Sunday, April 11, 2021

STROKE

What should you do if someone has a stroke?

A stroke is a medical emergency. Quick intervention may increase a person’s chance of survival and reduce the risk of long-term disability.

Strokes occur when the blood supply to the brain is blocked or limited. Each year, over 795,000 peopleTrusted Source in the United States have a stroke, which is about one every 40 seconds.

Yet a 2005 survey by the Centers for Disease Control and Prevention (CDC) showed that only 38%Trusted Source of people could spot the key signs of a stroke and knew to call 911/ In Singapore Emergency Ambulance 995 ; Police 999 ; Police Emergency SMS 71999.

If someone is having a stroke, quick action is vital. Call 911 / In Singapore Emergency Ambulance 995 ; Police 999 ; Police Emergency SMS 71999, immediately or have someone else make the call.

This article gives a step-by-step guide on what to do if someone appears to be having a stroke.

What are the first steps in dealing with stroke?

Knowing how to spot the signs of a stroke and what to do next can save a life.


Recognize the signs and call 911/ In Singapore Emergency Ambulance 995 ; Police 999 ; Police Emergency SMS 71999.

The first step is to recognize the signs of a stroke. Use the acronym FAST to help you remember:


F = Face: Has the person’s face changed? Is the mouth drooping on one side? Is their smile straight or lopsided?

A = Arms: Can they raise both arms? Can they hold them up, or do the arms drift down?

S = Speech: Can the person repeat a simple sentence? Is their speech slurred?

T = Time: If the answer to any of the above is yes, call 911 / In Singapore Emergency Ambulance 995 ; Police 999 ; Police Emergency SMS 71999.

For more on signs and symptoms of a stroke, see the “Symptoms” section below.

After calling 911/ In Singapore Emergency Ambulance 995 ; Police 999 ; Police Emergency SMS 71999

Remain calm.

Ensure the surrounding area is safe and that there is no imminent danger to the person, such as from moving vehicles.

Talk to the person. Ask them their name and other questions. If they cannot speak, ask them to squeeze your hand in response to questions. If the person does not respond, they are likely unconscious.

If the person is conscious:

Gently place them into a comfortable position. Ideally, they should be lying on their side with their head and shoulders slightly raised and supported with a pillow or item of clothing. After this, try not to move them.

Loosen any tight clothing, such as buttoned-up shirt collars or scarves.

If they are cold, use a blanket or coat to keep them warm.

Check that their airway is clear. If there are objects or substances, such as vomit, in the mouth that may be hindering breathing, place the person on their side in the recovery position (see below).

Reassure the person. Tell  victim that help is on the way.

Do not give the victim any food  .

Note the person’s symptoms and look for any changes in condition. It is important to give the emergency personnel as much information as possible about the situation.

Try to remember the time that the symptoms started. Look at a clock if possible, as it is hard to estimate the passage of time when you are in a stressful situation.

If the person is unconscious:

Move them into the recovery position (see below).

Monitor their airway and breathing. To do this:

•lift the person’s chin and tilt their head slightly backward

•look to see if their chest is moving

•listen for breathing sounds

•place a cheek over their mouth and try to feel their breath.

•If there are no signs of breathing, begin CPR (cardiopulmonary resuscitation)

Current practice for CPR is for people who are not formally trained in the procedure to do chest compressions only. 911 can instruct you how to do this if you do not know how.


The recovery position

If someone is unconscious, or if their airway is not completely clear, place them in the recovery position. To do this:

1.Kneel beside them.

2.Take the arm that is farthest away and place it at a right angle to their body.

3.Place the other arm across their chest.

4.The leg that is farthest away should remain straight. Bend their other knee.

5.Support their head and neck and roll the person onto their side, so that their bottom leg is straight and their top leg is bent at the knee, with that knee touching the ground.

6.Tilt their head slightly forward and down so that any vomit in the airway can drain out.

7.Manually clear out the person’s mouth, if necessary.

Performing cardiopulmonary resuscitation (CPR)

CPR is a lifesaving technique that can be performed to help people whose breathing and heartbeat have stopped. If someone who has had a stroke is not breathing, performing CPR until the emergency services arrive may save their life.

For people who have not received training in CPR, it is recommended initiating hands-only CPR on teenagers and adults.


It consists of two steps:

1. Calling 911/ In Singapore Emergency Ambulance 995 ; Police 999 ; Police Emergency SMS 71999

2. Pushing hard and fast in the center of the chest.

People who have received training and have a mouth guard can deliver high-quality chest compressions and rescue breaths at a rate of 2 breaths to every 30 compressions. If they do not have a mouth guard, they should only do compressions.


