Today I attended our Annual Nursing Stroke Conference at work. I learned a lot of new evidence based practice for the management of stroke care. I think it is important in my line of work to have continuing education; to stay on top of any changes in practice either with new equipment, technology, or standards of care. I was hesitant to write this post because the material is not as fun as writing about going to a concert or trying a new health craze, but I think it is important to share information regarding this health issue that affects thousands of people, which then could potentially save lives.
Did you know that annually 800,000 people in the U.S. will suffer from a stroke and 130,000 people will die from it? Pretty gruesome statistics. I want to share some basic information regarding the symptoms of stroke and how important it is to receive quick treatment if you do have a stroke. In nursing school we learn that “Time is brain”, meaning the longer you wait for treatment after having a stroke the more permanent damage to the brain will occur. Don’t wait for someone to come home or for the symptoms to go away on its own. If you have sudden onset of symptoms that you can’t attribute to be caused by any specific reason, call 911 to get to the emergency department as soon as possible. The American Stroke Association endorses the typical symptoms of a stroke to be under the acronym F.A.S.T.
- Face drooping
- Arm weakness
- Speech difficulty
- Time to call 911
Depending on the area of the brain that is affected with a stroke from either an infarct (blockage of blood flow from a blood clot) or from a hemorrhage (blood in the brain) there are many other different symptoms. It is important to get to the emergency department if you have sudden onset of confusion, dizziness, trouble walking, numbness or weakness of face, arm, or leg, visual disturbances, severe headache, and nausea/vomiting. It may be difficult to discern if these symptoms are from other causes, but when in doubt you should definitely check it out.
It is critical for someone having a stroke to be seen in the emergency department to assess if it is caused by a blood clot (cerebral infarct); and to receive the medication, tissue plasminogen activator (TPA), which is an enzyme that dissolves clots. This is used within 4.5 hours after the patient’s last known normal. The old literature used the parameters of less than 3 hours of last known normal, but we learned today that the requirement has changed. If it is given to a person with symptoms longer than 4.5 hours then there is a higher chance for a hemorrhage to occur from the TPA, so then the medication is contraindicated. TPA has evidence based practice to reduce stroke deficits and improving the chances of recovery from a stroke.
If the stroke is caused by a bleed it is still crucial to be seen and treated swiftly. The buildup of blood causes increased pressure and swelling in the brain. This can cause irreversible damage to the brain tissue and nerves and can ultimately be fatal. I am seeing more and more people and at younger ages to be affected by a stroke. To learn more about risk factors for stroke go here.
The take home message is to be seen as quickly as possible if you have any stroke symptoms. I can’t emphasize that enough. Please excuse the technical medical jargon, but this is my line of work and I can’t help but use this language. I care about you and your loved ones! If you have any comments or questions I would love to hear from you.