Module 3 Flashcards
Causes of Altered Mental Status (AMS)
-Altered mental status can be a life-threating emergency. Do not delay calling EMS
-AMS can be the result of many different things
~Lack of blood flow to brain, lack of oxygen, lack of sugar, electrolyte abnormalities, brain injury, brain swelling, medications/drugs, infection (sepsis), cardiac emergencies, etc.
-The condition we’ll talk about
~Fainting
~Seizures
~Strokes
~Diabetic Emergencies
Altered Mental Status (AMS)
-Caused by a number of medical conditions/use of alcohol, medications, or drugs
~Significant or unusual change in a person’s personality, behavior, or consciousness
~Indication of a change in brain function
~Warning sign of serious problem and is considered a medical emergency
Altered Mental Status (AMS)
-In case of Altered Mental Status
- Activate EMS
- Position person for comfort
- Calm and reassure as best you can
- Consider recovery position to protect airway if responsiveness becomes severely diminished
- Reassess regularly until another provider or EMS personnel takes over
- Condition could deteriorate quickly and require additional care
Fainting (Syncope, Syncopal Episode, Near-Syncope)
-A momentary loss of consciousness due to unexpected drop in blood pressure and blood flow to the brain, caused by
~Anxiety
~Fear
~Pain
~Stress
~Standing in place too long
~Rapid movement such as standing up quickly
~A MEDICATION OR UNDERLYING MEDICAL CONDITIONS
Fainting
-If someone complains of suddenly feeling warm, lightheaded, or that vision is narrowing
-Quickly lay person flat on his or her back on the ground
-Elevate feet 6-12 inches, allowing blood from legs to move back into body
~DO NOT elevate if it causes pain or you suspect person may be injured
-Fainting is a temporary condition that should pass quickly
-Consider calling EMS
Seizures
- Excessive electrical discharge from one or a group of neurons
- Frequency increase and eventually involves other neurons
- Electrical discharge travels to the brain stem and spinal cord
- Generally categorized as partial or complete
Seizures
-Causes
- Epilepsy
- Fever
- Drugs/ ETOH
- Hypoxia (low oxygen)
- Poisonings: pesticides, plants and/ or chemicals
- Electrolyte abnormalities
- Heat Illness
- head Trauma
- Diabetes
- Genetics
Seizures
-What you need to know
-Usually self-limiting and not life-threatening
-Hypoxia, low blood sugar
-Status Epilepticus
~True Emergency
~More than 5 minutes
~2 or more seizures without regaining consciousness
Seizures
-Typical Seizure Progression
-Aura Phase ~Alterations in smell, taste, vision -Tonic/Clonic Phases ~Stiffening/jerking of the muscles -Postictal Phase ~Unconscious for several minutes, gradually regaining consciousness. Often confused and exhausted
Seizures
-Activate EMS if the person
- Is injured or vomits during the seizure
- Has no history of seizures
- Has multiple seizures or continues to seize from more than 5 minutes
Seizure
-Most seizures last a short time and stop without any special treatment
- Once stopped, place person in recovery position to protect airway
- If responsiveness and breathing is absent, begin CPR and use AED
- Normally, responsiveness improves slowly over time
- Reassure as person improves
- Provide privacy to minimize embarrassment
- DO NOT allow person to preform action that pose rick for additional injury
- Continue to monitor until EMS takes over or person returns to normal
Cerebrovascular Accident (CVA)
-Is another name for Stroke
Stroke Overview
-800,000 strokes occur in US Annually
-No. 5 cause of death in US
~133,000 deaths annually
-Leading preventable cause of disability
-11.8% of deaths worldwide
~2nd leading cause of death
Stroke Classifaction
-Ischemic Stroke ~80% of strokes ~Clot from build-up plaque ~Bester outcomes -Hemorrhagic Stroke ~20% of strokes ~Weakness in the walls of the vessels *Aneurysms
CVA
-Risk Factors
- Heart Disease
- Arrhythmias
- Diabetes
- High Blood Pressure
- Smoking
- Obesity
- Genetics
CVA
-Signs and Symptoms
- Unilateral weakness/numbness
- Facial droop
- Slurred speech
- Altered mentation
- Dizziness
- Loss of coordination
- Headache
Stroke Assessment
- Just remember FAST
- Cincinnati Stroke Scale
- 1 sign = 72% probability
- All 3 = 85% probability
FAST
-Face ~Does one side of the face droop *Ask the person to smile -Arms ~Is one arm weak or numb *Ask the person to raise both arms ~Does one arm drift downward -Speech ~Is speech slurred *Ask the person to repeat a simple sentence ~Is the sentence repeated correctly -Time ~If the person shows any of these symptoms; Call 911 or get to the hospital immediately
Transient Ischemic Attack (TIA)
-Sometimes called a "mini stroke" ~Same symptoms as a stroke, but the symptoms resolve ~Treat the same ~Seek immediate medical care ~Patient may still be having a stroke
Stroke
-Occurs when blood supply to a portion of the brain is suddenly interrupted
-Signs vary depending on location of damage and show up suddenly
~Numbness or weakness of face, arm, or leg
~Confusion
~A change in ability to speak or be understood
~Change in sight and balance
~A sever, sudden headache
Stroke
-If you suspect a stroke
- DO NOT give food or drink
- Prepare for possibility of sudden cardiac arrest and need for CPR and use of AED
- Person can become frustrated at inability to move or communicate clearly
- Person may appear confused but still be aware of what is happening
- Stay close; calm, comfort, and reassure until another provider or EMS takes over
Diabetes
-How due cells get “food”
~Food is digested
~Sugar is moved from the intestines into the blood stream
~Insulin is released by the pancreas into the blood stream
~insulin is the “key” that allows glucose to move from the blood stream into the cells
Diabetes
-Pathophysiology
-The body either does not produce insulin or cannot utilize it
-Cells are not supplied with glucose
-Type of emergencies
~Hypoglycemia (too little)
*Type 1
~Hyperglycemia (too much)
*Type 2
Diabetes
-HYPOglycemia
-A diabetic takes either too much insulin or does not eat enough after taking it
-Low blood sugar means cells are starving
-Signs and Symptoms
~Headache, fatigue
~Altered mentation
~Cool, pale, diaphoretic skin
~Unresponsive
~Seizures
-ABCs
-Give sugar only
~Juice
~Gatorade
~GU
~Candy
-If able, give something substantial
~PB&J
-It is never appropriate to administer insulin in an emergency setting
-Calm, comfort and reassure the person
-If response to sugar, mental status will improve
-If not response to sugar in 10-15 minutes or condition worsens, activate EMS and provide additional glucose or sugar
Diabetes
-HYPERglycemia
-High blood sugar from not using insulin
-Sign and Symptoms
~Altered mentation
~Dehydration
~Fruity, acetone breath
~Deep, rapid respirations
~Warm, dry skin
Respiratory Emergencies
-Can be a chronic or acute problem
~Heart failure, lung disease, asthma, allergic reactions
-Result in a reduced ability to oxygenate blood
-Also an accumulation or carbon dioxide
-The brain and the heart are the most sensitive to change in oxygen and carbon dioxide
-Pediatric individuals are particularly at risk
Breathing Difficulty, Shortness of Breath
- DO NOT wait for improvement, activate EMS
- If AED available, have someone get is
- Allow person to find comfortable position
- Loosen tight clothing
- Prepare to provide CPR and use AED if breathing stops
- Reassess regularly until another provider or EMS takes over
Asthma
- Reactive airway disease
- Spasm and narrowing of bronchioles
- Swelling or mucus membranes with increased mucus production
- Mucus plug formation due to the drying of the mucus
