Stroke/CVA

Question 1

what kind of patient history should you get?

Answer 1

• OPQRST/SAMPLE
• Hx of CVA/TIA
• Medications (blood thinners)
• Hx of HTN, HLD, diabetes
• Hx of A-Fib, MI, blood clots
• Previous cardiac/vascular surgeries
• Hx of head trauma, intracranial bleed

Question 2

What kind of s/s should you look for?

Answer 2

• AMS, Syncope, Dizziness
• Weakness/paralysis
• Vision or sensory loss
• Headache
• Seizure
• Hyper/hypotension
• Aphasia or Aphagia

Question 3

What are the guidelines for SL1?

Answer 3

• General patient care
• Airway management/ O2
• Onset of symptoms
• BGL
• CPSS

Question 4

What do you need to establish about onset of symptoms?

Answer 4

Last known time the patient was symptom free

Question 5

When do you treat a pt IAW diabetic emergencies protocol?

Answer 5

If <60mg/dL

Question 6

What is CPSS?

Answer 6

Cincinnati
Pre-Hospital
Stroke
Stress

Question 7

What are you looking for in the CPSS?

Answer 7

• Facial droop
• Arm drift
• Speech abnormality
• Time of onset

Question 8

What are the guidelines for SL2?

Answer 8

• Minimize scene time
• Initiating “Stroke Alert”
• Elevating head
• Cardiac monitoring and 12 lead EKG

Question 9

What should scene time be?

Answer 9

<10 min

Question 10

When do you initiate the “stroke alert”?

Answer 10

• CPSS exam positive
• BGL >50mg/dL
• Onset of symptoms within 6 hours

Question 11

When should you elevate head of the stretcher?

Answer 11

If SBP >110mmHg

Question 12

What degrees should you put the head of the stretcher?

Answer 12

15-30 degrees

Question 13

What should you maintain when lifting up the head of the stretcher?

Answer 13

Maintain head/neck in neutral alignment

Question 14

What are the guidelines for SL3?

Answer 14

Vascular access

Question 15

What equipment is recommended?

Answer 15

Twin-Cath and one large bore IV

Question 16

Why is the “Last Known Well Time” important?

Answer 16

Helps determine patient treatment options and direct patient transport

Question 17

When do you document symptoms, when do you document?

Answer 17

The last time the patient was symptom free