Reduced LOC (Tech)

You start your assessment of the patient using a primary survey. You quickly note there are no CABC deficits. On assessing disability, there is an obvious deficit present in the behaviour and actions of the patient. The patient has eyes open spontaneously, is confused, and withdraws from pain. What GCS score does this make the patient

You assess for any head injury but cannot find any obvious injuries, you look into the pupils and use the PERRLA mnemonic, what does this stand for

The PERRLA assessment shows no deficits. You complete a FAST assessment of the patient to assess for a potential CVA and it comes back negative. What other scoring tool can be used to help assess the risk of Strokes in TIA patients

The ABCD² covers age >60, BP >140/90, Clinical features of a TIA, Duration of symptoms, and what else to come up with a final score

Although using scoring systems such as ABCD2 can help clinicians with severity of risk of subsequent stroke. Should we use tools like this to inform decision making and the potential urgency of referral with patients with suspected TIA?

You complete a blood sugar analysis of the patient and the reading comes back as 2.9 mmol/l. In this scenario where there are no other concerns of deficits found in any of the observations or assessments, what is the likely cause for the patients’ behaviour and reduced GCS

You note that he has a small bracelet with information stating he is a type 1 diabetic which further confirms your impression of cause. In a patient with diabetes the definition of hypoglycaemia is a blood glucose level of less than

You aim to treat the patient for their hypoglycaemia. Having assessed the patient, although a GCS of 12, he is able to talk and you note no risk of choking or aspiration. Given this information is Glucogel still able to be administered

You administer a 10 g tube of Glucogel and the patient takes it well. What is the maximum total dose that can be given

What further IM drug could you consider for a hypoglycaemic patient if Glucogel doesn’t work or cannot be administered safely

As time passes, the patient becomes more alert and their GCS returns to normal. They are now fully conversing with you and give you a detailed history that their diabetes is normally strictly controlled but today he missed breakfast and lunch due to work commitments and deadlines. His blood sugar reading is now 4.2 mmol/l, is it advisable that he consumes starchy foods

The Paramedic crew have arrived and you give them a handover of the events and observations. The crew complete some further assessments and paperwork is completed. The patients’ friend has arrived and they are happy to keep a close eye on them. Within this setting and following a hypoglycaemia referral, can the patient be discharged home with their friend