Stroke assessments

[Guest guest]

I'm getting ready to take a class in CPR for the very part time job I now

have in home care doing speech therapy with patients. Even though I got an

MD letter stating I CAN'T perform CPR due to my joints, etc. the company is

requiring me to take the class to satisfy state regulations. I had to get

another letter from the MD that I COULD take the class....arrrgghhh!!! I

wish they'd make up their minds! I just have to demonstrate that I can do

the procedures in the class but will not be required to do them on patients

(I hope....especially after the letter from the MD).

Since a lot of EDSers can be prone to strokes, I typed up some of the info

on signs/symptoms of strokes. I will also post this to the files section of

the groups too.

Bonnie

Clinical Presentation of Stroke Signs:

1. Alteration in consciousness (coma, stupor, confusion, seizures, delirium)

2. Intense or unusually severe headache of sudden onset or any headache

associated with decreased level of consciousness or neurologic deficit;

unusual and severe neck or facial pain.

3. Aphasia (incoherent speech or difficulty understanding speech)

4. Facial weakness or asymmetry (paralysis of the facial muscles, usually

noted when the patient speaks or smiles); may be on the same side as limb

paralysis or on the opposite side.

5. Incoordination, weakness, paralysis, sensory loss of one or more limbs;

usually involves one half of the body, particularly the hand.

6. Ataxia (poor balance, clumsiness, or difficulty walking)

7. Visual loss (monocular or binocular); may be a partial loss of visual

field.

8. Dysarthria (slurred or indistinct speech).

9. Intense vertigo, double vision, unilateral hearing loss, nausea,

vomiting, photophobia, or phonophobia (sensitive to noise

Cincinnati Prehospital Stroke Scale:

Try to elicit one of the following signs (abnormality in any one is strongly

suggestive of stroke):

Facial droop (has patient show teeth or smile)

Normal: both sides of face move equally well

Abnormal: one side of face does not move as well as the other side

Arm drift (have patient close eyes and hold both arms straight out for 10

seconds):

Normal: both arms move the same or both arms do not move at all (other

findings,

such as pronator grip, may be helpful)

Abnormal: one arm does not move or one arm drifts down

Abnormal Speech (have the patient say " you can't teach an old dog new

tricks:)

Normal: patient uses correct words with no slurring

Abnormal: patient slurs words, uses the wrong words, or is unable to

speak.

Glasgow Coma Scale (Score appropriate points listed by each type of

response)

Eye Opening

Spontaneous Speech 4

To speech 3

To pain 2

None 0

Best Motor Reponse

Obeys 6

Localizes 5

Wthdraws 4

Abnormal flexion 3

Abnormal extension 2

None 0

Best Verbal Response

Oriented conversation 5

Confused conversation 4

Inappropriate words 3

Incomprehensible words 2

None 1