TIA or CVA - Neurological Emergencies Flashcards
1
Q
Primary Survey
A
- Confirm there are no D-Spine precautions
- Assess lvl of consciousness (AVPU scale)
- Assess and manage ABC’s as required
- Complete RBS and Stroke assessment - visualize, palpate, where appropriate
- Intervention at each injury site as per traumatic injuries chart
- Apply O2 (standard face mask or non-rebreather)
- Consider best position for patient dependent on spinal precautions
2
Q
Decision Point
A
Patients with any neurological deficits are unstable
3
Q
Load and Transport
A
Transport unstable patient immediately after primary survey
4
Q
Critical History
A
- Compare CVA to previous episodes (if any)
- Note any recent episodes of symptoms
- Note the time of onset of symptoms
- Note if symptoms resolved at any point
- Note history of falls/head injuries
- Note whether onset of symptoms was gradual or sudden
- Note the use of anti-hypertensive medications; record any change in medication or compliance
- Note previous or recent history of CVA, hypertension, enforced bed rest or clot medication or compliance
- Note the last oral intake and what they are or drank
5
Q
Patient History
A
SAMPLE and OPQRRRST
6
Q
Vital Signs
A
- Complete enroute to hospital in unstable patient
- Assess blood glucose lvls
- Assess pupil size & reactivity
- Complete vitals q5 for unstable PT
- Complete vitals q15 for stable PT
7
Q
Hospital Notification and Head to Toe/Functional Inquiry
A
Complete enroute to hospital
8
Q
Protocol(s)
A
None indicated
9
Q
Treatment
A
Utilize “FAST-VAN”:
Face: Right droop? Left droop?
Arms: Right weak? Left weak?
Speech: Slurred?
Time: < 6 hrs or woke up w/ symptoms?
- if YES to one or more above and <6 hrs or awoke w/ symptoms proceed w/ “VAN”
- If NO transport to nearest hospital
Addtl assessment:
Vision: Right gaze? Left gaze?
Aphasia: Naming difficulties?
Neglect: Ignoring left body?
- If YES to any above questions notify hospital of possible large vessel occlusion
