Definition:
“A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.” (Mayo Clinic, Stroke). Strokes are life-threaten and debilitating emergencies, which, if not treated swiftly, can result in permanent disability or death.
Causes:
Pathophysiology – blood flow and oxygenation to the brain can be interrupted by an occlusion (blockage) or hemorrhage (break and leak) of the blood vessels inside the skull.
-The Ischemic Stroke is usually caused by a clot (embolism), similar to a heart attack. When the clot plugs the blood vessel, not enough blood can get to that specific area of the brain. That’s why specific deficits are noticed, like facial drop on either the left or right side. The effects are usually quite localized.
-Hemorrhagic Strokes are more often the result of trauma to the head, but they can spontaneously occur without trauma. When a blood vessel in the skull weakens and ruptures (aneurysm), blood leaks out of the vessel and into the cranial vault (space inside the head that holds the brain). This increase in fluid (blood) causes an increase in pressure inside the skull, pushing on the brain, which presents an even more serious life threat than the Ischemic Stroke.
Health History/Risk Factors – the presence of certain health conditions can increase the possibility of a person having a Stroke:
– High Blood Pressure
– High Cholesterol
– Atrial Fibrillation
– Diabetes
– Women are at a higher risk for Stroke than men
– Smoking
– Age over 55 years
– History of previous TIA or Stroke
– The occurrence of Strokes are higher among African-Americans, Hispanics, and Asian Pacific Islander
Emergency Situation: Signs & Symptoms – are outward, noticeable indications that people can use to detect a potential emergency. The following are typical Signs & Symptoms of Stroke:
– Patient has altered mental status (confused, disoriented, acting irregular), loss of speech, decreased sensation, or unexplained loss of motor function without suspected trauma.
– Patient may have a past history of stroke or focal seizures.
– Altered mental status. May range from confusion and disorientation to coma.
– Speech disturbances – inappropriate, incomprehensible, slurred, or complete loss of speech.
– Weakness or paralysis on one side of the body.
– Weakness, paralysis, or loss of expression on one side of the face.
Treatment: It’s important to gather specific information so EMS Providers can relay the information to the attending doctors and help speed up the treatment time:
• If you suspect you or someone you know is having a Stroke, first call 911.
• Document the duration of the deficit by identifying the last time the patient showed normal neurological function.
• Encourage any individuals with knowledge of the patient’s recent past medical history to proceed directly to the emergency department.
• Those with transient neurological deficits or Transient Ischemic Attacks (TIAs), temporary stroke that resolves itself, also need to be transported to the hospital for further evaluation, in order to avoid the completed stroke that may otherwise await them.
• NEW THERAPIES FOR STROKE ARE AVAILABLE: However, successful use is only possible during a very short time window after the start of symptoms. Notify the receiving hospital promptly, minimize scene time, and expediently transport the patient to the receiving hospital. This is an important part of the strategy to treat patients quickly.
Prevention: Reducible Risk Factors, or, ways you can reduce the risk of having a Stroke:
• Lower your high blood pressure. Hypertension (high blood pressure) is the number one most treatable risk factor for stroke. You can help prevent a TIA or stroke considerably by working to lower your blood pressure. Cardio exercise and proper diet are great for this.
• Lowering cholesterol levels may decrease the risk of stroke. By working to lower your cholesterol, you can help prevent a TIA or stroke. Again, proper diet and cardio exercise also help reduce cholesterol.
• Stop smoking. If you stop smoking, you can decrease your risk for stroke to that of a non-smoker within two to five years.
• Management of heart disease and diabetes may also help to decrease your risk of stroke.
• Poor diet and inactive lifestyles are (relatively) easily changed and make definitive improvements in a person’s quality of life and reduced risk of Stroke (and many other diseases).
Resources: American Heart Association (Ed.). (2011, November 7). Hemorrhagic Strokes (Bleeds). Retrieved May 14, 2015, from http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/HemorrhagicBleeds/Hemorrhagic-Strokes-Bleeds_UCM_310940_Article.jsp
Fresno County EMS. (2005). Stroke. In Emergency Medical Services Administrative Policies and Procedures (Vol. Policy # 510.16). Fresno CA: Fresno County Public Health Department, from http://www.co.fresno.ca.us/uploadedFiles/Departments/Public_Health/Divisions/EMS/content/Policies,_Procedures_and_Memos/content/Fresno,_Kings_and_Madera_Counties/500_-_699/510_BLS_Protocols/510.16.pdf
The Internet Stroke Center. (n.d.). Retrieved May 12, 2015, from http://www.strokecenter.org/professionals/stroke-management/for-pharmacists-counseling/pathophysiology-and-etiology/
Mayo Clinic. (2015, April 28). Stroke. Retrieved May 12, 2015, from http://www.mayoclinic.org/diseases-conditions/stroke/home/ovc-20117264
About the Author Peter Schierling has a Bachelors degree in Kinesiology with an emphasis in movement science from San Jose State University. He is also a certified ACE CPT. He specializes in sports training, functional movement, and injury prevention. Peter enjoys creating a positive impact on the lives of his clients and athletes by delivering results.
