It could happen anywhere — over the dinner table, at a bus stop, during a party. You’re having a conversation with someone. That’s when you notice: Your companion’s face is drooping and his speech is slurred. You ask, “Are you OK?” But you sense that something is definitely wrong.
Recognizing the signs of a stroke can save a life. Strokes can happen suddenly, and likewise, they require immediate action.
The doctors and other team members of the UCI Health Comprehensive Stroke & Cerebrovascular Center want to draw attention to the importance of quick, expert treatment to boost survival and recovery.
As Orange County’s first Joint Commission-certified comprehensive stroke center, UCI Health is dedicated to stroke prevention and the most advanced treatment.
“Every minute is extremely critical,” says UCI Health neurologist Dr. Steven C. Cramer, an expert in stroke and stroke recovery. Millions of brain cells are lost every minute until the stroke is diagnosed and treated.
Training yourself to recognize these tell-tale signs — face drooping, lack of arm control and slurred speech, collectively known by the acronym FAST — is step one. Step two is knowing how to respond — and quickly.
Cramer shares some do's and don’ts on how to care for someone who might be having a stroke.
- Don't drive to the hospital. “Call 9-1-1,” says Cramer. “Paramedics are faster and can recognize when someone is in trouble and needs emergency assistance.” The paramedics will also be in direct contact with the hospital, which gives the hospital time to prepare in advance. Responding paramedics may be directed to a designated stroke center, which are hospitals that have specialized doctors 24/7 and the latest diagnostic and treatment technology.
- Don’t give the person aspirin. “For many strokes, aspirin is a very good idea — but for many other strokes, aspirin will make things much, much worse. One has to undergo a CT scan for doctors to know which of those two groups a stroke victim is in. If you give a person aspirin before you know which one, there’s a chance you could do very serious harm.”
- Don’t give the person anything to eat or drink. Stroke can cause difficulty with muscle control, including the ability to swallow. “If someone is having a stroke, there is a significant chance of an increased choking hazard,” says Cramer. Even water can be dangerous in this situation.
- Call 9-1-1 immediately. For every minute the brain is deprived of oxygen, it loses about 1.9 million neurons, which is exactly why every minute counts. “We say, ‘Time is brain,’” Cramer explains. “During a stroke, the brain loses millions and millions of nerve cells that can never be replaced.” Do not wait to see if symptoms pass.
- Use the word ‘stroke’ with the emergency dispatcher. Even if you are uncertain a stroke is underway, letting the dispatcher know it could be a stroke gives the paramedics and the hospital more time to prepare.
- Write down the time. This will greatly help the emergency team to act as efficiently as possible. Knowing when the symptoms started can help doctors determine the appropriate treatment. If you are not sure when the symptoms started, knowing when the person was last seen “normal” is helpful as well.
- Help the person lie down. A stroke can cause dizziness, difficulty controlling movement, even paralysis. Keep stroke victims on their side with the head slightly elevated to promote blood flow. It may slow the process. “Help them lie down and be comfortable,” says Cramer. “But if the person has fallen and incurred head and neck trauma, we do not move them in case there is some kind of spinal cord injury.”
- Loosen any restrictive clothing. This helps the stroke victim breathe more easily. Avoid pulling or straining any weakened limbs.
- If the person is unconscious, check his or her breathing. Check for pulse and breathing. If there is no pulse, begin CPR immediately.
- Unlock the front door. Ensure that arriving paramedics have immediate, unfettered access to the possible stroke patient.
- Stay calm and remain by the person’s side. It can be very difficult to keep calm, but remember you are there to help. The person will likely be disoriented and frightened. Stay nearby and speak softly. Assure the person that help is on the way.
- Describe what happened to the paramedics. “Be very clear with the EMTs or paramedics as to when the symptoms started, and when was the last time this person seemed normal,” Cramer advises. “If this person woke up with a stroke, the last time they seemed normal will be when they went to bed.” If you know the person has health concerns, such as high blood pressure or diabetes, uses any medications or has certain drug allergies, share this information with the emergency team immediately.