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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.
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 immediately.
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.
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.
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.
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.
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.
Common 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.
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