Medical Emergencies Three Study Guide.docx

1. ALOC a. Central nervous system has been affected in some manner, it's your responsibility to figure out how (use AEIOUTIPS!) b. Significant indication of some kind of injury or illness 2. AEIOUTIPS! c. This is the S of SAMPLE on a patient with ALOC. (S of SAMPLE for...

1. ALOC a. Central nervous system has been affected in some manner, it's your responsibility to figure out how (use AEIOUTIPS!) b. Significant indication of some kind of injury or illness 2. AEIOUTIPS! c. This is the S of SAMPLE on a patient with ALOC. (S of SAMPLE for an [alert medical] [patient] would be OPQRST, BUT since a patient with [ALOC can't talk to you normally], do a rapid physical exam looking for AEIOUTIPS) d. Alcohol (smell alcohol? Bottles lying around?) e. Epilepsy (Bit tongue/bloody mouth, incontinence) f. Insulin (check blood sugar) g. Overdose/Underdose (pupil assessment, paraphernalia lying around?) h. Uremia (recent infection) i. Trauma (trauma) j. Infection (recent infection, antibiotics) k. Psychological (history, what was the onset of symptoms? Fast onset, look for other causes) l. Stroke (Cincinnati stroke scale) 3. Stroke m. Used to be known as a cerebral vascular accident (CVA) n. Two types i. Ischemic 1. Much more common 2. Similar patho to a myocardial infarction, just in a cerebral artery instead of a coronary artery ii. Hemorrhagic 3. Burst of an artery in the brain 4. Aneurysm 5. Complains of the worst headache in their life! o. TIA iii. Transient Ischemic Attack 6. Mini stroke? 7. Stroke like symptoms that resolve a. Usually resolve within the hour (poss even 15 minutes) b. Diagnosed as a TIA if the patient then remains symptom free for 24 hours 8. Major precursor for a full blown stroke in the future 4. Stroke assessment p. When was the last time seen normal? iv. This is THE MOST IMPORTANT QUESTION v. Must deliver to a stroke center hospital within 9. 3 hours per NR 10. 6 hours in SD County q. Cincinnati Stroke Scale vi. Arm drift vii. Facial droop viii. Slurred speech 5. Seizures r. Define seizures s. Understand primary vs secondary seizures 6. Define status epilepticus t. Generalized seizure lasting longer than 5 minutes, OR recurrent seizures without a lucid interval 7. Know and differentiate the following types of seizures u. Generalized / Grand Mal (know the stages too!) v. Absence / Petite Mal w. Febrile x. Simple partial y. Complex partial 8. What do we do while a patient is seizing? 9. What is our assessment and treatment during the postictal phase? 10. Syncope z. Define a. Causes b. When do patients normally regain consciousness after a syncopal episode?