Chapter 18 EMT

The type of stroke where a blood vessel in the brain has ruptured is​ called:

hemorrhagic.

Altered mental status resulting from a​ space-occupying lesion or from destruction of brain tissue has​ a:

structural cause.

At a​ minimum, how often should the EMT assess the unconscious patient for changes in mental​ status, breathing, and​ circulation?

Every 5 minutes

For which type of stroke is the patient NOT a candidate for​ "clot-busting" drugs?

Hemorrhagic

A patient informs the paramedic of a severe headache and suspects it is a migraine. Which clinical manifestation would the paramedic expect the patient to​ report?

Photosensitivity

Patients who present with a stroke are considered what transport​ priority?

High priority

A Brief Resolved Unexplained Event applies to infants less​ than:

12 months.

A sign of severely altered mental status that is commonly associated with trauma to the brainstem is flexion of the arms toward the trunk. What term is applied to this​ sign?

Decorticate posturing

The​ "E" in​ AEIOU-TIPPSS stands​ for:

epilepsy

Which of these statements by a patient regarding a headache should indicate to the EMT that rapid transport may be​ necessary?

​"It's the worst headache I have ever​ had."

Your​ 62-year-old male patient was experiencing weakness on one side of his body and slurred speech. After you arrived and evaluated the​ patient, you are noticing the symptoms beginning to subside. What is the likely cause of his​ condition?

Transient ischemic attack

Your patient cannot remember his name. You would document this finding by writing that he has​ a/n:

altered mental status.

The​ "A" in​ AEIOU-TIPPSS stands​ for:

alcohol intoxication.

Depending on the location of the nontraumatic brain​ injury, signs and symptoms may​ include:

hemiplegia or hemiparesis.

In order for the patient to have a maximal response to interventions designed to treat an embolic​ stroke, how soon do they need to get to the emergency department from time of symptom​ onset?

4.5 hours

A​ 49-year-old man calls 911 and explains to the dispatcher that the left side of his face is numb and his left arm is severely weak. Upon your​ arrival, the symptoms have completely resolved. The patient most likely experienced​ a/n:

tia

Your patient has a history of multiple TIA​ (transient ischemic​ attack) events. They are usually​ self-limiting and resolve quickly.​ Currently, the findings on the patient have lasted about 25​ minutes, and the patient is now scared. What should the EMT​ conclude?

It may actually be a stroke.

Which​ stroke-screening method(s) relies on speech as one of the screening​ criteria?

The Cincinnati Prehospital Stroke Scale​ (CPSS)

This prehospital stroke screen has been found to have a 97 percent success rate in determining which patients have actually suffered a stroke.

LAPSS

Which of the following may be considered a Brief Resolved Unexplained​ Event?

Cyanosis

Why is it still necessary to take the patient to the hospital if the symptoms of a stroke have subsided by the time you arrive on the​ scene?

The cause of the TIA needs to be explored by the hospital.

Which of the following diseases is an infection of the membranes surrounding the brain and spinal​ cord, and can easily result in an altered mental status in the pediatric​ patient?

Meningitis

Which of these is listed as a goal in the American Heart​ Association's "Stroke Chain of​ Survival"?

Early recognition of stroke symptoms

You are assessing a patient whom you feel is having a stroke. Which of these findings is typically associated with a stroke​ patient?

A headache

The first goal of the American Heart​ Association's "Stroke Chain of​ Survival" is​ rapid:

recognition of stroke signs and symptoms.

Serious causes of headaches include each of the​ following, EXCEPT:

heart attack.

What is your minimum oxygenation target for the patient who is displaying an altered mental status with adequate​ respirations, who you believe is having an ischemic​ stroke?

An

SpO2

of 94 percent or above

You arrive on scene for a female patient who awoke from sleep at night with a mild headache and the inability to speak clearly. The patient has a history of​ hypertension, high​ cholesterol, and constipation. Given the​ findings, the EMT should initially​ suspect:

stroke

The patient reports a history of vascular headaches to a paramedic on the scene. Which assessment finding would be a cause of these types of​ headaches?

Blood pressure​ 160/120

When a clot forms​ elsewhere, breaks​ free, then lodges in the​ brain, it is called​ a/n:

embolic stroke.

Into what category of causes of altered mental status would​ anoxia, hypoglycemia, and carbon monoxide poisoning​ fall?

​Toxic-metabolic causes

You are assessing a​ 3-year-old male child. He opens his eyes to​ command, localizes​ pain, and is disoriented. What is his Pediatric Glasgow Coma​ Scale?

12

The emergency medical care of a serious headache should include each of the​ following, EXCEPT:

use Trendelenburg position.

3 multiple choice options

What type of stroke is likely to have the slowest​ onset?

​Thrombotic-type stroke

3 multiple choice options

In order for a condition to be considered a​ TIA, the symptoms must resolve in how many​ hours?

24 hours

3 multiple choice options

Which of these is the MOST likely candidate for a​ stroke?

