脑卒中的救治规范PPT.ppt

Answer 1: You conclude that the patient has had a stroke or transient ischemic attack (TIA). Stroke = sudden focal neurologic deficits or loss of consciousness caused by acute disruption in brain blood supply. TIA = a reversible episode of focal dysfunction secondary to transient occlusion of an artery. A TIA can be thought of as “cerebral angina” and is an important forecaster of stroke (permanent cell damage). Clinical signs persist, making stroke more likely than TIA. Right-sided findings are consistent with a left-sided stroke. Answer 2: Major actions needed (try to get oral answers from course participants). Notify EMS dispatcher and ED that you are transporting a patient with a possible stroke. Transport the patient as quickly as possible to an ED that is capable of managing an acute stroke. Continue to assess and support cardiorespiratory function and monitor for signs of neurologic deterioration. Obtain serum glucose measurement and treat hypoglycemia as needed. Inappropriate actions: Any extensive neurologic examination Delay to start an IV Any unnecessary delay Answer 3: The additional information that is most important: establish time when the symptoms started if at all possible (ask the daughter what the exact time was in relation to the 911 call). Determine if the patient has any other significant medical history (eg, recent surgery), is taking medications (eg, coumarin), or has allergies. Answer 1: Ask the daughter to recall what she and her mother were doing at the time of symptom onset. If they were eating in a restaurant, had they just ordered, were they halfway through the meal, or had they paid the check? If they were walking in the mall, what store were they near? Did they see any televisions or clocks? Answer 2: Notify the ED by radio of the likelihood that the patient has had a stroke with symptom onset at 6:20 pm. Answer 3: Priorities during transport include monitoring and support of cardiorespiratory function and continued monitoring of