If an automated external defibrillator device (AED) is available, it can be used to check heart rhythm and deliver an electric shock to the chest, if necessary.


Know the symptoms of a stroke

Recognizing the signs and symptoms of a stroke is vital. Some symptoms can be subtle while others are more noticeable.

A stroke can affect individuals differently, and not everyone will experience all the symptoms. However, below are some of the most common ones.

As a reminder, use the FAST acronym to recognize stroke symptoms:


•Face: Is there weakness or drooping on one side of the face?

•Arms: Can they raise both arms?

•Speech: Is their speech slurred or difficult to understand?

•Time: If any of the above apply, call 911 without delay. In Singapore Emergency Ambulance 995 ; Police 999 ; Police Emergency SMS 71999

Other symptoms of stroke include:


•weakness and numbness on one side of the face or body

•vision problems affecting one or both eyes

•difficulty talking or understanding speech

•coordination problems and loss of balance

•severe and sudden headache

•sudden confusion

•dizziness

•loss of consciousness

Even if symptoms last just a few minutes or hours, the person needs emergency medical attention. It may be a sign of a mini-stroke, or transient ischemic attack (TIA), which can be a warning of a major stroke to come.

Emergency first aid treatment is the same for all strokes, regardless of their cause. These are the two main types of stroke and their causes:

Ischemic stroke

Ischemic stroke is the most common type. It is caused by a blockage or narrowing of the arteries that carry blood to the brain. The blockages may be caused by blood clots or fatty deposits.

Hemorrhagic stroke

These happen when arteries in the brain leak blood or break. This blood damages brain cells and reduces blood supply to the brain.

Risk factors

The following factors increase the risk of stroke:

high blood pressure

•high cholesterol

•history of stroke

•diabetes

•heart disease

•smoking nicotine

The risk of stroke increases with age, but the CDC note that, in 2009, over one-third of people who received hospital treatment for a stroke were under 65 years of age. Strokes can also affect children, with infants under 1 year having the highest risk in this group.

At the hospital, doctors will examine the person and may carry out tests such as an MRI or CT scan to help confirm the diagnosis and identify the cause.

Treatment options include:

  • medication
  • physical therapy
  • speech therapy
  • lifestyle measures
  • surgery

The doctor might administer medications to address blood clots and reduce the risk of long-term effects.

Outlook

The outlook for people who have had a stroke varies. Age, overall health, and lifestyle choices can affect recovery and the risk of having another strhourss

According to the ASA, one quarter of people who have one stroke will have another one at some time. However, following a treatment plan that includes medication such as aspirin and lifestyle measures can prevent 80% of strokes and heart attacks.

Speedy intervention is vital. It can take months or yearsTrusted Source to recover from a stroke, and some people will experience lifelong challenges.

However, the CDC advise that people who arrive at the emergency room within 3 hours of the appearance of stroke symptoms are less likely to experience disability than those who received delayed care. People with diabetes have a higher risk of stroke than those without it. But a person can reduce their stroke risk by controlling their diabetes well and making certain lifestyle changes.

For an individual with diabetes, the chances of having a stroke are 1.5 times higher than in people who do not have the disease, according to the American Diabetes Association. This is because frequent shifts in blood sugar levels can affect the cardiovascular system.

This article discusses the link between diabetes and stroke. It also looks at ways of preventing or lowering the risk of a stroke. 

What is the link?

High blood sugar levels can damage blood vessels and nerves, making a stroke more likely.

A stroke occurs when the blood supply to the brain is interrupted. Most strokes result from a blood clot blocking a blood vessel in the brain or neck.

Over time, high blood sugar levels can damage blood vessels and nerves. People with diabetes have longer periods of high blood sugar than those without diabetes, especially if the condition is not well-controlled. This makes a person with diabetes more likely to have a stroke.

People with diabetes are also more likely to have other conditions that increase the risk of heart disease and stroke, such as high blood pressure and obesity.

The American Heart Association (AHA) report that 16 percent of adults over the age of 65 with diabetes die from a stroke and that 68 percent die from some form of heart disease.

According to their website, the AHA consider diabetes to be “one of the seven major controllable risk factors for cardiovascular disease,” a list that also includes obesity, high blood pressure, an unhealthful diet, and smoking cigarettes.

What to know about stroke

A stroke occurs when blood flow is blocked to an area of the brain, due to either a clot or a ruptured blood vessel. When this happens, brain cells in the area are deprived of oxygen and nutrients, causing cell tissue death and, in some cases, brain damage.

There are three types of stroke:

An ischemic stroke results from a clot blocking blood flow to the brain.

