Neurologic Emergencies

Learning objectives (22)

1. Define a general seizure, focal-onset seizure, and status epilepticus; include how they differ from each other and their effects on patients — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
2. Define altered mental status; include possible causes and the patient assessment considera- tions that apply to each — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
3. Demonstrate how to use a stroke assessment tool such as the Cincinnati Prehospital Stroke Scale, 3-Item Stroke Severity Scale (LAG), or BE-FAST mnemonic to test a patient for aphas — Knowledge/skills objective (printed page 724); confirm wording in your course copy.
4. Describe how the different stages of a seizure are characterized — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
5. Describe the anatomy, physiology, and functions of the brain and spinal cord — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
6. Describe the process of history taking for a patient who is experiencing a neurologic emergency and how this process varies depending on the nature of the patient’s illness — Knowledge/skills objective (printed page 724); confirm wording in your course copy.
7. Discuss scene safety considerations when responding to a patient with a neurologic emergency — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
8. Discuss the causes, similarities, and differences of an ischemic stroke, hemorrhagic stroke, and transient ischemic attack — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
9. Discuss the different types of headaches, the possible causes of each, and how to distinguish a harmless headache from a potentially life- threatening condition — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
10. Discuss the importance for EMTs to recognize when a seizure is occurring or whether one has already occurred in a patient — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
11. Explain how to use stroke assessment tools to rapidly identify a stroke patient; include two commonly used tools — Knowledge/skills objective (printed page 724); confirm wording in your course copy.
12. Explain the care, treatment, and transport of patients who are experiencing headaches, stroke, seizure, and altered mental status — Knowledge/skills objective (printed page 724); confirm wording in your course copy.
13. Explain the concept of a stroke alert and the important time frame for the most successful treatment outcome for a patient who is suspected of having a stroke — Knowledge/skills objective (printed page 724); confirm wording in your course copy.
14. Explain the postictal state and the specific patient care interventions that may be necessary — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
15. Explain the primary assessment of a patient who is experiencing a neurologic emergency and the necessary interventions that may be required to address all life threats — Knowledge/skills objective (printed page 724); confirm wording in your course copy.
16. Explain the secondary assessment of a patient who is experiencing a neurologic emergency — Knowledge/skills objective (printed page 724); confirm wording in your course copy.
17. Explain the special considerations required for geriatric patients who are experiencing a neurologic emergency — Knowledge/skills objective (printed page 724); confirm wording in your course copy.
18. Explain the special considerations required for pediatric patients who exhibit altered mental status — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
19. Explain the various ways blood flow to the brain may be interrupted and cause a cerebrovascular accident — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
20. List the general signs and symptoms of stroke and how those symptoms manifest if the left hemisphere of the brain is affected and if the right hemisphere of the brain is affected — Knowledge/skills objective (printed page 723); confirm wording in your course copy.
21. List the key information EMTs must obtain and document for a stroke patient during assessment and reassessment — Knowledge/skills objective (printed page 724); confirm wording in your course copy.
22. List three conditions with symptoms that mimic stroke and the assessment techniques EMTs may use to identify them — Knowledge/skills objective (printed page 723); confirm wording in your course copy.

Vocabulary (14)

Stroke

A sudden loss of brain function caused by interrupted blood supply — either a blocked artery (ischemic) or bleeding in the brain (hemorrhagic).

Ischemic stroke

A stroke caused by a blockage in an artery supplying the brain, often by a clot; accounts for the majority of strokes.

Hemorrhagic stroke

A stroke caused by bleeding into or around the brain when a blood vessel ruptures.

Transient ischemic attack (TIA)

A brief episode of stroke-like symptoms caused by temporary reduced blood flow to the brain, usually lasting less than an hour with no lasting damage — often a warning of future stroke.

Seizure

A sudden burst of uncontrolled electrical activity in the brain that can cause changes in movement, sensation, behavior, or consciousness.

Status epilepticus

Continuous seizure activity lasting longer than five minutes, or two or more seizures without recovery of consciousness between them — a medical emergency.

Postictal state

The period of altered consciousness, confusion, fatigue, or focal weakness immediately following a seizure.

Aura

A subjective warning sensation — visual, sensory, or other — that some people experience just before a seizure or migraine.

Aphasia

Loss of the ability to understand or produce spoken or written language, often resulting from a stroke affecting the brain's language areas.

Hemiparesis

Weakness on one side of the body, commonly seen after a stroke affecting the opposite cerebral hemisphere.

FAST

A stroke-recognition mnemonic — Face drooping, Arm weakness, Speech difficulty, Time to call 911.

Glasgow Coma Scale (GCS)

A standardized 3-to-15 score of a patient's level of consciousness based on eye-opening, verbal, and motor responses.

Syncope

A temporary loss of consciousness from a brief reduction in blood flow to the brain; commonly called fainting.

Strokes

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