What do you do if you witness or experience a stroke?

This week, I want to talk about stroke signs and symptoms.  Again, it is a little different than what has previously been written on my blog but I feel it is SO important and SO necessary to make people aware about this—the CDC reports that strokes are the leading cause of death in the US and nearly 130,000 people in the US die every year because of a stroke (1 in 19 deaths).  Strokes are a medical emergency!  Not only is it the leading cause of death, but strokes can cause severe disabilities in people: weakness or paralysis, cognitive issues, speech impediments, difficulty walking, etc.

The American Stroke Association, a branch of the AHA, has come out with an acronym called FAST which helps people in remembering and recognizing symptoms of a stroke.

·         F- facial drooping: often times a victim experiences one-sided weakness which can be manifested through facial drooping.  If you suspect facial drooping, ask the victim to smile.  Their smile will be lopsided.

·         A- arm weakness: again, this is a result of one-sided weakness.  Ask the victim to raise both arms in front of them. If one is unable to raise or is held lower than the other, this is a sign of stroke.

·         S- speech difficulty: ask the victim to talk.  They may say nonsensical things, are unable to communicate clearly, or have slurred speech.

·         T- Time is brain! If any of these signs manifest, call 9-1-1 immediately.

Outside of the acronym FAST, other signs may be evident: numbness or weakness of the leg, confusion, sudden blurred vision or blindness in one or both eyes, trouble walking, dizziness, loss of balance and sudden severe headache, often called “the worst headache of my life.”

If you or your loved ones are ever confronted with any of these signs or symptoms, do not hesitate to contact emergency medical services.  Quick recognition and identification of a stroke can save someone’s life!

What should you do if you find someone unresponsive?

For this week’s blog, I figured I will take a different approach.  In past blogs I discussed hypothermia as a post-resuscitation treatment after a sudden cardiac arrest (SCA).  But what can the layperson do if they witness someone experiencing a cardiac arrest?  This week I will talk about the proper way to perform CPR (cardiopulmonary resuscitation) so that the victim of a SCA has an increased chance of survival so that hypothermia may be used afterward.

The best resource for learning CPR is through the AmericanHeart Association (AHA).  New best practices and guidelines are always changing, so it is important to keep up to date.

When you see someone suddenly become unconscious or unresponsive, or find someone unconscious or unresponsive:

1.    Determine whether or not the environment is safe: Is there a fire around? Is the building about to collapse? There are 2 reasons for this: first, it will not do you or the victim any good if the environment is unsafe and you are risking yourself and second, if it is possible, pull the victim to safety.

2.    Once the environment is deemed safe, check the victim’s level of consciousness.  This can be assessed by shaking the victim and asking if they are okay.  If they are unresponsive, you can check the carotid artery for a pulse which is located in the neck.  You will also want to assess the victim for breathing.  If they are not breathing or are only gasping, then you will want to look into the victim’s mouth to see if there is something blocking their airway.

3.    If the victim is still unresponsive and a pulse is not palpable, immediately begin CPR.  Chest compressions are the first thing you will want to do.  You will want to interlock the fingers of your hands and begin chest compressions in the middle of the victim’s breastbone (sternum).  You will want to push hard and fast, usually about 100 beats per minute.  You will do 30 compressions before switching to 2 rescue breaths.

4.    After 30 compressions, 2 rescue breaths will be given to the victim.  In order to make these rescue breaths effective you will want to tilt the victim’s chin back to establish a patent airway.  When administering these breaths, you can check the victim’s chest for a rise—this indicates the breaths are effective.

5.    You will continue this cycle until 1 of 3 things occur: either first responders are available on the scene or if you are in a public place, someone brings an AED (automatic external defibrillator), or the patient is no longer unconscious or unresponsive.

6.    In the event that first responders are still not available and an AED is available, follow the prompts given by the AED.

The long list of CPR can be intimidating to those who have either never performed it or formally learned CPR.  The AHA always has classes available so if you are interested, I strongly recommend taking one.  As I mentioned before, guidelines are always changing and there are some new studies that have come out recently that say to not even worry about the 2 rescue breaths, just do the compressions because that will circulate what oxygenated blood is left. If you are ever confronted with this situation, do not panic! Just remember to check the environment, the victim, and then immediately begin chest compressions if nothing else. Remain calm, you can do it!