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46 Cards in this Set
- Front
- Back
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List some causes of Altered Mental Status AMS
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Poisoning of Drug OD
Post seizure or postictal Traumatic head injury Hypoxia Shock Alcohol or drug intoxication Infection - Septis Diabetes |
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What is postictal
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It describes the state of the patient when they first come out of a seizure
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List the signs and symptoms of AMS in Trauma patients
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Obvious injury (DCAP/BTLS)
Abnormal respiratory pattern Increased or decreased heart rate Unequal pupils High or low blood pressure Racoon eyes and battle signs Pale cool moist skin Flexion or extension in extremities (decoriate or decerebrate) |
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List the signs and symptoms of AMS of Medical patients
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Abnormal respiratory pattern
Dry or Moist/Cool or Hot Skin Pinpoint, midsize, dilated or unequal pupils Stiff Neck Tongue lacerations High BP and Low heart rate Loss of bowel or bladder control Abnormally high or low blood glucose readings |
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What do we need to take into consideration when dealing with the Elderly in regards to AMS
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Brain shrinks with age
Normal decrease in bodily functions Don't assume AMS is normal They are at a higher risk for CNS injury and illness |
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What do we need to consider when dealing with children and AMS
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Their bodily systems are not as developed
They can often have febrile seizures Scared parents |
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Define Diabetes Melitus
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A disorder in which the body cannot metabolize glucose
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What is the purpose of insilin in the blood
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Allows sugar to pass from the bloodstream into the cells to be used for energy
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What happens to cells without insulin
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They burn fat instead and produce high levels of Ketones and Acetones
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Define Type I diabetes
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Patient is insulin dependent. Their body does not produce any insulin
They must take daily injections of synthetic insulin |
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Define Type II diabetes
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Person produces an inadequate amount of insulin or ineffective insulin
Can be controlled by diet, exercise and oral medications and insulin if severe |
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What is the normal level of glucose in the blood
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80 to 120 mg/dl (milligrams per deciliter of blood)
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Define Hypoglycemia
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A blood sugar level below 60 mg/dl with signs and symptoms
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Define Hyperglycemia
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Persistant blood sugar level above 120
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Decribe the diabetic emergency of hypoglycemia or Insulin shock
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Most common in Type I diabetics
Can occur rapidly caused by high insulin and low blood sugar It is life threatening AMS is most common sign |
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List the signs and symptoms of hypoglycemia
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Altered LOC
Pale, moist skin Diaphorresis Dizziness headache Rapid pulse Aggressive or confused behavior Fainting/seizure/coma |
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True or False
Hypoglycemia patients can appear as drunk, stroke like or psychiatric in nature |
True
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What are the signs and symptoms of Hyperglycemia or Diabetic Coma
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3 Polys
Nausea vomiting Tachycardia Fruity odor on breath Muscle cramps Abdominal pain Warn dry flush skin AMS Coma |
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What are the three Polys of Hyperglycemia
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Polyuria Excessive urination
Polyphagia Excessive Hunger Polydipsia Excessive Thirst |
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When can oral glucose be given
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History of diabetes
AMS Patient can swallow Med control approval |
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What other signs can you look for to determine if patient is diabetic besides the patient
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Wallet card
Insulin in frige Oral medication Medical ID jewelry |
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True or False
A drooling patient is capable of swallowing |
False
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How do you handle a diabetic patient who becomes unconscious during oral gluse treatment
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Stop giving the glucose
Secure the Airway Call Med control Transport |
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What is the dosage for glucose
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1 tube 15 grams
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Define Stroke
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Sudden disruption in blood flow that results in brain cell damage.
Also known as CVA or Cerebrolvascular attack |
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Define TIA
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Transient Ischemic Attack
A brief periodic episode with stroke like symptoms that are gone in 24 hours |
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List two types of Stroke
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Ischemic or blockage
Hemorrhagic or bleeding in the brain |
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List two types of Ischemic strokes
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Thrombotic or clot forming in the artery
Embolic or clot travels to brain |
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What are the signs and symptoms of Hemorrhagic stroke
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Severe Headache
Worsening AMS Seizure Stiff Neck |
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What are the symptoms of Ischemic stroke
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AMS
Numbness/ loss of sensation/ Weakness/ paralysis on one side of the body Incontinent Unequal pupils Nausea/vomiting Visual disturbances Facial droop |
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Name a very important item when getting history of possible stroke patient
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Timeframe
Treatment needs to be given within 3 hours of onset |
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What are the 7 D of stroke Care
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Detection -Patient calls 911
Dispatch - 911 recognzies stroke Delivery - Patient transported Door - - ER Data - ER Decision - ER Drug - ER |
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What can you do on scene to help derermine stroke
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Ask patient to smile big
Hold arms straight out for 10 Sec with eyes closed Give them something difficult to repeat |
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How do you transport stroke patient
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O2
Position of comfort On paralyzed side 6 in head elevation |
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List 3 other aliments that mimic stroke
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Hypoglycemis
Postictal state Subdural or epidural bleeding |
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Define Seizure
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Sudden and temporary alteration of brain function caused by massive continuing electrical discharges in a group of nerve cells
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List 5 types of seizures
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Grand Mal or Generalized
Absence or Petit mal Febrile - Simple partial or focal motor Complex partial or Psychomotor |
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Where are febrile seizure seen
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In children 6 month to 6 years with sudden spikes in fever
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Describe Generalized or Grand Mal seizures
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Unconsciousness
Generalized skeletal contraction |
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Describe Absence Seizure - Absent of memory
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Blank Stare starting and ending abruptly for only a few seconds
Rapid blinking / chewing lack of attention and no memory of event |
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Describe simple partial seizure or focal motor
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Jerky muscle activity in one area patient is conscious and aware
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Describe Complex partial Seizures or Psycomotor
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Lasts 1- 2 minutes
Stares with blank stare Followed by random chewing or something similar Patient seems absent minded |
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Describe Epilepsy
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Congenital chronic brain disorder characterized by recurrent seizures
Most commonly Grand mal AKA tonic-clonic seizures |
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List some causes of seizures
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Epilepsy / High fever
infection Poisoning hypoglycemia /Hyerglycemia Head injury /Shock Hypoxia / stroke Substance withdrawal Hypertension /Pregnancy |
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What are the 6 phases of the Grand Mal Seizure
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Aura - warning
Loss of consciousness Tonic phase - body contracts, bacl arches Hypertonic phase - Extreme muscular rididity with hyperextenion of the back Clonic - Body jerks violently Postictal - end |
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What is Status Epilepticus
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When the patient has two or more seizure without regaining consciousness in between
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