blackouts, head injury and impaired conscious level

Question 1

what happens when you black out?

Answer 1

temporary loss of consciousness- SYNCOPE

Question 2

what are common cardiovascular blackout causes?

Answer 2

• vasovagal attack (faint- bp drops)
  -postural hypotension (stand up- bp drops)
  -cardiac arrhythmias (fast hr slow hr)
  -aortic stenosis
  -carotid sinus hypersensitivity (turning head)

Question 3

what are common neurological blackout causes?

Answer 3

-transient ischaemic attack (precursor to stroke)
-epileptic seizure

Question 4

what is a common metabolic blackout cause?

Answer 4

-hypoglycaemia (low blood sugar)

Question 5

what is a vasovagal attack commonly known as?

Answer 5

a faint

Question 6

what are the prodromal (pre) symptoms of a vasovagal attack?

Answer 6

• feeling faint
  -nausea
  -visual problems (visual fields closing in)

Question 7

what are the signs of a vasovagal attack?

Answer 7

-transient loss of consciousness
-pallor (pale)

Question 8

what causes a vasovagal attack?

Answer 8

-low bp and low hr

Question 9

how long does a vasovagal attack normally last

Answer 9

around 2 mins

Question 10

what should you do if someone has a vasovagal attack?

Answer 10

-lie flat
-elevate legs to increase venous return

Question 11

how does postural hypotension occur?

Answer 11

bp drops when standing (normally increases when standing)

Question 12

what group of people does hypotension normally occur in? and how would you diagnose?

Answer 12

-elderly
-take blood pressure lying down and standing up and compare

Question 13

what type of injury has a high mortality and morbidity?

Answer 13

head injury

Question 14

what group of people are most commonly affected by head injuries?

Answer 14

-elderly as they fall easily

Question 15

what is essential to do if a person suffers a head injury?

Answer 15

assess the loss of consciousness using the Glasgow coma scale to recognise a deteriorating patient

Question 16

how do you assess conscious level 1?

Answer 16

glasgow coma scale

Question 17

what are the 3 domains of the GCS and what are the minimum/maximum scores?

Answer 17

• eye opening -motor response-verbal response
  3 (worse)- 15(better)

Question 18

how do you assess conscious level 2?

Answer 18

avpcu

Question 19

what are the metabolic causes of impaired consciousness?

Answer 19

hypoglycaemia- low blood sugar- ALWAYS check blood glucose level
hypoxia- not enough o2- check 02 saturation (should be 95-100%)
hypercapnia- too much co2 in blood
hypothyroidism- not enough hormone produced
hypercalcaemia- too much calcium-weakens bones/kidney stones
hyponatraemia- low sodium levels

Question 20

what are examples of impaired consciousness due to infection?

Answer 20

brain- encephalitis, meningitis and malaria
bacterial infections causing sepsis

Question 21

what sort of drugs can cause impaired consciousness?

Answer 21

-alcohol
-opiates
-recreational drugs
-any sedating drugs in overdose- opiates, tranquilisers, anti-depressants

Question 22

what is the clinical approach to impaired consciousness?

Answer 22

abcde
identify cause
treat cause

Question 23

what is assessed with abcde

Answer 23

a- airways- obstruction?
b- breathing- 02 saturation
c-circulation hr and bp
d-disability- glucose levels- ggc and avpcu
e-exposure- temp/rash etc

Question 24

what is the normal 02 saturation levels

Answer 24

95-100%

Question 25

what would the max saturation level be of someone with copd?

Answer 25

88-92%

Question 26

what does NEWS stand for and what does it check?

Answer 26

national early warning signs- hr, rr, bp, o2 sat, temp

Question 27

what is the normal respiratory rate?

Answer 27

12-20 breaths/min

Question 28

what is the normal systolic blood pressure?

Answer 28

90-120

Question 29

what is the normal heart rate range?

Answer 29

60-100 bpm

Question 30

what would you give someone if they had an overdose of sedation medication?

Answer 30

antidotes