EMS Neurological Emergencies 1 — Questions and Answers
Question 1: What is the Cincinnati Prehospital Stroke Scale (CPSS) primarily used to assess?
- Traumatic brain injury severity
- Signs and symptoms of stroke (Correct answer)
- Spinal cord injury level
- Seizure activity and duration
Correct answer: Signs and symptoms of stroke
The CPSS is a rapid prehospital tool that evaluates facial droop, arm drift, and abnormal speech to identify potential stroke patients.
Question 2: Which of the following is NOT a component of the Cincinnati Prehospital Stroke Scale?
- Facial droop
- Arm drift
- Abnormal speech
- Pupil dilation (Correct answer)
Correct answer: Pupil dilation
The CPSS assesses three findings: facial droop, arm drift, and abnormal speech; pupil dilation is not part of this scale.
Question 3: A patient reports a sudden, severe headache described as 'the worst headache of my life.' What condition should the EMT most suspect?
- Tension headache
- Subarachnoid hemorrhage (Correct answer)
- Migraine with aura
- Cluster headache
Correct answer: Subarachnoid hemorrhage
A sudden, severe 'thunderclap' headache described as the worst ever is a classic presentation of subarachnoid hemorrhage and requires immediate transport.
Question 4: What is the correct term for a temporary neurological deficit that fully resolves within 24 hours?
- Ischemic stroke
- Hemorrhagic stroke
- Transient ischemic attack (TIA) (Correct answer)
- Todd's paralysis
Correct answer: Transient ischemic attack (TIA)
A TIA produces stroke-like symptoms that resolve completely within 24 hours (usually within 1 hour) and is a major warning sign for an impending stroke.
Question 5: Which of the following is a common postictal sign following a generalized tonic-clonic seizure?
- Elevated blood pressure with bradycardia
- Confusion and drowsiness (Correct answer)
- Widened pulse pressure
- Hypertensive crisis
Correct answer: Confusion and drowsiness
The postictal phase after a seizure typically involves confusion, drowsiness, fatigue, and disorientation as the brain recovers from abnormal electrical activity.
Question 6: A patient with signs of acute ischemic stroke should ideally be transported to:
- The nearest hospital regardless of capability
- A certified stroke center capable of administering thrombolytics (Correct answer)
- A level I trauma center
- Any facility with a licensed radiologist
Correct answer: A certified stroke center capable of administering thrombolytics
Time-sensitive thrombolytic therapy (tPA) requires a certified stroke center; bypassing closer hospitals to reach such a center improves patient outcomes.
Question 7: The AVPU scale is used in EMS to quickly evaluate which parameter?
- Vital sign trends
- Level of consciousness (Correct answer)
- Stroke severity
- Pain intensity
Correct answer: Level of consciousness
AVPU (Alert, Verbal, Painful, Unresponsive) is a rapid tool for assessing a patient's level of consciousness during the primary survey.
EMS Neurological Emergencies 1
What is the Cincinnati Prehospital Stroke Scale (CPSS) primarily used to assess?