The Do’s and Don’ts of Stroke Response
Author: Tashan Arrivas, RN
With stroke, every second matters.
How quickly you respond – from the
first warning signs to
receiving treatment – can be the difference between getting back to your everyday life
or a lifetime of disability. In fact, for
every 30-minute delay in removing a stroke-causing clot, the chances of a good recovery go down
by 10 percent.
For the best outcomes, knowing what
to do and what
not to do in the event of a stroke are critical.
DO: Call 911 Immediately
From the moment stroke is identified – whether you tell the dispatcher
you’re having a stroke or first responders suspect you’ve
had a stroke – it starts a process designed to get you the care
you need as quickly as possible. Your ambulance is routed to the closest
Stroke Center. Washington Hospital is a Primary Stroke Center, with a
dedicated stroke team. In stroke care, where minutes matter, this means
the ambulance calls ahead to alert the hospital of a possible stroke arriving.
Our stroke team is then ready and waiting for your arrival to move quickly
to provide the care you need.
As tempting as it can be to drive yourself to the hospital, stroke can
affect your motor functions and impair your ability to safely operate
your vehicle. Or if your loved one is having a stroke, driving them to
an emergency department can be dangerous and cost precious minutes between
navigating Bay Area traffic, not knowing if your closest hospital is a
designated stroke center, not giving the hospital advanced warning and
not having the emergency training to stabilize them should their condition
deteriorate. Additionally, emergency medical technicians can begin treatment
DON’T: Wait to See if Symptoms Go Away
While it’s important to take note of when symptoms began, if you
think you or a loved one is having a stroke, waiting to see if they worsen
or go away is a dangerous gamble. In addition to being the leading
cause of serious long-term disability, stroke is the fifth-leading
cause of death in the United States.
By seeking help immediately, you’re giving yourself or your loved
one the best chance of survival. One of the two approved treatments in
an ischemic or non-bleeding stroke is tissue plasminogen activator (tPA).
It is a medication given through an intravenous catheter that can dissolve
the stroke-causing blood clot and reduce your risk for further complications.
In some circumstances, with additional imaging, strokes can be treated
with interventional radiology. A specially trained doctor can go in through
the groin and remove a blood clot or apply tPA inside the vessel, right
at the location of the clot.
DO: Support and Stabilize the Person
A stroke can cause dizziness and loss of motor function. That’s why
it’s important to get to a safe position to reduce the risk of further
injury. To promote blood flow and reduce the risk of aspiration, lie on
your side and keep your head slightly elevated.
If your loved one is having a stroke, they may lose consciousness. In that
case, check for signs of breathing and pulse. If you haven’t already,
call 911 and begin CPR immediately. If you’re not sure how to perform
CPR, the dispatcher can walk you through it. Finally, stay calm and focused.
Having to respond to an emergency situation like a stroke can be scary
and stressful, but quick action means better outcomes.
DON’T: Try to Treat Stroke Yourself
While it may be tempting to lie down for a while, and see if your symptoms
improve. This is not recommended, treatment is a race against the clock.
Time is brain. 1.9 million neurons die every minute in a large vessel stroke.
Even if you’re waiting for EMTs to arrive, you should not take or
give your loved one food, drink or medications. A stroke can affect one’s
ability to swallow, so it’s possible to inhale food or liquids,
which can cause aspiration pneumonia.
Additionally, although most strokes are ischemic (caused by a clot obstructing
blood flow within the brain), taking aspirin is not recommended. For the
15-20 percent that are hemorrhagic (caused by an artery leaking into the
brain), blood thinners like aspirin can prevent clotting, causing more
bleeding and damage.
DO: Be Prepared in the Event of a Stroke
We never want to think a medical emergency, like a stroke will happen to
us. But being prepared can save valuable time. Oftentimes, stroke can
cause slurred speech or difficulty speaking, which makes communicating
with first responders and hospital staff especially challenging. That’s
why I recommend having a running list of medications and allergies, as
well as a brief medical history and emergency contact information written
out. Keep it in a place that is easily accessible. The Alameda Fire Department
participates in a program called the
Vial of Life. They will give you a vial, all of the paperwork you need as well as a
sticker to place on or by your front door. This will direct EMTs to a
designated medical information storage place: your refrigerator (yes,
you read that right).
For patients on a blood thinner or significant medical history, I recommend
a medical alert bracelet or necklace. This provides first responders quick
access to pertinent medical history and an emergency contact number.
DON’T: Assume You’re Too Young to Have a Stroke
In the U.S.,
nearly 795,000 people suffer a stroke each year – and about a third of those occur in
individuals under the age of 65.
ischemic stroke risk factors like obesity, hypertension, and diabetes can develop at any
age. Other things, like medications, narcotic use, pregnancy and migraine
headaches may also increase the risk of stroke in younger patients.
Stroke Response Matters
As a stroke nurse, there’s nothing more rewarding than seeing a patient
walk out of the hospital on their own, but it all starts with patients
or their loved ones recognizing the signs of stroke and responding accordingly.
Fast action and knowing what to do – and what not to do –
in this situation may very well save your life or the life of a loved one.
If you’d like to learn more about the Stroke Program at Washington
Hospital and what being certified as a Primary Stroke Center means for
patient care, visit
the Hospital website.
Posted May, 2019