EMS Neurological Emergencies 3

Question 1

A patient presents with sudden dizziness, nausea, difficulty walking, and slurred speech but no facial droop or arm weakness. What type of stroke is most likely?

Accepted Answer

Posterior circulation (cerebellar/brainstem) stroke

Answer

Right hemisphere ischemic stroke

Answer

Left hemisphere ischemic stroke

Answer

Lacunar infarct of the basal ganglia

Question 2

Which of the following is a contraindication to administering oral glucose to a hypoglycemic patient?

Accepted Answer

Patient is unconscious or unable to protect their airway

Answer

Blood glucose of 55 mg/dL with the patient alert

Answer

Patient is conscious but mildly confused

Answer

Patient has a history of diabetes

Question 3

Todd's paralysis following a seizure is best described as:

Accepted Answer

Temporary, focal weakness or paralysis on one side of the body that resolves after minutes to hours

Answer

Permanent hemiplegia caused by a focal seizure

Answer

Bilateral lower extremity weakness lasting 24 hours

Answer

Cranial nerve palsy caused by postictal hypertension

Question 4

What is the primary prehospital management priority for a patient with suspected increased intracranial pressure (ICP)?

Accepted Answer

Preventing hypoxia and hypotension

Answer

Routine hyperventilation to maintain PaCO2 at 25 mmHg

Answer

Administering mannitol in the field

Answer

Aggressively restricting IV fluids to prevent cerebral edema

Question 5

A patient is found unresponsive with pinpoint pupils, cyanosis, and a respiratory rate of 6 breaths per minute. What is the most likely cause?

Accepted Answer

Opioid overdose

Answer

Stimulant overdose

Answer

Hypoglycemic coma

Answer

Hypertensive emergency

Question 6

The Los Angeles Prehospital Stroke Screen (LAPSS) differs from the Cincinnati Prehospital Stroke Scale in that it:

Accepted Answer

Includes exclusion criteria such as age, seizure history, and blood glucose to rule out stroke mimics

Answer

Focuses only on verbal deficits

Answer

Requires a CT scan for confirmation

Answer

Is designed exclusively for pediatric patients

Question 7

When a patient is actively seizing on scene, what is the EMT's first priority after ensuring scene safety?

Accepted Answer

Protect the patient from environmental hazards and monitor the airway

Answer

Restrain the patient's limbs to prevent self-injury

Answer

Insert an oral airway immediately to secure the airway

Answer

Administer a benzodiazepine immediately per standing orders