Preparedness is everything when it comes to responding to a stroke. Knowing the signs in advance and acting quickly can make a dramatic difference in outcomes.
“Education is key,” says David Hale, MD, an emergency medicine physician with ThedaCare. “It’s important to have conversations with family before a stroke happens.”
The stroke adage is true: time lost is brain lost. A stroke can cause death or permanent disability if not treated quickly.
In recognition of American Stroke Month, we’re sharing a reminder of stroke signs and ways you can help ensure more effective emergency care if you or a loved one experience a stroke.
Spotting a Stroke: BE FAST and Beyond
BE FAST is the well-known and longstanding acronym for recognizing stroke symptoms. It stands for:
- Balance: Loss of balance or coordination
- Eyes: Sudden trouble seeing in one or both eyes
- Face: Facial drooping or uneven smile
- Arms: Weakness or numbness in one arm — or leg
- Speech: Slurred speech or difficulty speaking
- Time: Time to call 911
According to the American Stroke Association, other symptoms include:
- Numbness or weakness in the face, arm or leg, especially on one side of the body
- Confusion or trouble speaking or understanding speech
- Severe headache with no known cause
While it’s important to remember BE FAST, people often overlook other key symptoms such as dizziness, Dr. Hale says.
“Assess the whole picture of what you’re seeing,” he says. “If something seems off, seek help immediately.”
Optimizing Emergency Care
As stated in BE FAST, it’s crucial to call 911 if you suspect a stroke. Don’t try to transport yourself or the impacted individual to the emergency department (ED).
Emergency medical services can begin lifesaving treatment in the ambulance and bring the affected person to the appropriate medical facility without delay.
“EMS connections are especially critical in our rural communities,” says Dr. Hale, who serves ThedaCare Medical Centers-Waupaca and Shawano. “Paramedics give the ED a heads-up that a potential stroke patient is on the way so teams can get neurology telemedicine alerted and ready the minute the patient arrives.”
Whether for yourself or a loved one, it’s also good to have pertinent information at the ready.
“It’s important to know what medications the person is taking and have a list handy, as that can determine course of treatment,” Dr. Hale says.
What to Expect at the ED
“Know that once you arrive in the ED, you’ll be in good hands,” Dr. Hale says.
Teams will first assess whether the person is indeed having a stroke and if so, what type. A CT scan can determine whether a stroke is ischemic or hemorrhagic. The ED team also will initiate a Code Stroke protocol, which notifies neurology to assist in collaborative care of the patient.
In addition to a CT scan, individuals will undergo a thorough medical exam. Other tests often include blood work, an EKG and a chest X-ray.
Stroke Types and Treatments
Approximately 87% of strokes are ischemic. This type of stroke occurs when a vessel supplying blood to the brain is obstructed. The urgent treatment for ischemic stroke is clot removal.
Medications can treat ischemic strokes by dissolving the clot and improving blood flow to the affected part of the brain. These medications are best administered within four and a half hours after symptom onset. If given in a timely fashion, they can improve the chances of recovering from a stroke.
A mechanical thrombectomy can remove a clot in eligible ischemic stroke patients with a large-vessel blockage. This procedure is usually done within six hours of the onset of acute stroke symptoms. However, it can be done up to 24 hours after symptoms begin if imaging tests show undamaged brain tissue.
The other 13% of strokes are hemorrhagic or bleeding strokes. These occur when a weakened vessel ruptures and bleeds into the surrounding brain. The blood accumulates and compresses the surrounding brain tissue. Hemorrhagic strokes often require neurosurgical intervention.
Trusted Stroke Care through ThedaCare
“At ThedaCare, our medical centers work together seamlessly to ensure we’re providing comprehensive stroke care,” Dr. Hale says.
DNV GL – Healthcare stroke certification verifies that an organization’s stroke care programs meet or exceed standards of care in the delivery of quality stroke care. ThedaCare has received certification for eight of its hospitals.
The highest level of stroke care within the ThedaCare system is available at ThedaCare Regional Medical Center-Neenah. Its Comprehensive Stroke Center offers round-the-clock acute care and partners with first responders and rural hospitals. The stroke team also provides virtual consultation to patients at ThedaCare critical access hospitals.
ThedaCare Regional Medical Center-Appleton is accredited as a Primary Stroke Center. This recognizes that the medical center offers the necessary staffing, infrastructure and programs to stabilize and treat most stroke patients.
Five ThedaCare critical access hospitals have earned Acute Stroke Ready certifications from DNV GL – Healthcare. These include ThedaCare Medical Centers in Berlin, New London, Shawano, Waupaca and Wild Rose.
This certification allows smaller and rural hospitals to demonstrate excellence by complying with standards of care for the initial treatment of stroke patients. It reflects that rapid action and proper medications can save lives and limit the long-term disabling effects of strokes.
Better Preparation, Better Outcome
It might feel uncomfortable to contemplate a medical emergency like a stroke, but knowing what to watch for and how to prepare can make a big difference. Dr. Hale has seen this play out countless times, both in positive ways and worst-case scenarios.
“Swift and effective treatment can make a huge difference in a person’s recovery and outcome,” he says.
