There Are New Guidelines For Stroke Management

“During a BBQ, a friend stumbled and took a little fall – she assured everyone that she was fine (they offered to call paramedics) … she said she had just tripped over a brick because of her new shoes. 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 the rest of the evening.
Ingrid’s husband called later telling everyone that his wife had been taken to the hospital. Ingrid passed away at 6:00 pm. 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. Some don’t die … they end up in a helpless, hopeless condition instead.

A neurologist says that if he can get to a stroke victim within three hours he can totally reverse the effects of a stroke … totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.”

Above two paragraphs are taken from an email sent to me by a friend in Calgary. It is not an uncommon story. Most people know somebody who has been paralyzed or killed by stroke. The good news is there is lot of research going on to prevent stroke. “Research in stroke care is generating new information at a rate that challenges our ability to effect health-system change in a timely manner,” says an article in the Canadian Medical Association Journal (CMAJ).

What is new now is the time window for delivery of thrombolytic therapy (clot buster) for acute ischemic stoke has been extended, from three to 4.5 hours after the onset of stroke symptoms. The CMAJ article says that for a person with stroke, “time is brain,” and earlier treatment is associated with better outcomes. Even if a patient presents later than the 3-hour window, he or she should still be considered for clot busting therapy.

For a better outcome, acute stroke teams and emergency departments must continue to give priority to all suspected stroke patients and follow agreed-upon protocols. Rapid transportation, diagnosis and treatment go hand-in-hand in improving prognosis. Patients with suspected transient ischemic attack (sort of a temporary stroke) or minor stroke, if treated early, can minimize the risk of disability significantly to less than five per cent.

How can you recognize stroke early? If you are a victim of a stroke or you see somebody complaining of some strange symptoms then you can make a rapid diagnosis by following the following check-list:

S: Ask the individual to smile (there should be no drooping on one side)

T: Ask the person to talk (coherently) and stick tongue out to see if it deviates on one side.

R: Ask the person to raise both arms (there should be no weakness on either side).

If he or she has trouble with any one of these tasks, call 911 immediately and describe the symptoms to the dispatcher. Don’t worry if you are wrong. There is no penalty for that. But if you are right then you will save somebody’s life or prevent lifelong disability.

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