2019 EMT Refresher Instructor Manual

Situation: 72-year-old, dispatched as confusion/disorientation

B.4.C

CVA I

Scene Size-up: Safety:

Scene is safe

BSI:

Gloves

Patients: 1 Mechanism/Nature: NOI – AMS Resources: ALS

Weakness

Primary Assessment: General Impression: Patient is sitting in chair looking confused Mental Status: Alert Airway: Patent Breathing: 12 per minute, unlabored Circulation: Palpable pulse at wrist, warm/dry, no severe bleeding

Desired Response: Primary then focused secondary

Physical Exam:

Head:

Unremarkable Pupil blown on right

Neck:

Unremarkable

Chest :

Unremarkable Breath sounds clear

Vitals: 1 Pulse: 68

2

3

66

64

Abdomen:

Unremarkable

BP:

184/102 190/100

190/106

Pelvis:

Unremarkable

Resp: 12

12

12

Extremities:

Unremarkable Weak on left side

SPO2: 94

94

94

Posterior :

Unremarkable

SAMPLE: (SPEECH IS SLURRED) S: I feel weak A: None M: HCTZ, Coumadin P:

OPQRST: O:

I’ve never had this before It does not get worse/better

P: Q: R:

N/A N/A N/A

Hypertension, Mini-stroke 1 year ago

L: E:

Tuna casserole 2 hours ago I was sitting here watching TV

S: T:

1 hour ago per bystander

OTHER: CINCINNATI STROKE SCALE: SPEECH + / ARM DRFT + / SMILE - /// 2/3 findings suggestive of stroke