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Neurological Assessment 1 Neurological Assessment 1

Neurological Assessment 1 - PowerPoint Presentation

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Neurological Assessment 1 - PPT Presentation

August 2017 v 21 Overview of Neurological Assessment Nervous System Overview Decompression Illness Conducting a Neurological Assessment Skills Development Final Assessment and Review ID: 734438

assessment neurological dci decompression neurological assessment decompression dci illness conducting system symptoms function nervous gas balance injury age coordination dcs aid overview

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Slide1

Neurological Assessment

1

August 2017 v 2.1Slide2

Overview of Neurological Assessment

Nervous System Overview Decompression Illness Conducting a Neurological Assessment

Skills Development Final Assessment and Review

2Slide3

Nervous System Overview

Primary Components

Central nervous system

Brain

Spinal cord Peripheral nervous system Nerves

Functional unit is the neuron or nerve cell

3Slide4

Spinal cord

Provides interface between central nervous system and peripheral nervous systemContains nerve tracts or columns that conduct impulses either to or from the brain

Possible causes of nerve pathway interruptions Trauma

Stroke Decompression Illness (DCI)

Nervous System Overview

4Slide5

Decompression Illness (DCI)

5

Decompression Illness (DCI) Describes the signs and symptoms of an injury caused by breathing gas at depth

Includes arterial gas embolism (AGE) and decompression sickness (DCS)

First-aid treatment for AGE and DCS is the same

N

2Slide6

Decompression Illness (DCI)

6

Decompression Sickness

Results from inert gas bubble formation in tissues or blood

Size, quantity and location determine impact on normal physiologic functionEffects can include distortion or tearing of tissue

blood flow interruption

activation of blood clotting mechanisms

systemic inflammation

circulatory system fluid leakage

vasoconstriction

Effects may persist long after bubbles are goneSlide7

Decompression Illness (DCI)

7

Decompression Sickness

(continued)Onset occurs after surfacing

Factors contributing to DCS includeExcess nitrogenRapid ascent

Decreasing ambient pressure

DCS symptoms may differ throughout the body

Any area of body can be affectedSlide8

Decompression Illness (DCI)

8

Arterial Gas Embolism (AGE)

Results from lung overexpansion injury

greatest risk is in shallow water breath-holding

Can allow air from lungs to enter bloodstream

Gas bubbles travel to heart then the arterial systemSlide9

Decompression Illness (DCI)

9

Arterial Gas Embolism (AGE)

(continued) Presents suddenly near or at the surface

Risk factors include Breath-hold during ascent

Asthma Previous lung injuriesSlide10

Decompression Illness (DCI)

Common Signs and Symptoms of DCI

Pain – 40% of casesNumbness and Paresthesia – 27%

Extreme Fatigue – 14%Balance and Equilibrium – 6%Muscular Weakness – 4%Cutaneous (Skin) Symptoms – 3%Altered Mental State – 1.2%

Bowel and Bladder issues – 0.04%

Note: Any suspicion of neurological symptoms should prompt immediate transportation to a medical facility.

10Slide11

Decompression Illness (DCI)

11

First aid for DCS and AGE is the same

Most important initial action

is early recognition and use of supplemental oxygen

Additional information on treating dive emergencies and how to treat injured divers utilizing emergency oxygen for scuba diving injuries is provided next in this course.Slide12

Conducting a Neurological Assessment

Note:

Performing a neurological assessment should never interfere with EMS activation, evacuation or essential first-aid measures.

Remember F-A-S-T FirstRegardless of cause, if a neurological injury is suspected

Call local EMS immediatelyBe prepared to initiate CPR

If injury is dive related, provide oxygen first aid if trained to do so

Complete full neurological assessment

12Slide13

Conducting a Neurological Assessment

Taking a History

Assists in understanding what happenedCan reveal underlying medical issues.Utilize mnemonic SAMPLE

Signs/symptoms A

llergies Medications

Pertinent medical history

L

ast oral intake

E

vents leading to the current situation

13Slide14

Conducting a Neurological Assessment

Vital Signs

Part of baseline historyIncludes pulse and respiration ratesCount each for 30 seconds and multiply by 2Monitor for changes - may reflect changes in the injured diver’s condition

14Slide15

Note:

Performing a neurological assessment should never interfere with EMS activation, evacuation or essential first-aid measures.

The Four Functional Areas

of a Neurological Assessment

Mental function

Cranial nerves

Motor function

Coordination and Balance

Conducting a Neurological Assessment

15Slide16

Mental Function

Assess Level of Consciousness (A V P U)A lert

V erbal stimulusP

ainful stimulusU nresponsive

Includes orientation to person, place, time, reason for being there Additional questions address

SpeechComprehension

Computational skills

Memory

Note responses

Conducting a Neurological Assessment

16Slide17

Cranial Nerves

Assess facial movement and hearing

Eye Control

Facial Symmetry and Control

Hearing

Conducting a Neurological Assessment

17Slide18

Motor Function

Assess motor strength and function.

Symptoms may range from weakness to paralysis.

Proper examination entails comparison with the other side of the body.

Subtle abnormalities are often detected or confirmed by this process.

Conducting a Neurological Assessment

18Slide19

Coordination and Balance

Assess coordination and balance if the injured person’s responses are normal to this point.

DCI and other injuries may cause nerve-cell injury or impairment affecting coordination and balance.

Conducting a Neurological Assessment

19Slide20

Skills

20

F-A-S-T

History

Vital SignsMental Function

Cranial NervesMotor Function

Coordination and BalanceSlide21

Questions?

21