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Questions and Answers
What should a senior clinician check immediately if a patient is convulsing?
What should a senior clinician check immediately if a patient is convulsing?
- Blood glucose level (correct)
- Body mass index
- Blood pressure
- Respiratory rate
Convulsions can be a sign of an underlying infection.
Convulsions can be a sign of an underlying infection.
True (A)
What phrase summarizes which patients should be transferred to the hospital?
What phrase summarizes which patients should be transferred to the hospital?
The First, The Worst or the Longest
Meningococcal disease is a general term used for bacterial infection of the ________ or infection of the bloodstream.
Meningococcal disease is a general term used for bacterial infection of the ________ or infection of the bloodstream.
Match the following conditions with their corresponding description:
Match the following conditions with their corresponding description:
What is the largest cause of disability following a stroke?
What is the largest cause of disability following a stroke?
Prompt treatment at a Hyper Acute Stroke Component (HASU) is crucial to save lives and reduce long-term disability.
Prompt treatment at a Hyper Acute Stroke Component (HASU) is crucial to save lives and reduce long-term disability.
What is meant by a 'positive FAST test'?
What is meant by a 'positive FAST test'?
Patients should remain __________ by mouth to prevent aspirations.
Patients should remain __________ by mouth to prevent aspirations.
Which of these is an option for managing a patient with convulsions?
Which of these is an option for managing a patient with convulsions?
What term describes the tendency to have recurrent unprovoked convulsions?
What term describes the tendency to have recurrent unprovoked convulsions?
Partial convulsions affect a larger part of the cerebral cortex compared to generalized convulsions.
Partial convulsions affect a larger part of the cerebral cortex compared to generalized convulsions.
Absence seizures are characterized by __________ episodes.
Absence seizures are characterized by __________ episodes.
Match the types of convulsions to their descriptions:
Match the types of convulsions to their descriptions:
What should caregivers do when transporting a patient who is TIME CRITICAL?
What should caregivers do when transporting a patient who is TIME CRITICAL?
What characterizes status epilepticus?
What characterizes status epilepticus?
A patient may experience the post-ictal phase after losing consciousness during a tonic-clonic convulsion.
A patient may experience the post-ictal phase after losing consciousness during a tonic-clonic convulsion.
What might a patient experience during partial convulsions?
What might a patient experience during partial convulsions?
Continuous convulsions lasting five minutes or longer are known as __________.
Continuous convulsions lasting five minutes or longer are known as __________.
Match the following causes of seizures with their descriptions:
Match the following causes of seizures with their descriptions:
What action should you take if the patient is actively convulsing?
What action should you take if the patient is actively convulsing?
All seizures are caused by epilepsy.
All seizures are caused by epilepsy.
What is the primary survey tool used to assess a patient's level of consciousness?
What is the primary survey tool used to assess a patient's level of consciousness?
In the primary survey, if the patient's airway is blocked, it may be caused by __________.
In the primary survey, if the patient's airway is blocked, it may be caused by __________.
Which of the following might NOT be a part of the convulsion assessment?
Which of the following might NOT be a part of the convulsion assessment?
How many patients are estimated to be affected by meningitis per year?
How many patients are estimated to be affected by meningitis per year?
A non-blanching rash is always present in patients with meningococcal disease.
A non-blanching rash is always present in patients with meningococcal disease.
List one of the primary survey assessments for a patient in severe condition.
List one of the primary survey assessments for a patient in severe condition.
A non-blanching rash suggests __________________ in an unwell patient.
A non-blanching rash suggests __________________ in an unwell patient.
Match the following assessment conditions with their corresponding problems:
Match the following assessment conditions with their corresponding problems:
In which situation will a patient be considered TIME CRITICAL?
In which situation will a patient be considered TIME CRITICAL?
Temperature changes and gastrointestinal symptoms are relevant assessments in patients with meningitis.
Temperature changes and gastrointestinal symptoms are relevant assessments in patients with meningitis.
What kind of rash suggests meningococcal septicaemia?
What kind of rash suggests meningococcal septicaemia?
What GCS score indicates a patient is in a coma?
What GCS score indicates a patient is in a coma?
All causes of coma can be identified in every patient.
All causes of coma can be identified in every patient.
What is one possible cause of coma related to a metabolic issue?
What is one possible cause of coma related to a metabolic issue?
