EAC Unconscious and Strokes Flashcards
causes of unconsciousness
Faint Infantile convulsions Shock Head injury Stroke Heart attack Asphyxia Poisoning Epilepsy/Extremes of temperature Diabetes/Drug overdose
rules of dealing with multiple unconscious patient’s
one patient: continue as normal
two patients: proceed with care, keep control informed
three patients: withdraw/isolate yourself, request specialist help
initial management of:
unconscious patient
DRABCDE
check for danger
note obvious signs and position of patient
Speak to patient, apply stimulus to assess AVPU
Ensure open airway
Check breathing
Check pulse
GET A HISTORY! WHO CALLED 999? WHAT DOES EOC KNOW??
define:
Stroke
A condition in which the blood supply to part of the brain is interrupted causing death of brain tissue
previously referred to as a CVA
Often referred to as a Brain Attack
Storkes are normally of sudden onset
They may be preceded by Transient Ischaemic Attacks (TIA)
causes of stroke
Ischaemia - cerebral thrombosis, cerebral embolism
Haemorrhage - cerebral haemorrhage
define:
cerebral thrombosis
A naturally forming clot which builds up over time from the effects of arteriosclerosis
Eventually it will impede or completely occlude a cerebral artery causing infarction and necrosis of brain tissue
define:
cerebral embolism
A mass of solid, liquid or gaseous material that is carried in the blood stream
Eventually it will occlude one of the cerebral arteries causing infarction and necrosis of tissues of brain tissue
causes: AF, recent surgery, DVT’s, oral contraceptives
define:
cerebral haemorrhage
This is the rupture of a cerebral blood vessel with resultant infarction and necrosis of brain tissue
often occurs in the patient who suffers from long term hypertension
high risk groups for Stroke
The elderly Patients with circulatory disorders Patients with high blood pressure Smoking Obesity AF
signs and symptoms of:
Stroke
Slow and full pulse Flushed and warm skin Noisy breathing/snoring (stertorous) Possible unequal pupils - dilated on affected side of brain Seizure Confusion, reduced LoC Possible loss of consciousness Incontinence and vomiting Aggressive or agitated behaviour Headache Hypertension Inability to understand/communicate
FAST
Face: facial droop
Arms: ask pt to lift arms and observe for obvious weakness and/or drift
Speech: Aphasia (inability (or impaired ability) to understand or produce speech)
Time: time critical
management of:
Stroke
Primary/Secondary survey O2 where indicated Check BM Reassurance to pt and relatives Be prepared for LOC Be prepared to manage secretions if pt cant swallow Constantly monitor vital signs time critical transfer HASU
Storke Care Bundle
Initial set of obs
Time of onset
BM
If >4.5 hours normal driving to HASU
patient positioning:
Stroke
Conscious: semi-recumbent with the head and shoulders both slightly raised
Unconscious: stable side with the paralysed side uppermost so as to avoid pressure on injured side
Stroke in children
True stroke rare in children
FAST+ in children usually due to seizure
