Published on May 18, 2012

Act FAST When It Comes To Stroke

Bystanders can often identify warning signs

So many times, it’s not the victims of stroke but their families, friends and coworkers who notice the telltale signs of a brain attack.

Because stroke injures the brain, the person having the stroke may not be able to comprehend what is happening to them but a bystander often can. Knowing the acronym FAST for the signs and symptoms of stroke -- and getting the stroke patient to the hospital quickly -- are life-saving messages during National Stroke Awareness Month.

The National Stroke Association says to “Think FAST.” Look for symptoms in the face, arms and speech and then remember time is crucial and call 911.

“It depends on what part of the brain the stroke attacks,” says Angie Overton, MSN, RN, CNRN, Genesis stroke coordinator. “Some people are having a stroke and don’t even realize it. Instead, it might be the 8-year-old who comes to visit a grandparent after school and notices their face drooping or slurred speech.

“I’ve talked to a patient who had a headache and was asking for Tylenol when a family member noticed the facial droop and suspected a stroke. A woman experiencing right-sided weakness might think it’s because she has been baking all day, for example. She ignores the symptom and just goes to bed. Sleep lowers her blood pressure, which only makes the stroke symptoms worse.”

Jill Bolte Taylor, the author of “Stroke of Insight,” got a research opportunity few brain scientists would wish for in 1996 when she suffered a brain hemorrhage. She understood completely what was happening to her as she experienced her brain functions -- motion, speech, self-awareness -- shutting down one by one.

She was unable to rationalize calling 9-1- 1, but remembered her mother lived thousands of miles away and it wouldn’t do much good to call her. She knew she worked at the Harvard Brain Tissue Resources Center and could recall four digits of the center’s telephone number, but it took her 45 minutes to remember the remaining digits and make the call. Although she was unable to form words or sentences, a colleague recognized her voice.

By the time she arrived at the hospital, she was curled up in a fetal position and existing largely in the right hemisphere of her brain and “a state of euphoria,” she writes in her book.

“The beauty of the Think FAST message is it’s simple to remember,” Overton says. “Stroke is a life and death emergency, and the brain loses 1.9 million neurons for every minute a stroke goes untreated.”

Stroke is the leading cause of serious, long-term disability in the U.S. On average, someone has a stroke every 45 seconds, and someone dies of a stroke every 3.1 minutes.

When symptoms appear

It’s important for a bystander or stroke patient to note the time symptoms first appear.

If given within four-and-a-half hours of the first symptom, a clot-busting drug called t-PA or Activase has the potential to reduce or eliminate long-term disability for ischemic strokes, when blood flow to the brain is obstructed.

“It’s not unusual for people to delay getting help for a stroke. They’re often in denial,” Overton says. “When people have a heart attack, they have pain and know it’s important to call 9-1-1. Unfortunately, that same level of awareness isn’t there for stroke. Most people having an ischemic stroke have no or little pain -- their hand might be numb or it doesn’t work right, for example, but there’s no pain.”

About 42 percent of stroke patients wait as long as 24 hours before going to the Emergency Room, according to the National Institutes of Health.

A primary stroke center

Genesis Medical Center, Davenport is the first hospital in the Quad Cities area to earn national distinction as a Joint Commission Certified Primary Stroke Center. Just recently, the hospital received the designation for the third time. “The certification elevates the care of our stroke patients and ensures everyone is on board with the latest treatments and working to coordinate care quickly and efficiently,” Overton says.

For the most rapid response, Genesis has instituted a “Stroke Alert” at all of its hospitals to mobilize a broad spectrum of hospital departments to respond in a wellplanned system of care. Often, paramedics initiate stroke alerts in the field.

Genesis has a dedicated Neuroscience Unit on the West Central Park campus in Davenport, where nurses are specially trained in stroke care. It offers the region’s only outpatient-designated Stroke Prevention and Recovery Center (SPARC) and CARF-accredited brain injury rehabilitation programs.

“Even though the stroke center certification is for Genesis Medical Center, Davenport, the same care protocols for stroke are in place at our Illini and DeWitt hospital campuses, making those hospitals stroke-ready as well,” Overton says. “The drug t-PA is administered, and then the patient is transferred to the Davenport campus.”

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