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Questions and Answers
What is a potential presenting sign of hypoglycaemia?
What is a potential presenting sign of hypoglycaemia?
- Severe headache
- Loss of consciousness
- Hypotension
- Convulsion (correct)
What should be prioritized in the management of a patient convulsing with a suspected significant head injury?
What should be prioritized in the management of a patient convulsing with a suspected significant head injury?
- Administering glucose immediately
- Monitoring the patient for signs of bacterial infection
- Encouraging the patient to drink fluids
- Transporting the patient to hospital without delay (correct)
Which condition is considered time-critical when managing convulsions?
Which condition is considered time-critical when managing convulsions?
- Chronic pain
- Heart condition
- Psychological disorder
- Underlying infection (correct)
In managing a patient with convulsions, which factor would NOT necessitate immediate hospital transfer?
In managing a patient with convulsions, which factor would NOT necessitate immediate hospital transfer?
What does the term 'Meningococcal Disease' refer to?
What does the term 'Meningococcal Disease' refer to?
What is the primary goal of prompt treatment at a Hyper Acute Stroke Component (HASU)?
What is the primary goal of prompt treatment at a Hyper Acute Stroke Component (HASU)?
Which vital sign indicates the need for oxygen therapy in a patient?
Which vital sign indicates the need for oxygen therapy in a patient?
What characterizes a generalised convulsion?
What characterizes a generalised convulsion?
How should a patient suffering from a stroke be positioned while awaiting transport?
How should a patient suffering from a stroke be positioned while awaiting transport?
What is a key characteristic of absences in generalised convulsions?
What is a key characteristic of absences in generalised convulsions?
What is the most critical reason for keeping a stroke patient Nil By Mouth?
What is the most critical reason for keeping a stroke patient Nil By Mouth?
Which of the following is NOT a component of the management options for a CVE patient?
Which of the following is NOT a component of the management options for a CVE patient?
What is the definition of epilepsy based on the content provided?
What is the definition of epilepsy based on the content provided?
What significant impact can epilepsy have on children specifically?
What significant impact can epilepsy have on children specifically?
Which type of convulsion might progress from a localized area to a generalized state?
Which type of convulsion might progress from a localized area to a generalized state?
What does a non-blanching rash in an unwell patient typically indicate?
What does a non-blanching rash in an unwell patient typically indicate?
Which symptom is not part of the primary assessment for a patient with suspected meningitis?
Which symptom is not part of the primary assessment for a patient with suspected meningitis?
What are the potential circulation problems noted in patients with meningitis?
What are the potential circulation problems noted in patients with meningitis?
In the context of meningitis assessment, what does 'E' stand for in the ABCDE approach?
In the context of meningitis assessment, what does 'E' stand for in the ABCDE approach?
What factors make a patient TIME CRITICAL when assessing for meningitis?
What factors make a patient TIME CRITICAL when assessing for meningitis?
Which of the following symptoms may indicate a neurological problem in a meningitis patient?
Which of the following symptoms may indicate a neurological problem in a meningitis patient?
What is a characteristic of the clonic phase during a tonic-clonic convulsion?
What is a characteristic of the clonic phase during a tonic-clonic convulsion?
What common gastrointestinal symptoms might accompany meningitis?
What common gastrointestinal symptoms might accompany meningitis?
In partial convulsions, which statement is true regarding consciousness?
In partial convulsions, which statement is true regarding consciousness?
How many patients are typically affected by meningitis each year?
How many patients are typically affected by meningitis each year?
What defines status epilepticus?
What defines status epilepticus?
Which of the following is NOT a potential cause of seizures?
Which of the following is NOT a potential cause of seizures?
In the primary survey of a patient experiencing a convulsion, what should not be done when the patient is actively convulsing?
In the primary survey of a patient experiencing a convulsion, what should not be done when the patient is actively convulsing?
During a post-ictal phase, which symptom might be observed in the patient?
During a post-ictal phase, which symptom might be observed in the patient?
What should be monitored to assess ventilations during a seizure?
What should be monitored to assess ventilations during a seizure?
Which sign indicates possible blood loss or injury in a seizure patient?
Which sign indicates possible blood loss or injury in a seizure patient?
What assessment tool should be used to evaluate the patient's response during a seizure?
What assessment tool should be used to evaluate the patient's response during a seizure?
When assessing circulation in a seizure patient, which factor is expected?
When assessing circulation in a seizure patient, which factor is expected?
What is the appropriate action to take if there is a suspicion of meningococcal septicaemia?
What is the appropriate action to take if there is a suspicion of meningococcal septicaemia?
Which of the following is NOT a possible cause of coma or reduced consciousness?
Which of the following is NOT a possible cause of coma or reduced consciousness?
What does a Glasgow Coma Scale (GCS) score of 8 or below indicate?
What does a Glasgow Coma Scale (GCS) score of 8 or below indicate?
What initial assessment is critical if there is an ABCD problem in a patient?
What initial assessment is critical if there is an ABCD problem in a patient?
Which of the following statements about coma management is true?
Which of the following statements about coma management is true?
In what scenario should the ambulance crew assess for a reversible cause of coma?
In what scenario should the ambulance crew assess for a reversible cause of coma?
What is a sign that a patient's condition is time critical?
What is a sign that a patient's condition is time critical?
Which of the following should always be included in the secondary survey for a patient in coma?
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 SPOâ‚‚ 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.
- 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 ETCOâ‚‚ 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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