Chapter 18 Neurological Emergencies
Knowledge Objectives Questions and Answers
List the general signs and symptoms of stroke and how those symptoms manifest if the left
hemisphere of the brain is affected and if the right hemisphere of the brain is affected.
The general signs and symptoms of stroke include:
Facial drooping
Sudden weakness or numbness in the face, arm, leg, or one side of the body
Decreased or absent movement and sensation on one side of the body
Lack of muscle coordination (ataxia) or loss of balance
Sudden vision loss in one eye; blurred or double vision
Difficulty swallowing (a primary reason for good airway management in a patient with a stroke)
Decreased level of responsiveness
Speech disorders
Aphasia
Difficulty expressing thoughts or inability to use the right words (expressive aphasia)
Difficulty understanding spoken words (receptive aphasia)
Slurred speech (dysarthria)
,Sudden and severe headache
Confusion
Dizziness
Weakness
Combativeness
Restlessness
Tongue deviation
Coma
If left hemisphere is affected:
patient may exhibit a speech disorder called aphasia, the inability to produce or understand
speech. This occurs when the left hemisphere of the cerebrum is impacted by a stroke.
You can detect this problem by asking the patient a question such as, "What day is today?"
If right hemisphere is affected:
If the right cerebral hemisphere of the brain is not getting enough blood, the patient will have
trouble moving the muscles on the left side of the body.
Usually, the patient will understand language and be able to speak, but the words may be
slurred and hard to understand.
Bleeding in the brain:
, Patients with bleeding in the brain (cerebral hemorrhage) may have very high blood pressure.
High blood pressure can either cause the bleeding or be a compensatory response to the
bleeding.
List three conditions with symptoms that mimic stroke and the assessment techniques EMTs
may use to identify them. 1. hypoglycemia-Always check the blood glucose level in
patients with altered mental status if allowed by your local protocol.
2. a postictal state
The period following a seizure that lasts 5 to 30 minutes; characterized by labored respirations
and some degree of altered mental status.
3. Subdural or epidural bleeding (a collection of blood near the skull that presses on the brain)
-usually result of trauma
-A fracture near the temples may cause an artery to bleed on top of the dura mater, resulting in
pressure on the brain.
Define a general seizure, focal-onset seizure, and status epilepticus; include how they differ
from each other and their effects on patients. seizure
Knowledge Objectives Questions and Answers
List the general signs and symptoms of stroke and how those symptoms manifest if the left
hemisphere of the brain is affected and if the right hemisphere of the brain is affected.
The general signs and symptoms of stroke include:
Facial drooping
Sudden weakness or numbness in the face, arm, leg, or one side of the body
Decreased or absent movement and sensation on one side of the body
Lack of muscle coordination (ataxia) or loss of balance
Sudden vision loss in one eye; blurred or double vision
Difficulty swallowing (a primary reason for good airway management in a patient with a stroke)
Decreased level of responsiveness
Speech disorders
Aphasia
Difficulty expressing thoughts or inability to use the right words (expressive aphasia)
Difficulty understanding spoken words (receptive aphasia)
Slurred speech (dysarthria)
,Sudden and severe headache
Confusion
Dizziness
Weakness
Combativeness
Restlessness
Tongue deviation
Coma
If left hemisphere is affected:
patient may exhibit a speech disorder called aphasia, the inability to produce or understand
speech. This occurs when the left hemisphere of the cerebrum is impacted by a stroke.
You can detect this problem by asking the patient a question such as, "What day is today?"
If right hemisphere is affected:
If the right cerebral hemisphere of the brain is not getting enough blood, the patient will have
trouble moving the muscles on the left side of the body.
Usually, the patient will understand language and be able to speak, but the words may be
slurred and hard to understand.
Bleeding in the brain:
, Patients with bleeding in the brain (cerebral hemorrhage) may have very high blood pressure.
High blood pressure can either cause the bleeding or be a compensatory response to the
bleeding.
List three conditions with symptoms that mimic stroke and the assessment techniques EMTs
may use to identify them. 1. hypoglycemia-Always check the blood glucose level in
patients with altered mental status if allowed by your local protocol.
2. a postictal state
The period following a seizure that lasts 5 to 30 minutes; characterized by labored respirations
and some degree of altered mental status.
3. Subdural or epidural bleeding (a collection of blood near the skull that presses on the brain)
-usually result of trauma
-A fracture near the temples may cause an artery to bleed on top of the dura mater, resulting in
pressure on the brain.
Define a general seizure, focal-onset seizure, and status epilepticus; include how they differ
from each other and their effects on patients. seizure
