David Patterson is an instructor & trainer at Advanced Cardiovascular Life Support (ACLS) Training Center. The mission of the organization is to provide health professionals top quality ACLS training as well as Basic Life Support and Pediatric Advanced Life Support. In one of his articles, he writes about recognizing and responding to stroke.
A stroke is a serious and life-threatening condition
Stroke is a leading cause of disability and the fourth leading cause of death among Americans. Today, there are treatments available that can prevent or limit disability caused by a stroke as well as saving many lives. The success of such treatments is dependent upon how much time has passed since the stroke symptoms appeared. Therefore, the early recognition of a stroke by the patient or their family is of the utmost importance.
What is a stroke?
The brain has blood vessels that are dedicated to providing each and every region with the oxygen and nutrients that it needs to survive and function. Over the years, plaque from cholesterol and other lipid substances starts to build up in the blood vessels and causes them to narrow. If that plaque ruptures and causes damage to the vessel wall, the body tries to heal it. Clot forming molecules will reach the site and clot off the vessel. Once the blood vessel is closed, there is no blood flow to the tissue beyond the blockage. Sometimes, the clot will dislodge, travel in the blood and block a smaller vessel downstream. Without oxygen and nutrition, the tissue beyond the blockage will begin to die. There are two types of strokes: ischemic, which is predominant, and hemorrhagic, which is a less frequent.
Recognizing a stroke by signs and symptoms
A useful acronym to recognize and respond to stroke is FAST: Face drooping, Arm weakness, Difficulty in Speech, it is then Time to call the emergency and seek help. Headache, nausea, and vomiting are common along with dizziness and a very stiff neck and are accompanied by confusion and even seizures. The only and best way to ascertain the type of stroke along with the adequate treatment for it, is through imaging studies, for example, a CT scan or an MRI.
I’m having a stroke! What should I do?
It is imperative that you get help and get to a hospital AS SOON AS POSSIBLE following the onset of symptoms of stroke. Treatment for stroke is very time dependent. A clot-busting medication can be given to clear the clot from the vessel, but only if you are at the hospital within 3 hours (4.5 hours for some patients) of onset of symptoms. Call 911 IMMEDIATELY.
What treatments are available for stroke?
Treatments for ischemic stroke are described here, which is the most common form of stroke. tPA is a clot-busting medication that has been in use for many years for stroke, heart attack, and pulmonary embolism (clots in the blood vessels of the lungs). It is given intravenously and dissolves the clot to restore blood flow. It is, however, not without its complications: tPA can cause bleeding in the brain and other parts of the body, and also, it cannot be administered if more than 3 hours (4.5 hours in some cases) have elapsed since symptom onset. After such time the risks outweigh benefits.
Just like with a heart attack there are procedures to place a catheter directly into a vessel that feeds the brain and remove the clot that is blocking it. A catheter is placed through the groin and threaded up to the blood vessel that has been blocked. The clot can then be dissolved by directly delivering clot-busting medication, or it can be physically removed with the help of a tiny device at the end of the catheter.
The importance of simulation training before stroke treatment
Mentice provides hospitals, training centers and the medical device industry with interventional simulation solutions. A stroke is an emergency treatment, which you cannot plan for in advance. Because it is so unpredictable, it is not possible to schedule the training when it is based on real patients.
A simulated environment allows realistic practice of technical skills in a non-emergency setting. It provides a way to safely practice interventional stroke treatment and train cardiologists or radiologists to perform this complex treatment under the guidance of an experienced interventionist. Practicing procedures and management of complications in a stress-free simulation environment, increases not only staff skills but also patient safety.
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