Left CVA predisposing Hx questions

[Ronsauce]

Hey all, I just signed up today and this is my first post, but I've been lurking for a while, and I have to say, this site is awesome!

Just a quick bit of info: I'm 24 from Ottawa, ON. I'm in my 2nd year of a two year BLS program. Our first year was spent doing a ton of theory(plenty of which was useless unfortunately) and some practical stuff. We only just started hospital clinicals this semester, and depending on if we get signed off on all of our equipment, we can start rideouts by Oct. 15 I believe. I definitely can't wait for that!

Anyways, we were given this neuro assessment assignment where we pick a problem/disease and have to come up with 3 questions related to predisposing Hx, 3 phyiscal exam hallmarks, and 3 vital sign hallmarks among other things. I'm having a little trouble with the history questions. I've gotten questions asking about previous stroke/tia, diabetes, and hypertension, but I feel they aren't maybe focused enough.

Basically, if you had to ask someone three questions regarding their predisposition to having a stroke(specifically a left one), what would you ask in order to rule it in?

Thanks all!

 

[Ridryder911]

History of HTN
Hx of predisposing factors such as Diabetes, prior CVA, TIA, H/A
PMHX of carotid occlusions, ASA therapy or anticoagulants
Any change in speech, vision, balance, swallowing,
Physical exam check for peripheral vision as well, and autonomy of right side versus left. Many may not even be aware of absence of one side (the brain fools itself, presuming it is working, even though there is paralysis)

Welcome to the site, and good luck in school

R/r 911

 

[Ronsauce]

Thanks tons.

I'm pretty fine with the P/E and vitals sections, but I was thrown a bit by the "predisposing Hx" because examples given by the teacher were more incident-related as opposed to actually being predisposing. He usually has a bit of a disconnect between what he says and what's written down, so I'm sure any of the examples you provided would be good. Thanks again!

 

[certguy]

Stroke assessment

The Cinncinati Stroke Scale is another good assessment tool . I don't know if they're teaching it in your program . Think FAST - Face , can pt. smile ? Is there facial droop ? Arms , have pt. hold thier arms up shoulder high with palms up and watch for paralysis or weakness , Speech , can pt. repeat a sentence you give him/her normally or is there any slurring ? Time , note the time symptoms started as this can effect whether or not clotbuster drugs can be used effectively to minimize the damage . Good luck with your program , that's gotta be the longest BLS program I've heard of . It gets better when you get into the field and see what you've learned in practice.

CERTGUY