Lesson 18: Stroke

When assessing a patient with a possible stroke, what should you check first?

Airway

Law enforcement has summoned you to a nightclub, where a 22 year old female was found unconscious in an adjacent alley. your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should:

Assist ventilations, perform a rapid exam, and prepare for immediate transport

A 29 year old male complains of a sever headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seems to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min. Treatments should include.

Dimming the lights in the back of the ambulance and transporting without lights and siren.

What are the three assessments that comprise the Cincinnati Prehospital Stroke Scale?

Facial droop, arm drift, speech

What is the most significant risk factor for a hemorrhagic stroke?

Hypertension

A 55 year old male is exhibiting signs of a stroke, including difficulty understanding what you are asking him. What is this type of aphasia called?

Receptive

You are assessing a 49 year old man who, according to his wife, experienced a sudden, severe headache and then passed out. he is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg, and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:

Ruptured cerebral artery

Which of the following symptoms would lead the EMT to believe that a patient's headache is caused by sinus congestion?

The pain is worse when bending over

A 75 year old female has left side weakness and facial droop that resolve on their own in less than 24 hours. Vital signs are BP 180/110 , P 88, R 18, and SpO2 96%. What should you suspect?

Transient ischemic attack

A patient with slurred speech is sitting slumped over to one side and showing one sided facial drooping. Which question is most important to ask?

When did the symptoms start?