​72-year-old male patient with previous TIAs

3 multiple choice options

You are evaluating a​ 52-year-old male patient complaining of facial drooping on his left side upon awakening this morning. You have established that he has NO prior medical​ history, vital signs were all within normal​ ranges, and his blood glucose level was 98. You have determined that he has​ right-sided facial​ droop, is slurring his words​ slightly, has equal​ grip, and has equal arm drift. What screening result would you determine according to the Cincinnati Prehospital Stroke​ Scale?

There is a high likelihood of an ischemic stroke.

3 multiple choice options

What causes the​ stroke-like symptoms of a TIA to​ disappear?

The ischemia is reversed.

3 multiple choice options

An unconscious state in which the patient does not respond to external stimuli is referred to​ as:

a coma.

3 multiple choice options

The target SpO2 for a pediatric patient with an altered LOC​ is:

94 percent.

3 multiple choice options

A symptom that is very common and is caused by a decrease or interruption to the blood supply to the brain​ is:

dizziness.

3 multiple choice options

You are evaluating a​ ?42-year-old male patient complaining of a headache and facial drooping on his left side upon awakening this morning. You have established that he has no prior​ medical? history, vital signs were all within​ normal? ranges, and his blood glucose level was​ 98?mg/dL. You have determined that he has​ ?left-sided facial?​ droop, unequal?​ grips, and unequal arm drift. He has a blood pressure of​ 178/92, heart rate of 102 and​ irregular, and respirations of​ 18/minute. According to the Los Angeles Prehospital Stroke​ Screen?(LAPSS) assessment scale​ criteria, what assessment criteria for calling a​ "code stroke" does he not​ meet?

Age

3 multiple choice options

You are caring for a patient whom you suspect is hypoglycemic because of his presenting signs and​ symptoms, and he has a history of type 1 diabetes. During your​ assessment, you find out the​ patient's blood glucose level​ (BGL) is 148​ mg/dL. What does this information tell​ you?

The patient may be having a stroke.

3 multiple choice options

The​ "T" in​ AEIOU-TIPPSS stands​ for:

trauma.

3 multiple choice options

The patient reports tightness in the neck and a headache all over that is squeezing. Which type of headache should the EMT document in the medical​ record?

Tension

3 multiple choice options

The third goal of the American Heart​ Association's "Stroke Chain of​ Survival" includes​ rapid:

assessment.

3 multiple choice options

A patient informs the EMT of an excruciating​ right-sided headache, nasal​ congestion, and excessive right eye watering. Which type of headache should the EMT​ suspect?

Cluster

3 multiple choice options

You are assessing a patient after the parent described a Brief Resolve Unexplained Event. You should maintain an SpO2 of at least:

94 percent.

3 multiple choice options

While evaluating a patient who experienced a Brief Resolved Unexplained​ Event, you should attempt​ to:

rule out underlying causes.

3 multiple choice options

You are caring for a pediatric patient with an altered mental status. If they are not oriented but the other parameters are within normal​ limits, what would be their numeric score on the Pediatric Glasgow Coma​ Scale?

14

3 multiple choice options

Which of these is true regarding a transient ischemic​ attack?

It is often a precursor to a stroke.

3 multiple choice options

Patients with an altered mental status and a pulse ox reading of 90 percent will benefit​ from:

oxygen.

3 multiple choice options

Your patient has been complaining of a severe headache. During​ transport, you notice that he is now developing an altered mental status. What is your primary​ concern?

Maintaining an adequate airway

3 multiple choice options

You arrive on the scene of an unresponsive elderly patient who struck his head when he lost consciousness and fell from a chair. As you approach the​ patient, what should your first action​ be?

Initiate manual spine motion restriction precautions.

3 multiple choice options

A patient suffering from what other disorder can sometimes be confused with a patient experiencing a stroke.

Hypoglycemia

3 multiple choice options

A​ 45-year-old male patient is confused. Which of these is a structural cause of his​ condition?

Brain infection

3 multiple choice options

When a patient loses the ability to​ speak, feel​ sensations, or​ move, he is experiencing what type of​ deficit?

Neurologic

3 multiple choice options

The second goal of the American Heart​ Association's "Stroke Chain of​ Survival" is​ rapid:

EMS response.

3 multiple choice options

Which of these is a structural cause of altered mental​ status?

Brain tumor

3 multiple choice options

A common risk factor for thrombotic stroke​ is:

high blood pressure.

3 multiple choice options

Of the following factors that impact the survivability of a stoke​ patient, which one does the EMT have influence​ over?

Time to treatment

3 multiple choice options

What treatment is the MOST critical factor in the emergency care of a stroke​ patient?

Minimizing the time between the stroke and definitive care

3 multiple choice options

Stroke caused by a vascular blockage is referred to​ as:

ischemic stroke.

3 multiple choice options

The first​ "S" in​ AEIOU-TIPPSS stands​ for:

shock.

3 multiple choice options