NEUROLOGY REVIEW WITH CASE STUDIES. Justin Astafan, EMT-P, CIC
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1 NEUROLOGY REVIEW WITH CASE STUDIES Justin Astafan, EMT-P, CIC
2 NYS EMT-P NYS CIC 17 years in the fire and ems profession Work both career and volunteer side Worked for commercial and notfor profit companies Currently employed as the Chief of Operations at Lewis County Search & Rescue
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5 WHAT IS NEUROLOGY?
6 WHAT IS NEUROLOGY? the branch of medicine or biology that deals with the anatomy, functions, and organic disorders of nerves and the nervous system.
7 ANATOMY OF THE BRAIN
8 ANATOMY OF THE BRAIN Cerebrum
9 ANATOMY OF THE BRAIN Cerebrum Lobes: Frontal Parietal Occipital Temporal
10 ANATOMY OF THE BRAIN Cerebrum Ventricles
11 ANATOMY OF THE BRAIN Cerebrum Ventricles Corpus Callosum
12 ANATOMY OF THE BRAIN Cerebrum Ventricles Corpus Callosum Thalamus
13 ANATOMY OF THE BRAIN Cerebrum Ventricles Corpus Callosum Thalamus Hypothalamus
14 ANATOMY OF THE BRAIN Cerebrum Ventricles Corpus Callosum Thalamus Hypothalamus Pituitary
15 ANATOMY OF THE BRAIN Cerebrum Ventricles Corpus Callosum Thalamus Hypothalamus Pituitary Pons
16 ANATOMY OF THE BRAIN Cerebrum Ventricles Corpus Callosum Thalamus Hypothalamus Pituitary Pons Medulla Oblongata
17 What does a normal brain look like?
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19 What are three major neurological conditions that concern EMS?
20 What are three major neurological conditions that concern EMS? Stroke
21 What are three major neurological conditions that concern EMS? Stroke Trauma
22 What are three major neurological conditions that concern EMS? Stroke Trauma Cancer
23 Dispatched for an 64 year old female patient complaining of facial numbness Alpha response. BLS unit on scene of a sick person call requested lifting assistance. Paramedic responded to assist. Upon arrival, pt was extricated from home on stretcher with assistance of the local fire dept. Paramedic noted the pt slouching to one side of the cot. Per BLS provider patient was laying in bed when the patient began to feel a tingling sensation in her head and became nauseous. At this time family called 911. Pt denies SOB, LOC or C/p, states she has hx of A-fib and pacemaker implantation. Vital signs: Blood Pressure: 150/90 Heart Rate: 70 and regular Respirations: 20 and regular GCS: 15 BGL: 128 Thoughts?
24 Dispatched for an 64 year old female patient complaining of facial numbness Alpha response. BLS unit on scene of a sick person call requested lifting assistance. Paramedic responded to assist. Upon arrival, pt was extricated from home on stretcher with assistance of the local fire dept. Paramedic noted the pt slouching to one side of the cot, and upon assessment found the pt to be exhibiting signs of a CVA. Per BLS provider patient was laying in bed when the patient began to feel a tingling sensation in her head and became nauseous. At this time family called 911. Pt denies SOB, LOC or C/p, states she has hx of A-fib and pacemaker implantation. ASSESSMENT: HEENT: Airway patent, slight right sided facial droop noted with an asymmetrical smile noted. Tongue midline. PERRLA. Atraumatic. No cyanosis noted. Speech is extremely slurred, which began with the facial tingling. CHEST: Lungs clear and = bilat, rise and fall =, atraumatic. ABD: Soft and non-tender EXT: Grips equal, strength equal bilaterally. Atraumatic. NEUROS: GCS=15, CA&OX4. No LOC noted.
25 TREATMENT: Pt care assumed by myself. BGL assessed, EKG applied, IV access initiated in left hand, site prepped medically clean +Flash+flush. Pt deemed within stroke treatment window, pt txp to St. Lukes. During transport pt speech became more slurred and facial droop more prominent. Pt vomited food type emesis, 4 mg zofran given IVP with relief noted. Stroke alert given to st lukes with no orders given and an ETA of 25 mins. Pt continually monitored and assessed for duration of trip. Arrive at St. Lukes, pt care transferred to CT radiology team, pt on CT table under care of RN. Verbal report given to MD and RN. Thoughts??????
26 STROKE
27 STROKE Patient had a blockage it was removed the patient went for rehab and was sent home with no deficits.
28 Dispatched for a 58 year old male patient involved in an ATV accident. Reports male patient is unresponsive but breathing. Upon arrival of EMS found the following: 58 year old male patient laying on the ground next to a tipped over ATV. Patient is conscious with his eyes open however unable to speak. Patient's breathing presents as a fish out of water...
29 Dispatched for a 58 year old male patient involved in an ATV accident. Reports male patient is unresponsive but breathing. Upon arrival of EMS found the following: 58 year old male patient laying on the ground next to a tipped over ATV. Patient is conscious with his eyes open however unable to speak. Patient's breathing presents as a fish out of water... Assessment: Pupils: PERRL No LOC Patient has no obvious signs of trauma No damage to the ATV Thoughts???
30 Dispatched for a 58 year old male patient involved in an ATV accident. Reports male patient is unresponsive but breathing. Upon arrival of EMS found the following: 58 year old male patient laying on the ground next to a tipped over ATV. Patient is conscious with his eyes open however unable to speak. Patient's breathing presents as a fish out of water... Assessment: Pupils: PERRL No LOC Patient has no obvious signs of trauma No damage to the ATV Vital Signs Blood Pressure: 158/96 Heart Rate: 120 and Regular Respirations: 24 and labored BGL: 284 Thoughts???
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32 PATIENT WAS AIRLIFTED TO SUNY-UPSTATE. HE WAS FOUND TO HAVE A SEPARATION OF C1 AND C2. UNFORTUNATELY THE PATIENT SUCCUMBED TO HIS INJURIES.
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Drip & Ship Protocol Acute Stroke Ready Hospital (ASRH) Duluth Area Primary Stroke Center (St. Luke s & St. Mary s Essentia) PATIENT LABEL Patient displays strokelike symptoms EMS/ED CSS > 0 Glucose >
Forebrain Brain Structures Limbic System. Brain Stem Midbrain Basil Ganglia. Cerebellum Reticular Formation Medulla oblongata
Brain structures (1) Cut out the following cards (2) Identify the three major divisions of the brain (as defined by your book). Initially, try this without any form of aid such as your textbook. (3) Organize
The Human Brain: Anatomy, Functions, and Injury
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Lab 12 Nervous System II
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