Mar 21 (edited) • Paramedic Talk
Medical Emergencies you NEED to know
NREMT Mini Lecture: Stroke, Sickle Cell & Key Medical Topics
Sickle Cell Anemia
A genetic disorder where RBCs become sickle-shaped, leading to blockage of blood flow.
Key Points
- Causes ischemia and severe pain
- Triggered by: Hypoxia Dehydration Infection
EMS Treatment
- Oxygen
- IV fluids
- Pain control (Fentanyl)
- Transport
Stroke Management (EMS)
Goal: Time is Brain
Key Actions
- Perform FAST / Cincinnati
- Determine last known well
- Check blood glucose
- Oxygen if hypoxic
- Rapid transport to stroke center
Stroke Patient Positioning
Awake & protecting airway:
- Supine with head elevated ~30°
- Keep head midline
👉 Helps reduce ICP and improve perfusion
Decreased LOC or vomiting risk:
- Lateral (recovery position)
👉 Protects airway and prevents aspiration
Important Notes
- Do NOT lay flat unless hypotensive
- Focus on airway first
NREMT Pearl
- Awake stroke → Head elevated
- Unconscious stroke → Lateral position
Ischemic vs Hemorrhagic Stroke
Ischemic (Most common)
- Clot blocks blood flow
Hemorrhagic
- Bleeding in the brain
- Often presents with severe headache
Field Approach
- Treat both the same
- You cannot differentiate definitively prehospital
Function of Insulin
What it does
- Moves glucose into cells
- Lowers blood sugar
Without insulin
- Hyperglycemia
- Cells starve → DKA
NREMT Pearl
Insulin = pushes glucose INTO cells
Wernicke-Korsakoff Syndrome
Caused by thiamine (B1) deficiency, common in alcoholics.
Wernicke’s (Acute)
- Confusion
- Ataxia
- Eye abnormalities
Korsakoff (Chronic)
- Memory loss
- Confabulation - Neuropsychiatric disorder where individuals generate false memories, beliefs, or verbal accounts without the intent to deceive, often called "honest lying".
EMS Treatment
- Thiamine before glucose
Rapid Review
Sickle Cell
- Vaso-occlusion → pain
Stroke
- FAST + glucose + transport
Positioning
- Awake → head elevated
- Unconscious → lateral
Insulin
- Moves glucose into cells
Wernicke
- Thiamine deficiency
7:57
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Medical Emergencies you NEED to know
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