Recognising a Stroke

[{Dakota}]

Not a question, but I figured it useful for all to know:

During a BBQ a friend stumbled and took a little fall - she assured everyone that she was fine (they offered to call paramedics). They got her cleaned up and got her a new plate of food - while she appeared a bit shaken up, Ingrid went about enjoying herself for the rest of the evening. Ingrid's husband called later telling everyone that his wife had been taken to the hospital - (at 6:00pm, Ingrid passed away.) She had suffered a stroke at the BBQ - had they known how to identify the signs of a stroke perhaps Ingrid would be with us today.

A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke...totally. He said the trick was getting a stroke recognized, diagnosed and getting to the patient within 3 hours.

Remember the "3" steps.

Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer brain damage when people nearby fail to recognize the symptoms of a stroke.

Now doctors say a bystander can recognize a stroke by asking three simple questions:

1. Ask the individual to SMILE.

2. Ask him or her to RAISE BOTH ARMS.

3. Ask the person to SPEAK A SIMPLE SENTENCE (Coherently) (i.e... It is sunny out today) If he or she has trouble with any of these tasks, call an ambulance immediately and describe the symptoms to the dispatcher.

After discovering that a group of non-medical volunteers could identify facial weakness, arm weakness and speech problems, researchers urged the general public to learn the three questions. They presented their conclusions at the American Stroke Association's annual meeting last February. Widespread use of this test could result in prompt
diagnosis and treatment of the stroke and prevent brain damage.

[{Dakota}]

p.s. - That story about Ingrid was not "my story" I received it through e-mail. At the bottom of the e-mail it mentions that for every 10 people who is aware of this, at least 1 person will be saved - so come on people - let's save some lives :D

[rampart]

Thanks for the information, Dakota. I will remember this.

[mycatis]

Thats great Dak, thanks for that, have printed out the symptoms bit!
I also read somewhere once that patients often say they have smelt "burnt toast" just before their stroke. I dont know why but I thought it was interesting!

[Buddy]

Extemely useful info Dakota.In my memory now - thank you.

[OBonio]

Similar to asking them to smile, asking them to poke their tongue out can indicate pressure on the brain if they can't poke it out straight (ie, it veers to one side).

[woofgang]

ummm I have just had a look at the American Stroke association website and couldn't find anything on there about 3 hours or reverse the effects and their signs of stroke are a bit different. What they say is that quick treatment can significantly reduce disability.

Not wishing to rain on anyone's parade here but i would like to know if anyone can corroborate Dak's posting. As a health care professional I am very interested!

http://www.strokeassociation.org/presenter.jhtml?identifier=1200037

[mimififi]

hi Dakota, I am a first aider, and I've never been told this. We have only ever been told that you can recognise a stroke my the victim having obvious sided weakness

The problem, like lots of things is the awareness....you can only recognise massive stroke in the above scenario.

I have committed this list of symptoms to memory and shall be sure to remember them if Im ever called to a first aid sit again....

This should be advertised properly like the meningitis is now.

thanks for sharing that dakota!

[MsBadely]

Snopes vouch for it's cromulence, though, as wolfgang says, it hasn't yet been endorsed by the ASA.

http://www.snopes.com/medical/disease/stroke.asp

[WendyS]

A fourth year medical student has also shared this information with us. They are being encouraged to use these three steps as part of early stroke diagnosis so it is legitimate advice. I just hope that if I happen to see somebody fall or stumble and see them dazed or confused afterwards I have the presence of mind to remember this information.

[woofgang]

Yes it is good basic advice and there is no doubt that the clotbuster drugs are the biz provided that they are administered early and that your stroke was caused by a blockage and not a bleed. The bit that worries me is the totally reversible if treated within 3 hours claim. I would like to see the evidence for this and can imagine that if it is not true, will cause unnecessary guilt among spouses and relis who will feel that their loved one would not have been disabled if they had acted more quickly!!

