F-A-S-T Response to Stroke Symptoms Saves Brain
By Barbara Goodwin, MSN, RN
There is a saying in the medical
community that “time is brain” when it comes to treating stroke because
the longer the brain is without sufficient oxygen, the more damaging a stroke
will be. Immediate recognition of stroke symptoms and transportation to the
Emergency Department within two hours of the onset of symptoms can make a
tremendous difference for someone who has suffered a
What causes a stroke?
A stroke occurs when the blood
supply to the brain is interrupted. Brain cells that are deprived of
oxygen-rich blood die, causing injury to the brain.
There are two kinds of stroke,
ischemic and hemorrhagic. An ischemic
stroke occurs when a blood vessel in the brain is blocked by a clot,
restricting blood flow to part of the brain. A hemorrhagic stroke occurs when a
blood vessel in the brain ruptures due to a weakness in the wall of the vessel,
resulting in bleeding inside of the brain.
How can I recognize symptoms of
The easiest way to remember the
symptoms of stroke is to use the acronym “FAST,” which stands for face, arms,
speech, and time. Look at the person’s face, look for weakness on one side of
the body, especially the arms, and ask him or her to speak to you. Then act
quickly to seek emergency medical attention.
The symptoms of stroke come on
abruptly from one minute to the next, not over a period of hours or days.
Stroke victims often experience a sudden deterioration in the face muscles. One
side of the face or mouth will droop. They may have weakness on one side of the
body and may not be able to raise one or both of their arms in the air. Their
speech is often affected; they may slur their words, have difficulty finding
the correct words to express themselves, or call objects by the wrong names.
When a person has any or all of
these symptoms, time is of the essence. Call an ambulance right away and tell
the operator answering the phone that you have a person with signs of stroke.
Why is it so important to get
Stroke is the third leading cause
of death in the U.S. and the number one cause of adult disability. Of the
people who survive stroke, 90 percent have a deficit. However, if you suffer an
ischemic stroke and you get to the Emergency Department within two hours, you
may receive medication that will dissolve the clot and minimize brain damage.
You should think of stroke as you
would think of a heart attack because there is the same level of urgency. Most
Americans have heard the expression “time is muscle” in reference to heart
attacks. The same notion holds true for stroke, which we also call “brain
attack.” Heart cells and brain cells both die when deprived of oxygen; however,
permanent damage can often be avoided or minimized if blood flow can be
restored within three hours of the onset of symptoms.
What should I do while waiting for
Keep the person safe, preferably
lying on their side. Do not give them anything to drink or eat in case the ability
to swallow has been compromised.
The ambulance will be in direct
contact with the Emergency Department, which is one of the many advantages of
ambulance transport. With notice from the EMTs, the medical center CT scan will
be readied for quick access once you arrive.
How are strokes diagnosed and
Strokes are diagnosed with a
physical examination and a CT scan of the brain, which identifies whether the
stroke is ischemic or hemorrhagic in nature. Doctors will also evaluate heart
rhythm with an EKG.
When the stroke is ischemic (caused
by blockage due to a clot in the vessel), the patient may be eligible for
treatment with a clot-busting medication called t-PA (tissue-Plasminogin
Activator). This medication must be administered within three hours of the
onset of symptoms. Studies show that when t-PA is administered after the
three-hour window, it is not effective.
If the stroke is hemorrhagic, t-PA
will not be administered because it will only exacerbate the bleeding in the
brain. However, doctors can still take
steps to minimize the effects of a hemorrhagic stroke, emphasizing the need for
an immediate call for an ambulance.
Barbara Goodwin, a clinical
educator on staff at Cayuga Medical Center, has a master’s degree in nursing
and is certified in critical care and in professional staff development. If you
would like to have her speak to your community group about stroke prevention
and treatment, please call (607) 274-4498 to make arrangements.