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Tue, 04/29/2014

Stroke: Immediate Response Imperative

When a heart attack occurs – like a heart attack – it is imperative to recognize the symptoms quickly and to call an ambulance immediately. The faster the doctor arrives, the more likely it is that drastic and irreversible damages can be prevented. So how do you recognize a stroke? Since it occurs suddenly and then disappears, you should take the symptoms very seriously indeed and not accept a "I am okay". A stroke is caused by narrowed blood vessels and affects people of all ages. In the elderly, however, it occurs more frequently. Risk factors favoring strokes, are obesity, diabetes, physical inactivity, high alcohol consumption, high blood pressure and elevated blood lipids. Does anyone have this predisposition, the suspicion that it is a stroke is extremely high if the person shows the following symptoms:

  • sudden vision problems
  • problems with anguage or understanding
  • paralysis
  • severe pain behind the breastbone that radiates to the left arm or shoulder
  • cold sweat breaks out
  • muscle weakness, instability in walking
  • dysphagia
  • hanging corner of the mouth
  • severe headache
  • sometimes nausea/vomiting

For lay people there is a simple test to detect a stroke. Ask the person concerned to smile as much as possible. Should one side of the face not respond this is a first indication of a stroke. Second, ask the person to raise both arms simultaneously with the palms facing up. With a suspected stroke one of the two arms is completely paralyzed or unable to move according to the other arm. At last ask the person to repeat the following sentence several times loudly: "I do not need help!". The sentence should be spoken properly and should not be recited unclear or impaired. Even if only one of these tests is positive, it is most likely that the person concerned had a stroke. In this case matters should not be delayed any longer and the paramedics must be called.

While waiting for an ambulance you should provide the patient as follows: put the upper body up high, not the legs, open tight clothing and provide fresh air. Do not let the affected person drink and/or eat under any circumstances. The body probably can not control the swallowing function properly and there is a risk of suffocation. Awareness should be controlled every minute by asking a question. If pulse and breathing stops, measures to revive the patient must be initiated. In case of cardiovascular arrest follow this procedure: resuscitation/respiration with heart massage (two breaths through the mouth, then 30 compressions, then start again without interruption). For mouth-to-mouth resuscitation the neck needs to be stretched out to open the windpipe, then close the patient's nose with two fingers and blow air into the mouth of the unconscious person. The cardiac massage is performed on a solid surface (not on a bed!) and on the lower third of the sternum. The clothing on the upper body of the patient must be removed. For the chest compressions you push with the heel of the hand on the sternum towards the spine. The revival measures must be carried out as long as the ambulance arrives – or the patient is breathing again by himself. All information will be shared with the arriving doctor or paramedics.