You are working as an ECA crew, called to a 63-year-old male who has experienced a sudden onset of dysphasia (an impairment of language or speech). His wife called and explained they were watching TV when she noticed her husband was acting a bit strange. When trying to ask if anything was wrong, the patient was trying to explain however the wife couldn’t understand and described it as ‘gibberish’.
Paramedic backup is available but due to reduced availability, is 40 minutes away. You arrive on scene, do a primary survey assessment, and quickly do a set of observations which are as follows: 86 HR, 20 RR, 98% Sp02, 172/96 BP, 37.0 Temp.
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What other observations may be of priority at this point in your patient assessment? (tick all that apply)
Strokes can be classed in two categories according to their pathophysiology, what are they?
According to well established systemic reviews of current research, approximately how accurate is the FAST test at detecting stroke patients?
If a patient is classed as FAST negative this rules out the possibility of a stroke?
What other differentials are appropriate to consider and can commonly be referred to as ‘stroke mimics’ according to JRCALC guidelines? (tick all that apply)
You have completed a BM reading of 5.4, the patient is FAST positive on speech, and the history matches the diagnosis of a CVA. The other observations are unchanged and no major CABC problems are noted. What are your treatment priorities? (tick all that apply)
What other signs and symptoms should a clinician be aware of that can be associated with a stroke that may not be picked up when completing a FAST test?
If you have suspicions that a patient is having a stroke but they are FAST negative, this means the patient is not time-critical?
You load the patient into the Ambulance and make progress to the hospital with no further issues.
Looking at further CVA pathologies, a TIA (transient ischemic attack) can be diagnosed if stroke symptoms are fully resolved within what time period?
If you have a high suspicion of a patient having suffered a TIA but now has returned to baseline and is back to feeling fit and well, what would you recommend as further assessment and/or management?
Where a patient has experienced a TIA where symptoms are fully resolved, patient is not going to hospital and has been referred into a local TIA pathway, what medication can be given where indicated and within your scope of practice?
What contraindications are included with Aspirin administration?
It is important that within your initial history taking to try and get an accurate onset time of symptoms in stroke patients as this can help the receiving hospital determine potential treatment for the patient and avoids further delays?
Around what percentage of stroke patients present in a community setting which may highlight the likelihood of emergency service contact with this patient population?
The chain of survival for stroke patients includes what subcategories? (tick all that apply)
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