EAC Unconscious and Strokes Flashcards Preview

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Flashcards in EAC Unconscious and Strokes Deck (16):
1

causes of unconsciousness

Faint
Infantile convulsions
Shock
Head injury
Stroke
Heart attack
Asphyxia
Poisoning
Epilepsy/Extremes of temperature
Diabetes/Drug overdose

2

rules of dealing with multiple unconscious patient's

one patient: continue as normal

two patients: proceed with care, keep control informed

three patients: withdraw/isolate yourself, request specialist help

3

initial management of:
unconscious patient

DRABCDE
check for danger
note obvious signs and position of patient
Speak to patient, apply stimulus to assess AVPU
Ensure open airway
Check breathing
Check pulse
GET A HISTORY! WHO CALLED 999? WHAT DOES EOC KNOW??

4

define:
Stroke

A condition in which the blood supply to part of the brain is interrupted causing death of brain tissue

previously referred to as a CVA

Often referred to as a Brain Attack
Storkes are normally of sudden onset

They may be preceded by Transient Ischaemic Attacks (TIA)

5

causes of stroke

Ischaemia - cerebral thrombosis, cerebral embolism

Haemorrhage - cerebral haemorrhage

6

define:
cerebral thrombosis

A naturally forming clot which builds up over time from the effects of arteriosclerosis

Eventually it will impede or completely occlude a cerebral artery causing infarction and necrosis of brain tissue

7

define:
cerebral embolism

A mass of solid, liquid or gaseous material that is carried in the blood stream

Eventually it will occlude one of the cerebral arteries causing infarction and necrosis of tissues of brain tissue

causes: AF, recent surgery, DVT's, oral contraceptives

8

define:
cerebral haemorrhage

This is the rupture of a cerebral blood vessel with resultant infarction and necrosis of brain tissue

often occurs in the patient who suffers from long term hypertension

9

high risk groups for Stroke

The elderly
Patients with circulatory disorders
Patients with high blood pressure
Smoking
Obesity
AF

10

signs and symptoms of:
Stroke

Slow and full pulse
Flushed and warm skin
Noisy breathing/snoring (stertorous)
Possible unequal pupils - dilated on affected side of brain
Seizure
Confusion, reduced LoC
Possible loss of consciousness
Incontinence and vomiting
Aggressive or agitated behaviour
Headache
Hypertension
Inability to understand/communicate

11

FAST

Face: facial droop

Arms: ask pt to lift arms and observe for obvious weakness and/or drift

Speech: Aphasia (inability (or impaired ability) to understand or produce speech)

Time: time critical

12

management of:
Stroke

Primary/Secondary survey
O2 where indicated
Check BM
Reassurance to pt and relatives
Be prepared for LOC
Be prepared to manage secretions if pt cant swallow
Constantly monitor vital signs
time critical transfer HASU

13

Storke Care Bundle

Initial set of obs
Time of onset
BM
If >4.5 hours normal driving to HASU

14

patient positioning:
Stroke

Conscious: semi-recumbent with the head and shoulders both slightly raised

Unconscious: stable side with the paralysed side uppermost so as to avoid pressure on injured side

15

Stroke in children

True stroke rare in children
FAST+ in children usually due to seizure

16

define:
TIA

A temporary reduction of blood supply to the brain caused by atheroma, thrombosis, embolus or arterial spasm

signs and symptoms of stroke

recovery within 24 hours is termed TIA

often referred to as little/mini stroke

THESE PT's WILL STILL BE SEEN IN HASU