Management of Neurovascular Conditions - AC 2.5
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Questions and Answers

What should be checked immediately in a patient experiencing convulsions?

  • Blood pressure
  • Pulse rate
  • Oxygen saturation
  • Blood glucose levels (correct)

    • Which of the following conditions necessitates urgent transport to the hospital?

  • Generalized muscle spasms
  • Minor head injury
  • Transient loss of consciousness
  • Status Epilepticus (correct)

    • During a primary survey for a patient with convulsions, which sign indicates an underlying infection?

  • Rash and pyrexia (correct)
  • Decreased heart rate
  • Regular breathing pattern
  • Elevated blood glucose levels

    • In managing a patient with seizures, what does the principle of 'The First, The Worst or The Longest' imply?

    <p>Seizures that are first in occurrence, most severe, or longest in duration should be transported</p> Signup and view all the answers

    What does Meningococcal Disease primarily refer to?

    <p>A bacterial infection of the meninges or bloodstream</p> Signup and view all the answers

    What is the Glasgow Coma Scale (GCS) score indicative of a coma?

    <p>GCS of 8 or below</p> Signup and view all the answers

    Which of the following conditions is NOT a potential cause of coma or reduced level of consciousness?

    <p>Severe head injury</p> Signup and view all the answers

    In the context of time-critical assessment of a patient, what does 'ABCD' primarily refer to?

    <p>Airway, Breathing, Circulation, Disability</p> Signup and view all the answers

    What is the first step to take if meningococcal septicaemia is suspected?

    <p>Transport to hospital as soon as practicable</p> Signup and view all the answers

    Which of the following is considered a supportive management approach for coma?

    <p>Maintaining airway and vital sign monitoring</p> Signup and view all the answers

    Which assessment tool is essential for documenting the patient's consciousness level?

    <p>Glasgow Coma Scale</p> Signup and view all the answers

    What is a critical condition that can result from hypovolaemia?

    <p>Cardiac arrhythmias</p> Signup and view all the answers

    Which of the following is a necessary step in the assessment of a time-critical patient?

    <p>Reassessing the patient regularly</p> Signup and view all the answers

    What is the significance of a non-blanching rash in an unwell patient?

    <p>It suggests meningococcal septicaemia.</p> Signup and view all the answers

    Which symptom is NOT a part of the primary survey assessment for meningitis?

    <p>Skin temperature</p> Signup and view all the answers

    What should be done if a patient presents with an acute airway difficulty?

    <p>Manage the airway as a time-critical issue.</p> Signup and view all the answers

    How many patients are estimated to be affected by meningitis each year?

    <p>1200 patients</p> Signup and view all the answers

    What is NOT considered a major problem in a time-critical patient assessment?

    <p>Abdominal pain</p> Signup and view all the answers

    Which of the following is a respiratory assessment finding in a patient with suspected meningitis?

    <p>Increased respiratory rate</p> Signup and view all the answers

    Which condition is suggested by the presence of photophobia in a patient?

    <p>Meningitis</p> Signup and view all the answers

    What condition could be excluded if a non-blanching rash is absent in a patient?

    <p>Meningococcal disease</p> Signup and view all the answers

    What is the most likely result of not receiving prompt treatment at a Hyper Acute Stroke Component?

    <p>Increased long-term disability</p> Signup and view all the answers

    Which of the following conditions is indicated by a positive FAST test?

    <p>Major ABC problem</p> Signup and view all the answers

    What is a key characteristic of generalized convulsions?

    <p>Altered level of consciousness</p> Signup and view all the answers

    What is the recommended patient position during a neurological emergency?

    <p>Comfortable position</p> Signup and view all the answers

    What is the primary focus of management during a convulsion?

    <p>Airway protection and ventilation assistance</p> Signup and view all the answers

    Which type of convulsion encompasses staring episodes and may include repetitive actions such as eye blinking?

    <p>Absence seizures</p> Signup and view all the answers

    In what scenario should oxygen therapy be administered to a stroke patient?

    <p>When the patient exhibits hypoxia (SPO₂ &lt; 94%)</p> Signup and view all the answers

    What is the term used to describe the tendency to have recurrent unprovoked convulsions?

    <p>Epilepsy</p> Signup and view all the answers

    What phase of bilateral tonic-clonic seizures involves body-wide rigidity?

    <p>Tonic phase</p> Signup and view all the answers

    What is the most important thing to do regarding the patient's diet during a neurological emergency?

    <p>Ensure the patient remains Nil By Mouth</p> Signup and view all the answers

    What is the primary treatment for Parkinson's disease?

    <p>Medication and physiotherapy</p> Signup and view all the answers

    Which of the following conditions is primarily characterized by damage to nerve impulses in the brain and spinal cord?

    <p>Multiple Sclerosis</p> Signup and view all the answers

    What is a common effect of a Cerebrovascular Event (CVE)?

    <p>Dependence on others for care</p> Signup and view all the answers

    Which statement about dementia is accurate?

    <p>It impairs memory, thinking, and daily life.</p> Signup and view all the answers

    Which risk factor does NOT belong to the non-modifiable group for CVE?

    <p>Diabetes</p> Signup and view all the answers

    What is the immediate action to take if a patient shows ongoing neurological signs during management for a TIA?

    <p>Treat them as a Stroke patient</p> Signup and view all the answers

    In which type of paralysis is both lower limbs affected?

