Stroke

INTRODUCTION :

A stroke occurs when there's bleeding into your brain or when normal blood flow to your brain is blocked. Within minutes of being deprived of essential nutrients, brain cells start dying — a process that may continue over the next several hours.

A stroke is a true emergency. The sooner treatment is given, the more likely it is that damage can be minimized. Every moment counts.

Some Points :

• Stroke is also called 'Cerebrovascular Accident'

• It is an acute neurological injury

• It may be due to blood clot (ischemic) or bleeding (hemorrhagic)

• Leads to stoppage of blood supply to a part of brain

• Oxygen supply is decreased

• This initiates 'ischemic cascade'-causes brain cell death/damage

• This results in a cerebral stroke.

Risk factors :

• High blood pressure
• Having a history of previous stroke
• Smoking
• Diabetes mellitus (DM)
• Having heart disease
• Age.

Signs and symptoms :

• Sudden weakness or numbness in your face, arm or leg on one side of your body
• Sudden dimness, blurring or loss of vision, particularly in one eye
• Loss of speech, trouble talking or understanding speech
• Sudden, severe headache — a bolt out of the blue — with no apparent cause
• Unexplained dizziness, unsteadiness or a sudden fall, especially if accompanied by any of the other signs or symptoms.

Follow the DRABC action plan :

St John Ambulance Australia recommends you follow the ‘DRABC Action Plan’ in every emergency. It helps you determine whether someone has a life-threatening condition and what first aid is needed.

The following plan assumes you have at least one other person to assist you. If you are alone with the casualty, work down the plan to ‘breathing’, check for breathing and turn the person into recovery position (see below) before calling an ambulance. Then resume the plan, starting mouth-to-mouth breathing if necessary.

D - Check for DANGER

• To you.
• To others.
• To the affected person.

R - Check RESPONSE

Ask the person their name. If someone has had a stroke, they may not be able to talk, so grasp both their hands and ask them to squeeze — they may respond by squeezing one of your hands.

Does the person respond? If so, they are conscious: follow the directions at the end of the page while you wait for help to arrive.

If the person does not respond, they are probably unconscious. Make sure someone has dialled 000 for an ambulance, then continue.

A- Check AIRWAY

• Is the airway clear of objects?
• Is the airway open?

If the airway is not clear, turn the person into recovery position.

• Kneel beside the person.
• Put their arm that’s farthest from you out at right angles to their body.
• Place their nearer arm across their chest.
• Bend their nearer leg up at the knee; the other leg should be straight.
• While supporting their head and neck, roll the person away from you.
• When they are on their side, keep their top leg bent at the knee, with the knee touching the ground.

Then tilt the head slightly backwards and downwards to let anything that’s in the airway (such as vomit) drain out, and clear the airway with your fingers.

B - Check for BREATHING

• Tilt the head back.
• Is the person’s chest rising and falling?
• Can you hear the person breathing?
• Can you feel their breath on your cheek?

If the person is not breathing:

• turn the casualty onto their back;
• tilt their head backwards;
• lift the chin, pinch the nose closed and give 2 initial mouth-to-mouth breaths;
• make sure the chest rises and falls with each breath; and
• if breathing does not return and there are no signs of life, go to the next step (step C).

If the person is breathing, follow steps below under ‘while waiting for help’.

C - Give CPR

• Kneeling beside the person, give 30 chest compressions on the lower half of the breastbone. Use 2 hands with the fingers interlocked.
• Then tilt the head backwards, tilt the chin and give 2 mouth-to-mouth breaths while pinching the nose shut.
• Keep alternating between 30 compressions and 2 breaths until the person shows signs of life or medical help arrives.

While waiting for help :

If the person is conscious:

• lie the person down with their head and shoulders raised and supported (use pillows or cushions);
• keep them at a comfortable temperature;
• loosen any tight clothing;
• wipe away any secretions from the mouth;
• make sure the airway is clear and open;
• assure the person that help is on the way (they may be able to communicate by squeezing your hands if they can’t speak) and;
• do not give them anything to eat or drink.

If the affected person becomes unconscious, put them in the recovery position as described above to prevent anything (blood, saliva, or their tongue) from blocking the windpipe and choking them. Continue to monitor their airway and breathing, and be ready to resume the DRABC plan as necessary.

Even if the symptoms are short-lived — a ‘mini-stroke’ or transient ischaemic attack (TIA) — ensure the person seeks immediate medical help, as these symptoms can be a warning sign of a future stroke.

Steps To Avoid :

• Never give a suspected stroke victim anything to eat/drink

• Do not permit the victim to move.

Prevention :

• Do regular checkups for BP

• Eat food with less salt

• Exercise regularly

• Eat a balanced, healthy diet

• Take the BP pills regularly.