CVA
Mid complexity — Central Nervous System
Goals
- Recognise neurological abnormalities using the ABCDE method.
- Describe the treatment for CVA and the importance of the short time window.
- Recognise and describe the risk factors for CVA.
Anamnese
- Name: Mr Diamant
- Age: 64 years
- Family: Married
- Occupation: Notary
- Cultural: Not known
AMPLE
- A.Unclear
- M.Aspirin, sotalol PRN
- P.Hypertension, atrial fibrillation
- L.Unclear
- E.Cardiac arrhythmias, confusion
SBAR
- S.Mr Diamant is admitted to your ward for observation due to cardiac arrhythmias. A colleague is now asking you to check on him because he appears confused.
- B.Mr Diamant is 64 years old and has a history of hypertension and 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, slight left-sided facial droop.
- B.RR 16 breaths/min, normal depth, symmetrical thoracic excursions, normal jugular veins, normal breath sounds, saturation 88%.
- C.Ashen colour, CRT 1 sec, HR 65 bpm, strong regular pulse, warm dry skin, BP 162/88.
- D.Voice on AVPU, dysarthria, glucose 4.3, pupils PEARL. Left facial droop.
- E.Temp 37.1°C, no oedema. Urine output: spontaneous 450 ml 1 hour ago.
Situation at the end of scenario
- A.Potentially compromised airway, unconscious.
- B.RR 14 breaths/min, symmetrical thoracic excursions, normal jugular veins, normal breath sounds, saturation 85%.
- C.Ashen colour, CRT 1 sec, HR 55 bpm, strong regular pulse, warm dry skin, BP 193/95.
- D.Pain on AVPU, glucose 5.3, pupils PEARL. Increasing left facial droop.
- E.Temp 37.1°C, no oedema.
Recommendations
- Brain CT scan as soon as possible