Questions and Answers
What is a potential presenting sign of hypoglycaemia?
What should be prioritized in the management of a patient convulsing with a suspected significant head injury?
Which condition is considered time-critical when managing convulsions?
In managing a patient with convulsions, which factor would NOT necessitate immediate hospital transfer?
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What does the term 'Meningococcal Disease' refer to?
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What is the primary goal of prompt treatment at a Hyper Acute Stroke Component (HASU)?
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Which vital sign indicates the need for oxygen therapy in a patient?
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What characterizes a generalised convulsion?
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How should a patient suffering from a stroke be positioned while awaiting transport?
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What is a key characteristic of absences in generalised convulsions?
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What is the most critical reason for keeping a stroke patient Nil By Mouth?
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Which of the following is NOT a component of the management options for a CVE patient?
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What is the definition of epilepsy based on the content provided?
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What significant impact can epilepsy have on children specifically?
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Which type of convulsion might progress from a localized area to a generalized state?
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What does a non-blanching rash in an unwell patient typically indicate?
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Which symptom is not part of the primary assessment for a patient with suspected meningitis?
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What are the potential circulation problems noted in patients with meningitis?
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In the context of meningitis assessment, what does 'E' stand for in the ABCDE approach?
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What factors make a patient TIME CRITICAL when assessing for meningitis?
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Which of the following symptoms may indicate a neurological problem in a meningitis patient?
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What is a characteristic of the clonic phase during a tonic-clonic convulsion?
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What common gastrointestinal symptoms might accompany meningitis?
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In partial convulsions, which statement is true regarding consciousness?
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How many patients are typically affected by meningitis each year?
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What defines status epilepticus?
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Which of the following is NOT a potential cause of seizures?
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In the primary survey of a patient experiencing a convulsion, what should not be done when the patient is actively convulsing?
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During a post-ictal phase, which symptom might be observed in the patient?
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What should be monitored to assess ventilations during a seizure?
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Which sign indicates possible blood loss or injury in a seizure patient?
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What assessment tool should be used to evaluate the patient's response during a seizure?
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When assessing circulation in a seizure patient, which factor is expected?
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What is the appropriate action to take if there is a suspicion of meningococcal septicaemia?
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Which of the following is NOT a possible cause of coma or reduced consciousness?
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What does a Glasgow Coma Scale (GCS) score of 8 or below indicate?
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What initial assessment is critical if there is an ABCD problem in a patient?
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Which of the following statements about coma management is true?
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In what scenario should the ambulance crew assess for a reversible cause of coma?
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What is a sign that a patient's condition is time critical?
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Which of the following should always be included in the secondary survey for a patient in coma?
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Study Notes
Stroke and Neurovascular Conditions
- 1.9 million neurons are destroyed every minute during a stroke.
- Stroke is the leading cause of disability, although many survive the initial event.
- Prompt treatment at a Hyper Acute Stroke Unit (HASU) saves lives and reduces long-term disability.
CVE Assessment
- Patients exhibit TIME CRITICAL signs if:
- Significant ABC issues necessitate nearest emergency department transport.
- A positive FAST (Face, Arms, Speech, Time) test indicates immediate transport to HASU.
- Continuous assess patient en route to appropriate facility.
CVE Management Options
- Airway protection and assist with ventilation if respiratory rate is <10 or >30.
- Oxygen therapy is required only if SPO₂ is <94%.
- Maintain patient comfort in a suitable position and ensure they are Nil By Mouth.
- Provide reassurance to patients and inform relatives of transport details.
Convulsions and Seizures
- Convulsions involve involuntary muscle contractions and alterations in consciousness.
- Epilepsy refers to the recurrent occurrence of unprovoked convulsions, affecting cognitive development in children.
Types of Convulsions
- Generalised Convulsions: Involve large areas of the cerebral cortex.
- Partial Convulsions: Affect localized cortical areas but may progress to generalised.
Generalised Convulsions
- Absence Seizures: Brief episodes of staring or daydreaming with immediate recovery.
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Bilateral Tonic-Clonic Seizures (BTCS):
- Tonic phase features body rigidity and loss of consciousness.
- Clonic phase involves rhythmic jerking, potential incontinence, and a prolonged post-ictal recovery phase.
Partial Convulsions
- Symptoms vary based on location in the cortex:
- May include consciousness alteration, repetitive actions, and localized clonic activity.
Status Epilepticus
- Defined as continuous convulsions lasting 5 minutes or longer, or a succession of multiple convulsions without recovery.
Causes of Seizures
- Diverse causes unrelated to epilepsy include:
- Hypoxia, kidney failure, hypoglycaemia, systemic infections, alcohol, tumors, stroke, and more.
Convulsion Assessment
- Assessment may include an actively convulsing patient, one in post-ictal phase, or a recovered individual.
- In 80% of cases, seizures resolve within 10 minutes.
Primary Survey for Convulsions
- Response: Assess using AVPU scale for consciousness level.
- Airway: Trismus and potential tongue-biting complicate assessment.
- Breathing: Monitor with ETCO₂ if available; administer oxygen as needed.
- Circulation: Check for capillary refill, skin condition; expect tachycardia.
- Disability: Evaluate AVPU again; consider possible hypoglycaemia.
- Expose: Look for medical alerts and signs of infection.
Convulsions Management
- TIME CRITICAL if:
- Major ABCD problems, serious head injury, status epilepticus, or signs of underlying infections.
- Transport to hospital while maintaining ongoing assessment.
Meningococcal Disease
- Represents bacterial infections of the meninges or bloodstream, impacting around 1200 patients annually.
Meningitis Assessment
- Key signs include reduced response, airway difficulties, breathing compromise, and neurological issues.
- Non-blanching rashes are indicators of meningococcal septicaemia.
Coma
- Defined by an absence of consciousness and loss of responsiveness, typically characterized by a GCS of 8 or below.
- Supportive management is essential; identify and rectify reversible causes where possible.
Causes of Coma
- Factors that can lead to reduced levels of consciousness include:
- Stroke, inadequate airway or respiration, hypoglycaemia, overdose, meningitis, and raised ICP.
Timeliness of Critical Care
- Any ABCD problems indicative of Time Critical situations require immediate and comprehensive assessments, including vital signs and secondary surveys.
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Description
This quiz addresses crucial knowledge about the management of neurovascular conditions, emphasizing the urgency of treatment during a stroke. It covers concepts about neuron destruction, stroke prevention, and the importance of rapid response to reduce disability. Gain insights on best practices for handling neurovascular emergencies.
