EMD Neurological Emergency Protocols 1 — Questions and Answers
Question 1: Which symptom combination during caller interrogation is most consistent with an acute ischemic stroke?
- Sudden facial drooping, arm weakness, and slurred speech (Correct answer)
- Gradual onset headache with nausea and light sensitivity
- Chest pain radiating to the left arm with diaphoresis
- Sudden shortness of breath with productive cough
Correct answer: Sudden facial drooping, arm weakness, and slurred speech
The FAST acronym (Face drooping, Arm weakness, Speech difficulty, Time to call) identifies the classic acute stroke symptoms recognized in EMD protocols.
Question 2: When a caller reports a patient is actively seizing, what is the EMD dispatcher's immediate priority?
- Ask the caller to restrain the patient
- Determine the patient's seizure history
- Ensure the patient is safe and will not be injured (Correct answer)
- Ask the caller to put something in the patient's mouth
Correct answer: Ensure the patient is safe and will not be injured
The immediate EMD priority during an active seizure is patient safety — clearing hazards from the area and never restraining the patient or placing objects in the mouth.
Question 3: In EMD neurological protocols, what does the rapid consciousness assessment scale 'AVPU' stand for?
- Alert, Verbal, Pain, Unresponsive (Correct answer)
- Airway, Ventilation, Pulse, Unconscious
- Assess, Verify, Prioritize, Update
- Activate, Ventilate, Position, Unload
Correct answer: Alert, Verbal, Pain, Unresponsive
AVPU is a rapid consciousness scale used during caller interrogation: Alert, responds to Verbal stimuli, responds to Pain, or Unresponsive.
Question 4: A dispatcher receives a call about a 65-year-old who suddenly cannot speak and has right-sided arm weakness. What should the dispatcher assume until proven otherwise?
- Hypertensive crisis
- Hypoglycemic emergency
- Acute stroke (Correct answer)
- Transient ischemic attack
Correct answer: Acute stroke
Sudden speech difficulty combined with unilateral weakness are classic stroke symptoms; EMD protocols require treating these as an acute stroke to minimize time to definitive treatment.
Question 5: What pre-arrival instruction is most appropriate for a patient who has just stopped seizing and is now unresponsive but breathing?
- Place the patient on their back with legs elevated
- Place the patient in the recovery (lateral recumbent) position (Correct answer)
- Keep the patient seated upright to maintain the airway
- Begin CPR immediately
Correct answer: Place the patient in the recovery (lateral recumbent) position
A post-seizure unresponsive but breathing patient should be placed in the recovery position to protect the airway and prevent aspiration.
Question 6: Which question during caller interrogation best helps distinguish a stroke from a hypoglycemic emergency?
- Does the patient have a history of heart disease?
- Has the patient eaten recently or taken insulin? (Correct answer)
- Has the patient had a recent head injury?
- Is the patient taking blood pressure medication?
Correct answer: Has the patient eaten recently or taken insulin?
Asking about recent food intake and insulin use helps identify hypoglycemia, which can mimic stroke symptoms and is rapidly reversible with glucose administration.
Question 7: A caller describes a patient with sudden onset of the 'worst headache of their life.' What should the EMD dispatcher suspect?
- Migraine headache
- Tension headache
- Subarachnoid hemorrhage (Correct answer)
- Cluster headache
Correct answer: Subarachnoid hemorrhage
A sudden, severe 'thunderclap' headache described as the worst ever experienced is the classic presentation of subarachnoid hemorrhage, a life-threatening neurological emergency.
EMD Neurological Emergency Protocols 1
Which symptom combination during caller interrogation is most consistent with an acute ischemic stroke?