    <p>Paraplegia</p> Signup and view all the answers

    Which neurological condition is primarily hereditary but can develop later in life?

    <p>Ataxia</p> Signup and view all the answers

    What is the primary method used by ambulance crews to assess stroke patients?

    <p>FAST test</p> Signup and view all the answers

    What is the typical duration for symptoms to resolve in a Transient Ischaemic Attack (TIA)?

    <p>Usually within minutes to a few hours</p> Signup and view all the answers

    What is a significant symptom of a cerebrovascular event?

    <p>Numbness and weakness or paralysis</p> Signup and view all the answers

    Which of the following conditions is least likely to require medication for management?

    <p>Cerebrovascular Event</p> Signup and view all the answers

    What is a distinguishing characteristic of hemiplegia?

    <p>Paralysis on one side of the body</p> Signup and view all the answers

    Why is time a critical factor in managing a stroke?

    <p>Affects treatment options and outcomes</p> Signup and view all the answers

    Study Notes

    Neurovascular Conditions Overview

    • Neurovascular conditions encountered in pre-hospital care include Alzheimer’s, Parkinson’s, Multiple Sclerosis, Ataxia, Coma, and CVE.
    • Dementia affects memory and daily life, impacting approximately 850,000 people in the UK, with common risk factors linked to age, genetics, or lifestyle.

    Parkinson's Disease

    • Affects about 1 in 500 people in the UK, primarily impacting men.
    • Symptoms emerge from gradual brain damage; treatment involves medication and physiotherapy.

    Multiple Sclerosis (MS)

    • Affects the brain and spinal cord, disrupting nerve impulse transmission, with over 130,000 cases in the UK.
    • More prevalent in women; management includes medication; no cure exists.

    Ataxia

    • Characterized by balance, coordination, and speech disorders, affecting roughly 1 in 50,000 individuals.
    • Primarily hereditary but can develop later in life; treated with physiotherapy and medication.

    Paralysis

    • Defined as partial or complete loss of muscle function, with various terms describing specific conditions:
      • Monoplegia: paralysis of one limb.
      • Hemiplegia: paralysis of one side of the body.
      • Quadriplegia/Tetraplegia: paralysis of all four limbs.
      • Paraplegia: paralysis of both lower limbs.

    Cerebrovascular Event (CVE)

    • CVEs are the third leading cause of death in England, resulting in 56,000 fatalities annually.
    • Approximately 1 million people in the UK live with CVE effects; half require assistance for daily activities.

    CVE Risk Factors

    • Non-modifiable: age, sex, ethnicity, family history.
    • Modifiable: hypertension, smoking, atrial fibrillation, diabetes, diet, physical activity, alcohol consumption, blood cholesterol, obesity, and history of previous strokes.

    Stroke Characteristics

    • Interrupts blood supply to the brain with rapid onset symptoms lasting for at least 24 hours, potentially caused by a bleed or blockage.

    Transient Ischaemic Attack (TIA)

    • Symptoms resemble a stroke but resolve within 24 hours, often within minutes to a few hours.
    • Annually, 20,000 TIAs occur in England.

    Symptoms of CVE

    • Key symptoms include numbness, weakness or paralysis, slurred speech, blurred vision, confusion, and severe headaches.

    CVE Assessment Protocol

    • Employ the ABCDE method and use the FAST test for stroke diagnosis:
      • Facial weakness
      • Arm weakness
      • Speech impairment
      • Time is critical; treatment time can significantly affect outcomes.

    Importance of Timeliness in CVE Management

    • A substantial loss of neurons occurs within each minute post-stroke.
    • Rapid transport to a Hyper Acute Stroke Unit (HASU) is essential for improving survival and reducing disability.

    CVE Management Options

    • Ensure airway protection, assist with ventilation if necessary, administer oxygen for hypoxia, and maintain a comfortable patient position.
    • Keep the patient Nil By Mouth and provide reassurance to relatives.

    Convulsions and Epilepsy

    • Convulsions are involuntary muscle contractions often associated with altered consciousness.
    • Epilepsy is defined as a tendency for recurrent, unprovoked convulsions, managed primarily through medication.

    Types of Convulsions

    • Generalised convulsions affect large brain areas; partial convulsions target specific cortex regions.
    • Bilateral tonic-clonic seizures involve body rigidity and may indicate underlying issues requiring urgent attention.

    Meningococcal Disease Overview

    • Refers to bacterial infection of the meninges or bloodstream, with around 1,200 patients affected annually in the UK.

    Coma Assessment

    • Defined as a state of unconsciousness with a Glasgow Coma Scale (GCS) of 8 or below; supportive management is often required.

    Causes of Coma

    • Include stroke, convulsions, inadequate airway or respiration, hypoglycemia, hyperglycemia, overdose, and meningitis.

    Assessment Protocol for Coma

    • Conduct thorough assessments focusing on the ABCD problems, document GCS, monitor pupils, and carry out a 12-lead ECG.

    Prioritization in Emergencies

    • Patients in critical condition require immediate hospital transport for assessment and treatment.

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    Description

    This session focuses on the management of neurovascular conditions encountered in pre-hospital care. Key topics include Alzheimer’s, Parkinson’s, cerebrovascular events, and convulsions. Prepare to enhance your knowledge on these critical medical issues.

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