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Scenario 3

Stroke

GENERAL SCENARIO DESCRIPTION
The patient was walking by the espresso vendor when s/he seemed to stumble. The patient (67 years old) was caught by a passerby and was eased to the ground. No trauma is involved.

INFORMATION GIVEN TO TRAINEE
Dispatch: You are called to the village coffee shop. Equipment and available personnel to be sent upon request.

PATIENT SUMMARY
Patient appears alert and is able to focus on the first responder as they approach. Patient attempts to answer questions, but speech is slightly impaired. Patient is exhibiting right-side face droop (will be relayed to trainee). Patient’s skin is pale, cool, and dry.

SCENARIO OBJECTIVES

Assessment:
    • Verify scene safety, obtain permission to assist 
    • Primary assessment reveals facial droop; speech difficulties, Cincinnati stroke scale 
    • Obtain information from witness (also Spanish speaking); request needed equipment and personnel and EMS
    • Secondary assessment, no other injuries or illnesses found
Problem Management:
    • Gather needed information (detailed history) from the patient 
    • Get statement from bystander who assisted
SPECIFIC INSTRUCTIONS FOR PATIENT

Position: Sitting up propped against the wall by the espresso shop

Answers to SAMPLE:
Signs and symptoms: right-side face droop, slightly impaired speech
Allergies: none 
Medication: none
Past history: none
Last meal: report actual
Events leading: walking to espresso shop when patient stumbled

Patient Behaviors:
You are slightly dazed but fully alert. You watch the first responder as he/she approaches you. You answer his/her questions but your speech is slightly impaired. You begin to get a little frustrated because communication is difficult. You do not remember what caused the stumble.

SPECIFIC COMMENTS FOR EVALUATORS
Responder needs to recognize “stroke” symptoms, the need to activate ALS, and the need for rapid transport. Evaluator will inform responder that there is right droop of the face.

Source: derived from National Ski Patrol
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