CVA
Low complexity — Central Nervous System
Goals
- Recognise neurological abnormalities using the ABCDE method.
- Name the treatment for a CVA and the importance of the short time window.
- Recognise and describe the risk factors for a CVA.
Anamnese
- Name: Mr Boonen
- Age: 69 years
- Family: Married
- Occupation: Retired
- Cultural: Not known
AMPLE
- A.Unknown
- M.Acetylsalicylic acid, flecainide as needed
- P.Peripheral vascular disease and paroxysmal atrial fibrillation
- L.Unclear
- E.Cardiac arrhythmias, confusion
SBAR
- S.Mr Boonen is admitted to your ward for medication adjustment for atrial fibrillation. A colleague is now asking you to go and check on him because he appears confused.
- B.Mr Boonen is 69 years old and has a history of peripheral vascular disease and paroxysmal atrial fibrillation.
- A.See ABCDE
- R.Please assess the patient using ABCDE and apply interventions where necessary.
Situation at the start of scenario
- A.Clear airway, slurred speech, slightly drooping left corner of the mouth.
- B.RR 17 breaths/min, normal depth, symmetrical thoracic excursions, normal jugular veins, normal breath sounds, saturation 91%.
- C.Greyish colour, CRT 1 sec, HR 71 bpm, strong regular pulse, warm dry skin, BP 157/82.
- D.Voice on AVPU, dysarthria, glucose 4.9, pupils PEARL. Slightly drooping left corner of mouth.
- E.Temp 37.0°C, no oedema. Urine output: spontaneous 350 ml 2 hours ago.
Situation at the end of scenario
- A.Potentially compromised airway, unconscious. Increasing droop of the left corner of the mouth.
- B.RR 12 breaths/min, symmetrical thoracic excursions, normal jugular veins, normal breath sounds, saturation 87%.
- C.Greyish colour, CRT 1 sec, HR 66 bpm, strong regular pulse, warm dry skin, BP 175/92.
- D.Pain on AVPU, glucose 4.9, pupils PEARL. Increasing droop of left corner of mouth.
- E.Temp 37.1°C, no oedema.
Recommendations
- Brain CT scan as soon as possible