[qapmoc]

I had a Brother-in-law who had a stroke two months ago, so I did a massive amount of reading into this subject and I also doubt the three hours total reversal of effects claim, all the stuff I saw says exactly what Woofgang said about ''reduces disability'' .
Many standard medical texts state that brain cells start to die after 5 minutes without oxygen, so surely a blockage in the blood supply to a part of the brain for three hours cannot be reversable can it ??

[dove]

my mum got up in the night last year and couldnt see properly in one eye, she went to the toilet and went back to bed. The next day she still couldnt see properly out of her eye and went to an eye hospital, they said she had suffered a stroke. Thank God she is still with us, but I will remember what you have said Dak, thankyou x

[Golem]

I'm an advanced care paramedic. Dakota's three signs are known as the Cincinati Pre-Hospital Stroke Code and we have been using it for nearly 4 years for the identification of patients having a cerebral vascular accident (CVA, or stroke). If the patient meets the criteria, I can call the hospital and initiate a "stroke code". This involves a team of nurses and doctors who will administer 'clot-busting' drugs. As an earlier answer says, there are two types of strokes, a bleed or a blockage. Clot busters can only be used on blockages.

The blockage may not be complete, which means that some blood and oxygen is getting to brain, just not enough. As with some heart attacks, if circulation can be fully restored within a certain time frame the damage will be minimal, or even non-existent, and I have seen it used successfully many times. The clot-buster, often known by it's initials "tPA", is only effective if treatment is started within 3 hours from the time of onset of symptoms. This has been shown to be crucially important. A patient who wakes up in the morning with left sided weakness, it's impossible to establish time of onset. Remember also, that you don't need to see ALL three signs, just one is enough.

The stroke code is not infallable. If you think about, a lot of drunk teenagers would technically qualify, so it does need some degree of commonsense.

You can find more specific information here; http://www.emedicine.com/neuro/topic603.htm

and the American Heart Association endorsement of the code here; http://www.americanheart.org/presenter.jhtml?identifier=3053

[Drusilla]

What a great post Dakota! My 9 year old daughter spotted this and came into the kitchen and told me all about it. She's now on the phone telling my parents the very same thing and no doubt everyone else in my phone book. Can I send you the bill???? Best wishes.

[{Dakota}]

Thanks for the clarification Golem :)

No payment required Dru, I think you'll be paying enough on your phone bill, LOL, awww bless her!

[smudge]

Thank you for that very caring & useful info Dakota.

[Supernick]

I always use this website to check the validity of any forward -

http://www.breakthechain.org/exclusives/strokeqs.html

Well worth remembering the information I think. I'll be passing it on. Cheers Dakota

[ursula62]

It would be worth hospitals taking note of this info too - or at least learning how to diagnose a stroke properly.

Several years ago my mother was rushed to hospital with stroke symptoms. I told the A&E sister and the consultant she had had a stroke (I was a student nurse at that time), but they said it was just a very bad migraine, and that I was overreacting because it was my mum. They kept her in overnight, supposedly to watch her, but she was put in the side ward in the abortion ward (the only free bed in the hospital). When Dad and I visited the next morning mum had been tied to the bed cot sides to stop her getting up in the night. The nurse's excuse was that normally the abortion ward didn't have overnight cases and they didn't know how to treat a "confused" patient. When we tried to help mum to the loo she couldn't walk and it turned out was completely paralysed down one side. We had to wait 2 more days for the brain surgeon consultant to get back from his holidays. By the time he saw mum he then said had she been treated straight away she would have been left with little or no disability but it was too late to fix anything, although they did do brain surgery to suck out the seepage and reduce pressure on the brain. Mum was left paralysed for 6 years before she died. Dad was too kind to sue the hospital - he said they did their best.

Hopefully things have got a little bit better, but somehow, with all the government targets and paperwork nurses have to deal with, I doubt it.