Mary -
You are right! Strokes are probably one of the most dangerous medical conditions that are completely looked over by most people as they DONT know what they are looking at. In the field, we see a wide variety of signs and symptoms of people having strokes - so attention to detail is the key.
Here is the down-low on strokes (aka CVA's or cerebral vascular accident). There are three types of strokes.
1) Ischemic strokes - the vessels in the brain have some type of occlusion, usually a clot, that prevents normal blood flow from reaching the brain. Account for about 80% of all strokes.
2) Hemorrhagic strokes - a vessel in the brain ruptures (aka aneurysm) and blood leaks from the vessel. Essentially, this type of stroke also prevents blood from reaching various parts of the brain.
3) Transiet Ischemic Attack (TIA) - a "quick" obstruction that clears itself within a short time frame. This is usually a warning sign of probably future strokes.
As for the "
what to look fors", this is a list of the most common things that are easily recognized by either the person themselves or someone dealing with the person. Remember, that if the person is actually having a stroke, they may not be able to effectively communicate with anyone.
- sudden weakness in an arm, leg, face or an entire side of the body.
- sudden confusion (inability to remember even basic details.... name)
- vision changes
- incoordination, balance problems or weakness
- severe headache without any cause (trauma)
The "
what to do's". Probably the biggest thing anyone having (or noticing) anything that could fall under the stroke list, should call 911 immediately. Don't wait to see if it will pass - each minute is probably brain tissue death. Do not attempt to take any type of medication (high blood pressure medications) namely Aspirin. Although the "clot-busting" power of aspirin may be effective for an ischemic stroke, if it is a hemorrhagic (or bleeding) stroke, the aspirin will actually prevent the blood from clotting and allow MORE bleeding.
What will happen in the ambulance and at the hospital? In the truck, we immediately perform a neurlogical assessment to try and localize where the complication is. You will be placed on a heart monitor - sometimes, if the condition is serious enough, the person may have cardiac problems in addition to the brain problem. Multiple IV's will be started so that medications can be given if/when needed. As a paramedic, I also watch your breathing. Some people with CVA's will develop breathing issues (stop breathing) so we can manage your airway completely if needed. At the hospital, you will get a CT scan of your head which will determine if there is a bleed (or hemorrhagic stroke). If there is, you will get immediate surgery. If there is a clot (ischemic stroke) there are options for the physicians - some will give clot-busting medications to break the clot, others will perform surgery to remove the clot. The big thing to remember is, all these procedures are TIME based!!! The clot-busting drugs cannot be given if you have developed signs more than 2-4 hours prior! After that time-frame, the clot will have already done its damage and most physicians will opt to just leave it and deal with rehab issues. This is where the ambulance comes into play - we can travel quickly to an appropriate facility (and YES we do have only certain hospitals that can handle a stroke) and we can often arrange for expediting in the hospital.
Common risk factors:
- age (older people are more susceptible)
- African Americans
- people with high blood pressure
- Male more than female
- Smokers
- People with family history of problems
- obese people
- prior stroke/CVA
- decreased activity or sedentary lifestyle
- alcoholics
- heart problems of any type (namely Atrial Fibrillation)
- drug abusers
For more information on strokes, visit the
American Stroke Association website.
There.... I think that about covers what I can type in one sitting...
I hope it helps. Please feel free to contact me or ask any more questions - I love to do homework. It really does keep me on top of my game as well!