Stroke update 2014
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Stroke or Cerebrovascular accident (CVA) is the sudden impairment in one or more of the blood vessels supplying the brain with blood, due to rupture or blockage of cerebral circulation.
Types of Strokes:
Ischemic strokes: Embolic and Thrombolic
Hemorrhagic: Subarachnoid and Intracerebral
TIA - Transient Ischemic Attack.
- Transient Ischemic Attack:
- - symptoms or TIA are the same as for a stroke but can resolve within minutes or hours.
- - up to 40% of TIA patients will have a future stroke
- - a TIA is a warning sign for a future stroke.
Risk Factors of Stroke:
- - Hypertension
- - Diabetes
- - Obesity
- - High Cholesterol
- - Excess ETOH
- - Previous Stroke
- - A-fib (atrial fibrillation)
- - Age > 55 yrs
- - Ethnicity: Hispanic & African American
Signs and Symptoms of Stroke:
- - Sudden numbness or weakness of face, arm, leg, especially on one side of body. (usually ischemic)
- - sudden confusion, trouble speaking or understanding speech. (usually ischemic)
- - sudden trouble see in one or both eyes (usually ischemic)
- - sudden troulbe walking, dizziness, loss of balance or coordination (usually ischemic)
- - sudden severe headache with no known cause (usually hemorrhagic)
Last Known Well Time:
The last time the patient was known to be without signs and symptoms of current stroke or at their prior baseline. Time of discovery does not always equal the last known well time.
Acute change in Neurological status suspicious of stroke?
- Act FAST:
- F - Face: smile, is there facial symmetry?
- A - Arm: raise both arms, is there arm drift?
- S - Speech: is their speech slurred?
- T - Time: when was last known Well Time?
Steps to activating code stroke
- 1. Recognize Act FAST (Face, Arm, Speech, Time)
- 2. Rule/Out Bells Palsy and hypoglycemia (accu-chek)
- 3. Confirm last known Well Time.
- 4. Activate Code Stroke for s/s < 3 Hours by dialing 911.
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