EMS Module 3: Pre-hospital phase – the difference EMS makes
Learning objectives
You will learn to:
- Understand the importance of rapid response times
- Recognise stroke symptoms from the first call to the EMS call centre
- React appropriately and send ambulance with properly trained paramedic
- Promptly evaluate and stabilise the patient (ABCDE approach)
- Provide priority transfer and pre-notify the selected hospital, preferably a stroke enabled hospital (1500 in SA)
- Recognise the severity of the stroke, using the FAST and National Institute of Health Stroke Scale (NIHSS)
- Understand how to perform the NIHSS Assessment (video-enabled learning)
- Understand the value of pre-notification to the hospital (video-simulated learning – video 6+7)
- Use a specially developed stroke patient checklist to guide actions
Click on the slide to enlarge the image
All of the following videos must be watched while following the slides in order to answer the CPD questionnaire (45 questions):
Video 1: How can you change a life in 60 minutes? (watch time 2:15min)
Video 2: Mild stroke patient (watch time 3:23min)
Video 3: Moderate stroke patient (watch time 6:20min)
Video 4: Severe stroke patient (watch time 3:47min)
Video 5: How to perform comprehensive NIHSS Assessment (watch time 6:51min)
Video 6: Simulation video without pre-notification (watch time 4:51min)
Video 7: Simulation video with pre-notification (watch time 3:18min)
Video 8: EMS Heroes (1:44) (Total 32:29 min)
Quiz-summary
0 of 45 questions completed
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- Answered
- Review
- Question 1 of 45
1. Question
1. What are the initial assessments you should follow when assessing a stroke patient?
- Question 2 of 45
2. Question
2. Which one of the following is incorrect with regards to the stroke treatment pathway of a stroke patient?
- Question 3 of 45
3. Question
3. What is the responsibility of the emergency medical services during the emergency stroke care pathway?
- Question 4 of 45
4. Question
4. Chose the correct option with regards to the target of the EMS in the stoke pathway:
- Question 5 of 45
5. Question
5. Filling in the missing values: Every __ minutes saved in treatment time results in a ____ reduction in mortality and ____ increase in chance of surviving the stroke with Life intact.
- Question 6 of 45
6. Question
6. What is the number needed to treat at 180 minutes when treating a patient with rt-PA?
- Question 7 of 45
7. Question
7. Choose the correct statement:
- Question 8 of 45
8. Question
8. What do the EMS Guidelines recommend with regards to EMS pre-hospital management?
- Question 9 of 45
9. Question
9. What is the goal of the EMS in stroke care?
- Question 10 of 45
10. Question
10. Fill in the missing words: Emergency call centres and dispatchers have an important role in _______________________ and ____________________ without delay.
- Question 11 of 45
11. Question
11. What are the a-typical stroke symptoms?
- Question 12 of 45
12. Question
12. Choose the correct statements with regards to emergency dispatch and response of the EMS:
- Question 13 of 45
13. Question
13. Which tools can be used to recognize a stroke as well as determine the severity of a stroke?
- Question 14 of 45
14. Question
14. What components make-up the Los Angeles Prehospital Stroke Screen tool?
- Question 15 of 45
15. Question
15. Is the statement Tue or False: Ischaemic strokes involving the posterior circulation as well as intracerebral bleeding or subarachnoid haemorrhage may require immediate airway management, especially if the patient has an altered level of consciousness?
- Question 16 of 45
16. Question
16. What is the reasoning for using stroke scales/ assessments in the pre-hospital phase of stroke management?
- Question 17 of 45
17. Question
17. What additional components to the FAST test does the FAST-ED scale look at?
a) There is scoring system for each components of the FAST-ED test
b) It looks at receptive aphasia, eye deviation and denial or neglect
c) It has a higher predictive value for large vessel occlusions - Question 18 of 45
18. Question
18. What is the maximum score for the NIHSS as well as the variance for patients to be eligible for thrombolysis?
- Question 19 of 45
19. Question
19. What does NIHSS stand for?
- Question 20 of 45
20. Question
20. If a patient is given a score of 2 for section 2 “Best Gaze” on the NIHSS, it means:
- Question 21 of 45
21. Question
21. If a patient is given a score of 1 for section 4 “Facial Palsy” on the NIHSS, it means:
- Question 22 of 45
22. Question
22. If a patient is given a score of 1 for section 6 “Motor leg” on the NIHSS, it means:
- Question 23 of 45
23. Question
23. If a patient is given a score of 2 for section 8 “Sensory” on the NIHSS, it means:
- Question 24 of 45
24. Question
24. If a patient is given a score of 1 for section 10 “Dysarthria” on the NIHSS, it means:
- Question 25 of 45
25. Question
25. If a patient is given a score of 0 for section “Extinction and Inattention” on the NIHSS, it means:
- Question 26 of 45
26. Question
26. What is the EMS role upon first medical contact?
- Question 27 of 45
27. Question
27. In choosing a hospital, the most appropriate hospital can provide patients with…
- Question 28 of 45
28. Question
28. Which of the following is more appropriate to treat a stroke patient in the acute phase?
- Question 29 of 45
29. Question
29. According to the guidelines, how much time should be spent on scene?
- Question 30 of 45
30. Question
30. To do as much as possible before arrival at the hospital, will include the following:
- Question 31 of 45
31. Question
31. In training paramedics in stroke assessment, it enables them to identify _________ % of strokes:
- Question 32 of 45
32. Question
32. The ABCDE approach was developed as a way to prioritise the order of assessment and treatment of trauma patients.
- Question 33 of 45
33. Question
33. Partial airway obstruction is not always immediately obvious. Therefore, clinical observation should ensure early detection of any increased respiratory effort or abnormal breathing sounds.
- Question 34 of 45
34. Question
34. According to the American Stroke Association, cardiac monitoring should be performed for the first ______ hours:
- Question 35 of 45
35. Question
35. Persistent in-hospital hyperglycaemia during the first 24 hours after as stroke is associated with a worse outcome than normoglycaemia.
- Question 36 of 45
36. Question
36. Abrupt blood pressure lowering, by a paramedic, should be avoided in a stroke patient.
- Question 37 of 45
37. Question
37. The stroke patient’s body must be elevated to________ °.
- Question 38 of 45
38. Question
38. Which of the following statements are true?
- Question 39 of 45
39. Question
39. Blood Glucose testing are important for the following reasons:
- Question 40 of 45
40. Question
40. What is the most important reason to get a clear relevant medical history of the stroke patient?
- Question 41 of 45
41. Question
41. Studies have shown that pre-notification leads to
- Question 42 of 45
42. Question
42. Please review stroke patient video 1 and diagnose the patient using FAST (indicate deficit(s) present
- Question 43 of 45
43. Question
43. Please review stroke patient video 2 and diagnose the patient using FAST (indicate deficit(s) present
- Question 44 of 45
44. Question
44. Please review stroke patient video 3 and diagnose the patient using FAST (indicate deficit(s) present
- Question 45 of 45
45. Question
45. Please review stroke patient video 4 and diagnose the patient using FAST (indicate deficit(s) present
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