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Look for signs of stroke

Living with a disability of any kind can be a struggle. Millions of Americans fight on a daily basis to keep up with their everyday routines.

Disabilities can come in many different forms ranging from small to large, both mental and physical. In any regard, we as a society view a disability as a restriction, for lack of a better word, something that restrains us from having what other see as a “normal” life.

For many, their disability is as much of who they are as is their hairstyle or eye color. People born with disabilities, both physical and mental, often don’t see themselves as being dealt an unfair advantage, rather a unique and exceptional life. However, there are times when someone develops a disability, or is thrust into a life with a disability based on an injury or medical condition.

One of the more common methods of uninherited physical and mental disability is stroke. Strokes are the No. 1 leading cause of all long-term disabilities in America. And even though you may not have personally experienced a stroke, one happens every 40 seconds somewhere across the nation, mostly affecting people over the age of 65.

Strokes will inadvertently have some sort of direct effect on 4 out of every 5 people in America, and for that reason alone, here are a few helpful early warning signs of strokes, stroke recognition and how to respond to someone having a stroke.

What is a stroke?

A stroke, or a cerebral vascular accident as its known in the medical field, is an injury to the brain as a direct result of not receiving oxygen-rich blood to the tissues. This accident can be caused in two different ways: occlusive or hemorrhagic.

To put simply, for an occlusive stroke, the vasculature that supplies the brain with oxygen-rich blood becomes obstructed, or cut off by a free-floating embolism or clogged by a thrombus. The other would be hemorrhagic, where the blood vessel in the brain “bursts” or breaks and leaks into the surrounding space of the brain.

In either case, the result is the same: Blood tissue does not receive oxygen and tissue damage occurs, and the part of the brain that is affected loses its ability to function and operate normally.

Early signs of stroke

So you’re thinking, how will I know if I am having a stroke? The classic signs we as paramedics are looking for fall into three categories: speech, arm drift and facial drift.

Someone who is suffering from a stroke will likely have slurred or inappropriate words. Their normal speech patterns will not be present, and they will have an abnormality to their speaking that will be evident that something is wrong.

Facial and arm drift are a signal that part of the brain is being affected. Typically when one half of the brain is affected it will be evident throughout the entire body.

Facial and arm drift may or may not happen concurrently. You will notice a loss of balance and coordination to one side of the body or the other. You may notice the muscles on the face will become flaccid and weak. One half of the face will be saggy or droopy while the other half may appear to be completely normal. Same goes for the arm drift.

A part of the test we use in the field to determine if a patient is having a stroke is called the Cincinnati Stroke Scale, and in doing so we have the patient close his or her eyes, hold both arms out in front of him or her, palms up, and look for one half of the body to respond. If and when we notice one half of the body is unable to hold muscle tone or the patient has a complete inability to hold up one arm, it is typically a good indication he or she is having a stroke.

A decrease in sensation such as numbness; altered mental status; an inability to swallow; altered smell, taste vision or hearing; and altered breathing or heart rate are signs and symptoms of a stroke.

What happens when I recognize a stroke?

You need to call 911 immediately. As a paramedic in Boulder City I can tell you this is one of our most serious calls. This is a life-threatening incident that does not need to be delayed. There is a time frame in which doctors are able to either give medications or physically break up the embolism or thrombus that is causing the occlusive injury, or perform surgery to stop the bleeding in a hemorrhagic stroke.

Stroke centers vary from facility to facility but generally the faster the better. Most doctors would prefer to see the patient within the hour and may be able to give certain “clot-busting” medications up to four hours post-CVA.

Paramedics on scene will be rapidly assessing the patient for any nuero-deficits to evaluate the extent of the injury and to preserve the ABC’s of life: airway, breathing and circulation. Getting the patient to the closest stoke center as fast as possible then becomes our No. 1 priority.

If you think someone is having a stroke, do not hesitate to call 911, time is an issue and every second counts in saving a life.

If you have any other questions regarding strokes, stroke care or additional warning signs, call me at the fire station at 702-293-9228, or check out www.strokecenter.org.

Brian Shea is a Boulder City paramedic/firefighter.

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