A hemorrhagic stroke results from a burst blood vessel or a leak from a weakened blood vessel.

A transient ischemic attack (TIA), previously known as a mini-stroke, results from temporary blood clots or low blood flow to the brain. 

Symptoms and warning signs

 Numbness or weakness in one side of the face can be a symptom of a stroke.

Stroke symptoms and warning signs typically develop suddenly. Many healthcare providers urge people with an increased stroke risk to learn the F.A.S.T. warning signs and action plan.


F.A.S.T. stands for the following:


Facial drooping on one side

Arm weakness or one arm drifting downward when both arms are raised

Speech problems, such as slurred speech

Time to call 911


Beyond the F.A.S.T. indicators, there are other symptoms of a stroke:

  • numbness or weakness in one side of the face or body
  • a severe headache
  • trouble walking and other coordination and balance problems
  • confusion
  • trouble seeing in one or both eyes

These symptoms tend to come on suddenly and can be severe.

Some symptoms vary between males and females.

Along with diabetes, there are other health problems that can increase a person’s stroke risk:

  • high blood pressure
  • obesity
  • high cholesterol
  • a history of heart disease
  • a previous stroke, including a TIA
  • sickle cell disease
  • bleeding disorders
  • depression

According to the Centers for Disease Control and Protection (CDC)Trusted Source, stroke is more common in certain groups:

  • older adults, with the chances of a stroke doubling every 10 years after the age of 55
  • males, though females are more likely to die from a stroke
  •  people with a family history of stroke

Additionally, lifestyle factors can increase a person’s risk of stroke, including smoking cigarettes, using alcohol or illicit drugs, and not getting regular exercise.

Prevention

Some people need to take medications to lower their risk of stroke. For others, managing their diabetes and maintaining a heart-healthy lifestyle is enough to reduce this risk.

People with diabetes can control their blood sugar levels by paying attention to their diet and taking other steps to prevent these levels from spiking.

Recommend that people follow an individualized diet plan, usually developed with the help of a dietician or nutritionist, to manage their blood sugar levels.

Some ways to reduce the risk of a stroke include the following:

•Exercise regularly, getting at least 2 hours and 30 minutes of moderate-intensity exercise per week, which can include brisk walks.

•Have a diet that includes lots of vegetables and little unhealthy cholesterol.

•Quit smoking.

•Use moderation when drinking alcohol.

•Maintain good cholesterol levels.

•Maintain a healthy weight.

•Treat high blood pressure.

Recovery

A person may experience balance and coordination problems following a stroke.

Stroke recovery is different for everyone. Some people make a full recovery from a stroke in a matter of weeks. For others, it can take years, and some people never fully recover.

Recovery largely depends on how quickly and effectively a doctor administers treatment. If a person receives emergency stroke treatment quickly, they are more likely to have a better outcome.

Emergency stroke treatment varies, based on the type of stroke, but it can include the following:

  • clot-busting drugs
  • endovascular procedures to remove any blockages
  • surgical stenting procedures
  • surgical blood vessel repair

After a stroke, there are often some lingering effects:

  • one-sided weakness or paralysis
  • trouble speaking or understanding speech
  • difficulty expressing emotions
  • balance and coordination problems
  • difficulty controlling the bladder or bowels
  • trouble eating and swallowing
  • depression

A person who has had a stroke may need rehabilitation, depending on their experience. Some potential elements of rehab:

  • physical therapy to help with balance, coordination, and weakness
  • occupational therapy to make daily tasks easier
  • speech therapy to help a person relearn how to speak and understand speech

A person with diabetes is more likely to have a stroke than a person without the disease. Strokes are the fifth leading cause of death in the United States and the leading cause of disability.

Some people make a full recovery after a stroke, while others have lasting symptoms. Fast treatment reduces the risk of long-term complications.

People can take steps to prevent a stroke by maintaining a healthful lifestyle and managing risk factors, including controlling diabetes symptoms, eating a varied, nutritious diet, and getting regular exercise.

What to know about brain stem strokes


The brain stem controls essential bodily functions, such as breathing, swallowing, and balance. A blockage or a bleed in the brain stem can cause a brain stem stroke, which can affect these vital roles.

In this article, we take a close look at brain stem strokes, including the symptoms, diagnosis, recovery, and outlook.

What is brain stem stroke?

The brain stem controls breathing, eye movement, facial movement, heart rate, and blood pressure.

According to the World Health Organization (WHO)Trusted Source, stroke is the “second leading cause of death and the third leading cause of disability” worldwide.

A stroke occurs when the blood supply to a part of the brain is interrupted, either due to a blocked artery or a leaking blood vessel.

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