological Emergencies (Chapter 14)



Stroke

  • rapid transport is vital
  • hemmorrhagic:
    • 10-20%
    • bleeding in brain
    • high BP a risk factor
  • ischemic:
    • ~80% of all strokes
    • due to clot

  • TIA-Transient Ischemic Attack
    • "mini-stroke"
    • signs/symptoms go away in less than 24 hours

  • Symptoms of Stroke: 
    • F.A.S.T
      • Facial droop
      • Arm drift
      • Speech issues
      • Time
    • high BP-may be cause of or caused by the stroke

  • Definitive care should start within 4-5 hours of symptom onset for greatest potential for recovery

  • Certain conditions may mimic stroke (ex. hypoglycemia)

Case Study: Negligent Stroke Victim

EMS was called by family members who were concerned for an elderly member of their family who has not left his house for the past couple of days.  Upon arriving, the patient presented with all the classical symptoms of stroke: facial droop, arm drift, slurred speech, and agitation, but merely said that he was feeling under the weather and did not want to go to the hospital.  EMT's had to show him a mirror in order to convince him that he was indeed having a stroke and to go to the hospital!  


Takeaway:

  • Patient may be unaware of the stroke, and may even deny it.  

Seizures

  • Simple partial seizure
    • not as severe
    • may involve brief twitching/tremors
  • Complex partial seizure
    • altered mental status
    • lack of bodily control
  • Tonic-clonic (Grand Mal) seizure
    • most severe types
    • loss of consciousness
    • apnea
    • chaotic muscle movements/body convulsions
    • often preceded by aura-sensation that they are about to have a seizure
    • tachycardia
    • hyperventilation
    • sweating
    • most last 3-5 minutes

  • What to do when you arrive on the scene and see a seizing patient:
    • do not restrict seizing patient. 
    • remove potentially harmful objects around the person  
    • administer Oxygen once patient stops seizing

  • Seizure patients should be transported to hospital