Neuro Emergencies

Question 1

ALS level 1 for AMS unknown etiology

Answer 1

Glucose check
Narcan - 0.4 mg IV/IO/IM every min (titrate to effect)(max. 10 mg)
Narcan - IN admins: 2mg/2mL = 2 mg (max. 10 mg)
Narcan - Nebulized: 2 mg/3mL saline

Question 2

Therapeutic goal of Narcan

Answer 2

Restore adequate ventilatory effort and/or mental status

Question 3

What does PRIORITY stand for in violent pts.

Answer 3

Psychological issues
Recent drug
Incoherent
Off clothes & sweating
Resistant to presence
Inanimate objects
Tough, superhuman strength
Yelling

Question 4

A state in which a person is in a psychotic and extremely agitated state

Answer 4

Excited Delirium

Question 5

Signs/Symptoms of ExD

Answer 5

Elevated temp
Nudity
Profuse sweating
Aggressive behavior - Instant tranquility

Question 6

ALS level 1 for Violent/ExD

Answer 6

Temp above 100F - cool pt. with ice packs
Cold fluids: 500 mL to max. 30mL/kg (goal: temp below 100F)
Sedate Pt. w/ Valium or Versed
Benadryl - 50 mg IM or SLOW IV
Transport code 3

Question 7

ALS level 1 for Seizures

Answer 7

Eclamptic female - Mag. Sulfate - 4g in 50 mL D5W over 5-10 mins (repeat at 2g in 50 mL D5W over 5-10 mins)
Valium - 5 mg IV/IM/IN (max. 10 mg)
Versed - 2 mg inc. IV/IO/IN (IN: 10mg/2mL) max. 10 mg

Question 8

Eclampsia timeline

Answer 8

Over 20 weeks gestation - 6 weeks postpartum

Question 9

Stroke Alert criteria

Answer 9

Last seen normal less than 12 hours
Deficit not due to TIA or Head trauma
BGL above 60 or not resolve after correction

Question 10

Stroke patient is transported in what position

Answer 10

Supine w/ head elevated 30*

Question 11

O2 is admins to stroke patient

Answer 11

SpO2 less than 94% - NC 2L

SpO2 cannot be maintained w/ NC - BVM

Question 12

ALS level 1 for Stroke (glucose check)

Answer 12

If glucose is less than 60 - D50: 12.5g (25mL) IVP. (recheck after 5 mins)
Glucagon - 1 unit IM/IN

Question 13

ALS level 2 for Stroke

Answer 13

Elevated BP may be lowered w/ physician order