Emt and the Nervous System

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to provide care for those patients with the nerve disorders. Say you are called to a scene for a seizure. Once on the scene you find a flaccid unresponsive 72-year-old woman. Marked facial droop is present. She is also on Eliqus (a new generation thinner). She needs a Comprehensive Stroke center since she isn’t a candidate for clot busters. And the closest is an hour away. The decision is made to fly. While starting IV’s she wakes up screaming and is combative. She is at risk of deepening what is obviously a bleed at this point. So, your next choice is to sedate her and intubate her. And when the helicopter lands you would turn the care over to them. When I researched, I was not able to find a lot about what care we give our patients who have nervous disorders, but I was able to find that there is not much do in our setting. But what we can do is get good diagnostics including a stroke screening and onset of symptoms. We would not use blood thinner and determine primary or comprehensive stroke center for transport. We would also give supportive care such as airway when needed, by using bilateral large bore IV’s if you’re ALS. (J. Hopkins Medical, 2016)

A transient ischemic attack is often called a "mini stroke" because it’s symptoms often mimic that of an actual stroke. Symptoms can vary but speech difficulty, weakness on one side of the body, blurred vision, and facial paralysis are the most common. TIAs often resolve on their own and could last anywhere from minutes to days. The biggest thing to remember about a TIA is that it is often a precursor to the real thing. So it should be taken seriously. . (behavioral emergencies, Ret, 2017)

From an EMS standpoint, we would treat TIA’s just like we would with a stroke. It starts with getting a history from either the patient or a family member. Then we would do a full neuro assessment to see how much deficit there is. Vital signs, EKGs are also performed if it is allowed at your facility. An IV is established, blood work is drawn and blood glucose is checked all before we leave the scene. If there are life threatening issues such as airway compromise, we would stabilize that too. Blood glucose is probably the most important thing to check because low blood sugar levels mimic stroke symptoms and are easily reversed. The next thing that is done is the transport. These patients would need to be taken to a hospital that has CT services available 24/7. The reason is because this is how a stroke vs a TIA are diagnosed. And what the treatment will actually be. (behavioral emergencies, Ret, 2017)