EMD Neurological Emergency Protocols 2 — Questions and Answers
Question 1: Status epilepticus is defined as a seizure lasting longer than how many minutes, or recurrent seizures without regaining consciousness between them?
- 2 minutes
- 5 minutes (Correct answer)
- 10 minutes
- 15 minutes
Correct answer: 5 minutes
Status epilepticus is defined as continuous seizure activity lasting 5 or more minutes, or two or more seizures without full recovery of consciousness between them.
Question 2: What is the most common trigger for febrile seizures in pediatric patients?
- Epilepsy diagnosis
- Rapid rise in body temperature (Correct answer)
- Bacterial meningitis
- Blunt head trauma
Correct answer: Rapid rise in body temperature
Febrile seizures in children are most commonly triggered by a rapid rise in body temperature rather than by the absolute temperature value, occurring most often between ages 6 months and 5 years.
Question 3: When a caller reports a patient with altered mental status (AMS), which question is LEAST useful for the EMD dispatcher?
- Is the patient breathing normally?
- Does the patient have a history of diabetes?
- What is the patient's favorite color? (Correct answer)
- Did the patient take any medications or substances?
Correct answer: What is the patient's favorite color?
During an AMS call, all questions must focus on identifying life-threatening causes; personal preference questions provide no clinically useful information.
Question 4: A caller states the patient 'just passed out but woke up right away' with no seizure activity or confusion. This presentation most closely describes:
- Absence seizure
- Syncope (vasovagal episode) (Correct answer)
- Transient ischemic attack
- Focal seizure with retained awareness
Correct answer: Syncope (vasovagal episode)
Brief loss of consciousness with rapid and complete return to baseline mental status without convulsions is characteristic of syncope, most often from a vasovagal response.
Question 5: In neurological emergencies, what is the significance of unequal pupils (anisocoria) reported by a caller during interrogation?
- It is a normal finding requiring no special concern
- It may indicate increased intracranial pressure or brainstem herniation (Correct answer)
- It is only significant in patients under age 40
- It indicates the patient is not truly unconscious
Correct answer: It may indicate increased intracranial pressure or brainstem herniation
Unequal pupils in the context of altered mental status or trauma can indicate life-threatening increased intracranial pressure or brainstem herniation, warranting highest-priority dispatch.
Question 6: What dispatch priority should typically be assigned to an adult with an active seizure and no prior seizure history?
- Alpha (non-urgent)
- Bravo (urgent)
- Charlie (potentially serious)
- Delta (life-threatening) (Correct answer)
Correct answer: Delta (life-threatening)
A first-time seizure with no known history is treated as a potentially life-threatening event in MPDS, warranting a Delta-level response due to unknown and potentially serious etiology.
Question 7: What pre-arrival instruction should an EMD dispatcher give to a caller whose family member is actively seizing?
- Hold the patient down to prevent injury
- Place something soft between the patient's teeth
- Clear the area and protect the patient's head without restraining (Correct answer)
- Give the patient water to swallow
Correct answer: Clear the area and protect the patient's head without restraining
EMD pre-arrival instructions for active seizures include clearing the area of hazards and protecting the head, but never restraining the patient or placing anything in the mouth.
EMD Neurological Emergency Protocols 2
Status epilepticus is defined as a seizure lasting longer than how many minutes, or recurrent seizures without regaining consciousness between them?