Podcast
Questions and Answers
Into what category of causes of altered mental status would anoxia, hypoglycemia, and carbon monoxide poisoning fall?
Into what category of causes of altered mental status would anoxia, hypoglycemia, and carbon monoxide poisoning fall?
Toxic-metabolic causes
What did the 49-year-old man most likely experience when he explained that the left side of his face is numb and his left arm is severely weak, but the symptoms have resolved upon arrival?
What did the 49-year-old man most likely experience when he explained that the left side of his face is numb and his left arm is severely weak, but the symptoms have resolved upon arrival?
TIA
What prehospital stroke screen has a 97 percent success rate in determining stroke patients?
What prehospital stroke screen has a 97 percent success rate in determining stroke patients?
LAPSS
What is your minimum oxygenation target for a patient displaying altered mental status with adequate respirations?
What is your minimum oxygenation target for a patient displaying altered mental status with adequate respirations?
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Which statement by a patient regarding a headache should indicate to the EMT that rapid transport may be necessary?
Which statement by a patient regarding a headache should indicate to the EMT that rapid transport may be necessary?
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What does the 'A' in AEIOU-TIPPSS stand for?
What does the 'A' in AEIOU-TIPPSS stand for?
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What type of cause does altered mental status resulting from a space-occupying lesion or destruction of brain tissue have?
What type of cause does altered mental status resulting from a space-occupying lesion or destruction of brain tissue have?
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Which stroke-screening method relies on speech as one of the screening criteria?
Which stroke-screening method relies on speech as one of the screening criteria?
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What term is applied to the sign of flexion of the arms toward the trunk, commonly associated with trauma to the brainstem?
What term is applied to the sign of flexion of the arms toward the trunk, commonly associated with trauma to the brainstem?
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What does the 'E' in AEIOU-TIPPSS stand for?
What does the 'E' in AEIOU-TIPPSS stand for?
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For which type of stroke is the patient NOT a candidate for 'clot-busting' drugs?
For which type of stroke is the patient NOT a candidate for 'clot-busting' drugs?
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What clinical manifestation may a paramedic expect a patient with a suspected migraine to report?
What clinical manifestation may a paramedic expect a patient with a suspected migraine to report?
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Depending on the location of the nontraumatic brain injury, signs and symptoms may include what?
Depending on the location of the nontraumatic brain injury, signs and symptoms may include what?
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When a clot forms elsewhere, breaks free, and then lodges in the brain, it is called what?
When a clot forms elsewhere, breaks free, and then lodges in the brain, it is called what?
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What is the likely cause of a 62-year-old male patient experiencing weakness on one side of his body and slurred speech, after which symptoms begin to subside?
What is the likely cause of a 62-year-old male patient experiencing weakness on one side of his body and slurred speech, after which symptoms begin to subside?
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As a patient with a neurological insult starts to deteriorate, to what body system will the EMT need to pay particular attention?
As a patient with a neurological insult starts to deteriorate, to what body system will the EMT need to pay particular attention?
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At a minimum, how often should the EMT assess the unconscious patient for changes in mental status, breathing, and circulation?
At a minimum, how often should the EMT assess the unconscious patient for changes in mental status, breathing, and circulation?
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If a patient has a history of multiple transient ischemic attack events, but currently findings have lasted about 25 minutes, what should the EMT conclude?
If a patient has a history of multiple transient ischemic attack events, but currently findings have lasted about 25 minutes, what should the EMT conclude?
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Patients who present with a stroke are considered what transport priority?
Patients who present with a stroke are considered what transport priority?
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What term would you use to document a patient who cannot remember his name?
What term would you use to document a patient who cannot remember his name?
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Which assessment finding would be a cause of vascular headaches reported by a patient?
Which assessment finding would be a cause of vascular headaches reported by a patient?
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Serious causes of headaches include each of the following, EXCEPT:
Serious causes of headaches include each of the following, EXCEPT:
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What should you do when treating a victim of a fall with an altered mental status who is now having sonorous respirations?
What should you do when treating a victim of a fall with an altered mental status who is now having sonorous respirations?
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Which goal is listed in the American Heart Association's 'Stroke Chain of Survival'?
Which goal is listed in the American Heart Association's 'Stroke Chain of Survival'?
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The type of stroke where a blood vessel in the brain has ruptured is called what?
The type of stroke where a blood vessel in the brain has ruptured is called what?
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What should the EMT initially suspect for a female patient who awoke from sleep at night with a mild headache and the inability to speak clearly?
What should the EMT initially suspect for a female patient who awoke from sleep at night with a mild headache and the inability to speak clearly?
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Why is it necessary to take the patient to the hospital if the symptoms of a stroke have subsided by the time you arrive on the scene?
Why is it necessary to take the patient to the hospital if the symptoms of a stroke have subsided by the time you arrive on the scene?
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What is the first goal of the American Heart Association's 'Stroke Chain of Survival'?
What is the first goal of the American Heart Association's 'Stroke Chain of Survival'?
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Study Notes
Altered Mental Status
- Causes include toxic-metabolic factors such as anoxia, hypoglycemia, and carbon monoxide poisoning.
- Altered mental status can result from structural causes, including brain tissue destruction or space-occupying lesions.
- Patients with altered mental status should maintain an SpO2 of 94% or higher.
Stroke Identification
- Transient Ischemic Attack (TIA) is indicated by temporary symptoms such as facial numbness and weakness that resolve quickly.
- LAPSS has a 97% success rate in accurately identifying strokes.
- The Cincinnati Prehospital Stroke Scale (CPSS) relies on speech as a screening criterion.
- High priority is assigned to patients presenting with stroke symptoms for transport.
Headache Assessment
- A severe headache described as the "worst headache ever" necessitates rapid transport.
- Clinical manifestation of migraines may include symptoms like photosensitivity.
- A blood pressure reading of 160/120 could indicate vascular headaches.
Stroke Types and Treatment
- Embolic strokes occur when a clot breaks free and lodges in the brain.
- Hemorrhagic strokes involve ruptured blood vessels in the brain and are not treatable with clot-busting drugs.
- Symptoms of a stroke that subside within 24 hours may indicate a TIA, but persistence beyond 25 minutes suggests a small stroke.
Patient Monitoring
- Regular assessments of unconscious patients should occur every 5 minutes to monitor changes in mental status, breathing, and circulation.
- Attention should be focused on the respiratory system as the patient’s condition deteriorates.
Emergency Protocols
- Serious headache causes include hypertension, subarachnoid hemorrhage, and cyanide poisoning; heart attacks are not typically associated.
- The jaw-thrust maneuver should be applied to patients exhibiting sonorous respirations after an altered mental status.
Importance of Hospital Evaluation
- Even if stroke symptoms have resolved, hospital evaluation is necessary to determine the cause of TIA.
- The American Heart Association emphasizes the importance of rapid recognition of stroke symptoms and dispatch as critical components of the "Stroke Chain of Survival."
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Description
Test your knowledge on altered mental status, strokes, and headaches with this comprehensive post-test quiz. This quiz covers critical concepts like toxic-metabolic causes of altered mental status and stroke symptoms. Enhance your understanding of emergency medical responses.
