NREMT EMT 6: Anatomy, Physiology, and Pathophysiology - Pathophysiology of Neurological Emergencies, Stroke, Seizure, Head Trauma

What This Is: Understanding Neurological Emergencies

A neurological emergency is a life-threatening condition that affects the brain, spinal cord, or nerves. Think of it like a computer crash – if the brain's "software" or "hardware" fails, it can cause serious problems. A stroke, seizure, or head trauma are all examples of neurological emergencies that require immediate attention.

Key Steps / Core Facts:

• Stroke: A blockage or bleed in the brain that can cause sudden weakness, numbness, or paralysis. (FAST: Face, Arm, Speech, Time)
  • Recognize the signs: sudden weakness, numbness, or paralysis (1 in 5 people experience a stroke each year).
  • Act fast: call 911 immediately (every minute counts).
• Seizure: A sudden, uncontrolled electrical discharge in the brain that can cause convulsions or loss of consciousness. (AVPU: Alert, Verbal, Pain, Unresponsive)
  • Know the warning signs: auras (e.g., flashing lights), confusion, or sudden changes in behavior.
  • Keep the person safe: clear the area of breakable objects and turn them onto their side.
• Head Trauma: A blow to the head that can cause bleeding, swelling, or damage to the brain. (OPQRSTI: Onset, Provocation, Quality, Region, Severity, Time, Injuries)
  • Watch for red flags: loss of consciousness, confusion, vomiting, or severe headache.
  • Monitor for worsening symptoms: if the person's condition worsens, call 911.
• CPR: Cardiopulmonary resuscitation is a lifesaving technique that helps restore blood flow and breathing in a person who has stopped breathing or whose heart has stopped beating. (CAB: Circulation, Airway, Breathing)
  • Use the correct compression depth: at least 2 inches (like pushing down a soda can).
  • Use the correct compression rate: 100-120 compressions per minute.
• Blood Pressure: The force of blood pushing against the walls of arteries. (BP: Blood Pressure)
  • Normal range: 90-120 systolic (top number) and 60-80 diastolic (bottom number).
  • High blood pressure: can lead to stroke, heart disease, or kidney damage.
• Pupils: The black centers of the eyes that control light entry. (Pupils: small, equal, and reactive)
  • Normal size: 2-4 mm in diameter.
  • Abnormal size: can indicate head trauma, stroke, or other neurological conditions.
• Glasgow Coma Scale (GCS): A scale used to assess a person's level of consciousness. (GCS: 3-15)
  • Normal score: 15 (awake and alert).
  • Abnormal score: can indicate head trauma, stroke, or other neurological conditions.

What Laypeople Can Do:

• If someone collapses, first check for danger (oncoming traffic, fire). Then shout and tap their shoulder.
• If someone is having a seizure, clear the area of breakable objects and turn them onto their side.
• If someone is experiencing a stroke, call 911 immediately and encourage them to follow the FAST acronym.
• If someone has a head trauma, monitor for worsening symptoms and call 911 if their condition worsens.
• If someone is experiencing a seizure, do not try to restrain them or put anything in their mouth.

Common Mistakes:

• Mistake: Not recognizing the signs of a stroke or seizure.
  • Fix: Learn the FAST and AVPU acronyms to quickly identify the signs of a stroke or seizure.
• Mistake: Not calling 911 immediately in a neurological emergency.
  • Fix: Remember that every minute counts in a neurological emergency – call 911 right away.
• Mistake: Trying to restrain someone having a seizure.
  • Fix: Keep the person safe by clearing the area of breakable objects and turning them onto their side.
• Mistake: Not monitoring for worsening symptoms in a head trauma.
  • Fix: Keep a close eye on the person's condition and call 911 if their symptoms worsen.

Quick Practice Scenarios:

1. A friend collapses while playing basketball. What should you do first?

Call 911 and check for danger (oncoming traffic, fire).

1. A family member is having a seizure. What should you do first?

Clear the area of breakable objects and turn them onto their side.

1. A coworker is experiencing a stroke. What should you do first?

Call 911 immediately and encourage them to follow the FAST acronym.

Last-Minute Exam Cram:

• Normal blood pressure range: 90-120 systolic and 60-80 diastolic.
• Normal pupil size: 2-4 mm in diameter.
• Glasgow Coma Scale (GCS) range: 3-15.
• FAST acronym: Face, Arm, Speech, Time.
• AVPU acronym: Alert, Verbal, Pain, Unresponsive.
• CPR compression depth: at least 2 inches.
• CPR compression rate: 100-120 compressions per minute.
• Agonal breathing is NOT normal breathing – start CPR.
• A person with a head trauma may have a normal CT scan but still have a serious injury.
• A person with a stroke may have a normal blood pressure but still have a serious condition.
• A person with a seizure may have a normal EEG but still have a serious condition.