Weak + Dizzy Flashcards
how to manage a patient with muscle weakness? (2)
secure ability to ventilate
refer to specialist
what must be differentiated when a patient presents with dizziness?
central vs peripheral vertigo
dysfunction of the brain or brain stem leading to a misinterpretation or peripheral stimuli
central vertigo
dysfunction of the inner ear or vestibular nerve creating incorrect stimuli that is sent to the brain
peripheral vertigo
what is central vertigo considered until proven otherwise?
CVA (stroke)
a patient presents with cranial nerve deficits, vertical nystagmus, and ataxia. Dx?
central vertigo
a patient presents with unilateral hearing loss, and tinnitus, which are all positional. Dx?
peripheral vertigo
what is the management for central vertigo? (4)
activate stroke protocol if w/in window
brain CT w/o contrast
brain MRI
admit if not thrombolytic candidate
what is the management for peripheral vertigo? (4)
epley maneuver
meclizine (antiemetic)
scopolamine (anticholinergic)
diazepam (benzodiazepine)
LOC after a psychological stressful event
vasovagal syncope (situational syncope)
LOS not related to psychological stressful event
syncope / presyncope
management for syncopal patient? (3)
fingerstick glucose
pregnancy test
detailed physical exam
what is the syncope rule for patients to determine if the patient is at high risk?
CHESS
Congestive heart failure
Hematocrit < 30
EKG abnormality
Shortness of breath
SBP < 90
what is the management for syncopal patient? (4)
O2
IV
monitor vitals
EKG
syncope + headache = (2)
subarachnoid
intracerebral hemorrhage
