FND CARE GUIDE FOR PARAMEDICS

🚑 QUICK FND GUIDE FOR EMTs / FIRST RESPONDERS

🧠 What is FND?

Functional Neurological Disorder (FND) is a real neurological condition where the brain does not send or receive signals properly, despite normal structure (normal imaging/scans).
Symptoms are involuntary, and can mimic:

• Stroke
  
  

• Seizures
  
  

• Paralysis
  
  

• Gait issues
  
  

• Weakness or unresponsiveness
  
  

⚠️ COMMON PRESENTATIONS

• Functional seizures (non-epileptic, psychogenic seizures – PNES)
  
  

• Sudden paralysis or limb weakness
  
  

• Tremors, dystonia, speech issues
  
  

• Gait problems, collapse with preserved consciousness
  
  

• Altered awareness or "blackouts"
  
  

🚨 EMERGENCY CARE BASICS

1. RULE OUT RED FLAGS

Treat like any neuro emergency until stabilized/diagnosed:

• Stroke signs → FAST check
  
  

• Seizure → check vitals, glucose, airway
  
  

• Trauma → spinal precautions if unclear
  
  

2. FND-SPECIFIC OBSERVATIONS

• Patient may appear unresponsive but preserve airway + blink reflex.
  
  

• Seizure-like activity may lack:
  
  

  • Post-ictal phase
    
    

  • Cyanosis, tongue biting, or incontinence
    
    

• Movements may wax and wane with distraction or stimuli.
  
  

🔄 FND IS:

• Not faked
  
  

• Involuntary
  
  

• Triggered by stress, fatigue, sensory overload
  
  

• Fluctuating — symptoms may resolve and reappear quickly
  
  

🧾 DOCUMENTATION / HANDOVER

• Note duration, type of symptoms, responsiveness.
  
  

• Record any unusual movements, speech changes, or functional paralysis.
  
  

• Note history of FND if patient or carer tells you.
  
  

• Consider if symptoms are consistent with known FND diagnosis or if this is first presentation.
  
  

🤝 APPROACHING THE PATIENT

• Reassure: "You're safe, we're here to help. We understand this can happen with your condition."
  
  

• Validate: Symptoms are real and distressing.
  
  

• Use calm tone, minimize sensory input, and avoid panic language.
  
  

🧠 REMEMBER:

FND patients often have been misdiagnosed or disbelieved — your empathy and understanding can prevent trauma.

Would you like this in PDF or badge card format? I can also make a 1-page printable version for training or station reference.

You said:

we need to add references from nz doctors, specilaists or st johns to validify these

ChatGPT said:

​Certainly, here's an updated Quick Familiarisation Guide for EMTs and First Responders in New Zealand regarding Functional Neurological Disorder (FND), incorporating references from New Zealand medical sources and guidelines:​

🚑 Quick FND Guide for EMTs / First Responders (NZ Context)

🧠 What is FND?

Functional Neurological Disorder (FND) is a genuine neurological condition where patients experience symptoms such as limb weakness, tremors, or seizures without an identifiable structural cause. These symptoms are involuntary and result from a disruption in the brain's communication pathways. FND is recognized by New Zealand health authorities and is supported by local resources like FND Aware NZ and Functional Neurological Disorder Aotearoa.​neurological.org.nz+2Fndaware+2Fnda+2

⚠️ Common Presentations

• Functional (non-epileptic) seizures
  
  

• Sudden limb weakness or paralysis
  
  

• Abnormal movements (e.g., tremors, dystonia)
  
  

• Gait disturbances or collapses
  
  

• Sensory changes or speech difficulties​
  
  

🚨 Emergency Care Basics

1. Rule Out Red Flags

Treat initial presentations as potential emergencies:

• Use FAST to assess for stroke symptoms.
  
  

• Monitor for signs of epilepsy during seizures.
  
  

• Ensure airway protection and assess for trauma.​
  
  

2. FND-Specific Observations

• Patients may have preserved awareness during episodes.
  
  

• Seizure-like activity may lack typical post-ictal confusion.
  
  

• Symptoms can fluctuate and may improve with distraction.​
  
  

🧾 Documentation / Handover

• Record detailed observations of symptoms and duration.
  
  

• Note any prior history of FND or similar episodes.
  
  

• Use structured handover tools like ISBAR to communicate effectively with receiving facilities.​St John
  
  

🤝 Patient Interaction

• Provide reassurance: "You're safe; we're here to help."
  
  

• Acknowledge the reality of their symptoms.
  
  

• Minimize environmental stressors and maintain a calm demeanor.​
  
  

📚 References & Resources

• FND Aware NZ
  
  

• Functional Neurological Disorder Aotearoa
  
  

• Health NZ – Functional Neurological Disorder
  
  

• NZTA – Medical Aspects of Fitness to Drive​Fndaware+1neurological.org.nz+1stjohn.org.pg+10Fnda+10Fnda+10Health Information and ServicesNZ Transport Agency

• updated April 2025