In cases of meningococcal septicaemia, you should transport the patient to hospital as soon as __________.
In cases of meningococcal septicaemia, you should transport the patient to hospital as soon as __________.
Match the following conditions with their potential causes:
Match the following conditions with their potential causes:
Which of the following is NOT a cause of reduced level of consciousness?
Which of the following is NOT a cause of reduced level of consciousness?
What should be documented during the assessment of a patient with coma?
What should be documented during the assessment of a patient with coma?
A thorough secondary survey is unnecessary if ABCD problems are present.
A thorough secondary survey is unnecessary if ABCD problems are present.
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Study Notes
Stroke Management
- 1.9 million neurons are lost every minute during a stroke.
- Most individuals survive their first stroke; however, it remains the leading cause of disability worldwide.
- Immediate care at a Hyper Acute Stroke Unit (HASU) can significantly save lives and lessen long-term disability risk.
Time-Critical Conditions
- A patient is TIME CRITICAL if they exhibit:
- Major airway, breathing, or circulation problems; transport to the nearest Emergency Department (ED) is essential.
- Positive FAST test results, necessitating immediate transfer to HASU.
Stroke Management Options
- Focus on airway protection and assist ventilation if respiratory rate is abnormal (<10 or >30 breaths per minute).
- Administer oxygen therapy only when SpOâ‚‚ is below 94%.
- Position patient comfortably and maintain nil by mouth status.
- Provide reassurance and inform relatives about transport details.
Convulsions Overview
- Convulsions involve involuntary muscle contractions and can result in altered consciousness.
- They are often linked with various serious conditions and require prompt assessment.
Epilepsy Information
- Defined as recurrent unprovoked convulsions; exact causes remain under study.
- Many patients manage symptoms effectively with medication, while others face difficulties.
- It can impede cognitive development, especially in children.
Types of Convulsions
- Generalised convulsions affect a large portion of the cerebral cortex.
- Partial convulsions are localized but can evolve into generalized seizures.
Generalised Convulsions
- Absences: short episodes characterized by daydreaming or staring, typically lasting a few seconds.
- Bilateral tonic-clonic seizures (BTCS): involve a tonic (rigid) phase followed by clonic (jerking) movements, with loss of consciousness and a prolonged recovery phase.
Partial Convulsions
- Can be accompanied by various states of consciousness, behavioral changes, or localised tonic-clonic activity.
- May progress to generalized convulsions.
Status Epilepticus
- Continuous seizures lasting more than 5 minutes.
- Occurrence of three or more seizures in one hour without recovery intervals.
Causes of Seizures
- Not all seizures are due to epilepsy. Potential causes include:
- Hypoxia, hypoglycemia, infections, alcohol, drugs, stroke, arrhythmias, eclampsia, and tumors.
Convulsion Assessment
- Assess if a patient is actively convulsing, in a post-ictal phase, or has recovered.
- Difficulties may arise in assessments while a patient is convulsing.
Primary Survey Steps
- Response: Use AVPU scale to determine consciousness level; call for backup if actively convulsing.
- Airway: Check for trismus or tongue injury; avoid OP airway in convulsing patients.
- Breathing: Monitor ventilation; use ETCOâ‚‚ for assessment and provide supplemental oxygen as needed.
- Circulation: Assess capillary refill and skin condition; expect tachycardia.
- Disability: Monitor responsiveness and check for potential hypoglycemia.
- Expose: Look for injuries, infections, and protect patient dignity.
Convulsion Management
- Time-critical conditions include any major ABC issues, serious head injuries, status epilepticus, or signs of infection.
- Ensure rapid transport to hospital and reassess en route.
Meningococcal Disease
- A bacterial infection affecting the meninges or bloodstream, impacting around 1200 patients annually.
- Evaluate for rashes, especially non-blanching ones indicative of meningococcal septicaemia.
Coma Overview
- Characterized by absence of consciousness and defined as GCS of 8 or below.
- Management is primarily supportive, though some causes may be treatable.
Possible Causes of Coma
- Conditions contributing to reduced consciousness include:
- Stroke, inadequate airway, seizures, hypoglycemia/hyperglycemia, overdose, meningitis, and others.
Assessment in Coma and Emergencies
- Conduct comprehensive vital signs assessment, document GCS, evaluate pupils, and perform a thorough secondary survey to identify reversible causes.
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