NREMT Preparation
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| STROKE | Death to brain tissue due to an interruption in blood flow.
Also called cerebrovascular accident (CVA) or "brain attack."
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| Ischemic Strokes | Blood flow to the brain is compromised due to a blockage.
Ischemic strokes are often due to atherosclerosis.
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| Hemorrhagic Strokes | Caused by bleeding within the brain.
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| Signs and Symptoms of Stroke | Severe headache, slurred speech
Facial droop, drooling
Unilateral (one-sided) numbness, weakness, or paralysis
Altered level of consciousness, difficulty moving or walking
Vision problems
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| Cincinnati Prehospital Stroke Scale- Elements | ~ Facial droop
Ask the patient to smile.
Abnormal: facial droop is present.
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| Cincinnati Prehospital Stroke Scale- Elements | ~ Arm drift
Ask the patient to close eyes while holding
arms out front, palms up.
Abnormal: one arm drifts unintentionally.
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| Cincinnati Prehospital Stroke Scale- Elements | ~ Speech
Ask the patient to repeat a given sentence.
Abnormal: speech is slurred, word choice is
incorrect, or patient is unable to speak.
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| Assessment and Management of the Stroke Patient | 1. Any patient with signs and symptoms of a stroke should
be considered a high transport priority and taken to an
approved stroke center per local protocol.
2. Protect patient from further harm during movement and
transport.
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| TRANSIENT ISCHEMIC ATTACK (TIA) | A. TIAs have the same presentation as a CVA. However, the signs
and symptoms self-correct within about 24 hours with no
permanent brain damage.
B. TIAs are also called mini strokes.
C. TIAs are a warning sign of an impending stroke.
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| SEIZURES | Seizures are caused by disorganized electrical activity within the
brain.
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| Types of Seizures | Generalized seizures
Also called grand mal seizures.
Patient is unresponsive and experiences full-body
convulsions.
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| Types of Seizures | Absence seizures
Also called petit mal seizures.
Patient does not interact with environment, but there is
no convulsive activity.
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| Types of Seizures | Partial seizures
Simple partial seizure: no change in level of
consciousness (LOC); possible twitching or sensory
changes, but no full-body convulsions
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| Types of Seizures | Complex partial seizures: altered LOC; isolated twitching
and sensory changes possible
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| Status epilepticus | Prolonged seizure (about 30 minutes) or recurring
seizures without the patient regaining consciousness in
between
Highly dangerous, possibly leading to permanent brain
damage and death
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| Phases of a Seizure | Not every stage is present for every type of seizure or every
patient.
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| Aura phase | This is the warning stage.
The patient may sense onset of seizure.
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| Tonic phase | Muscle rigidity
Possible incontinence
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| Tonic-clonic phase | Patient experiences uncontrolled muscle contraction and
relaxation.
Patient may be apneic during the tonic or tonic-clonic
phase.
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| Postictal phase | This is the "recovery" phase.
Patient's LOC progressively improves over about 30
minutes.
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| Causes of Seizures | Seizures can be caused by congenital problems, traumatic
injuries, or medical conditions, including alcohol, brain
injury, tumor, diabetic emergency, epilepsy, fever, infection,
insulin or other medications, poisoning or toxic exposure,
stroke, or biological or chemical weapons.
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| Febrile seizures | are a common cause of seizures in pediatric
patients. Caused by high fevers that develop rapidly, they do
not typically present significant risk to the patient. The child
should, however, be transported and evaluated by a physician.
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| Recognizing seizures | Often, EMS providers will not arrive until the patient is in
the postictal phase.
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| Question bystanders. | Assess for incontinence, tongue biting.
Obtain thorough history, medications, etc., when able.
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| Management of seizure patients | If possible, position postictal patient in the lateral recumbent
position to protect airway. If vomiting occurs while in
cervical-spine precautions, tilt the long board.
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| SYNCOPE | Syncope is fainting.
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| Syncope causes | It is typically caused by a temporary loss of blood flow to the
brain.
Causes include cardiac emergency, hypotension, neurological
problem, stress, diabetes, pregnancy, anemia, medications, and
toxic exposure.
Patients typically regain consciousness as soon as they are
supine and blood flow returns to the brain.
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| Syncope- It is typically caused by a temporary loss of blood flow to the brain. | Causes include cardiac emergency, hypotension, neurological
problem, stress, diabetes, pregnancy, anemia, medications, and
toxic exposure.
Patients typically regain consciousness as soon as they are
supine and blood flow returns to the brain.
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| Syncope Assessment and Management | When in doubt, err on the side of caution and encourage
treatment and transport for a patient experiencing a
syncopal episode.
Consider assistance from ALS providers or contact medical
direction.
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| HEADACHE | Headaches have many causes, some of them neurological.
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| Headache causes | A few causes of headache include stroke, aneurysm, tumor,
hypertension, migraines, trauma, and meningitis.
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| Signs and symptoms of possible medical emergency Headache | include
severe headache, hypertension, fever, stiff neck, neurological
impairment, or recent trauma.
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| Assessment and Management Headache | When in doubt, err on the side of caution and encourage
treatment and transport for a patient with a headache.
Consider assistance from ALS providers or contact medical
direction.
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| How long of a window do you have in treating a stoke patient | They should receive treatment within 3 hours
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| What is an important question to ask the family of a stroke patient | When did the patient last appear normal.
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Created by:
ditchdoctech
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