About 80 percent of strokes are preventable and with rapid treatment death can be prevented and brain damage minimized. Do you know the warning signs?
Mary Jarschke, RN, SCRN shares what the acronym F.A.S.T stands for, and why it is so important to seek help immediately if you or a loved one is having a stroke.
Selected Podcast
Recognizing Stroke: F.A.S.T
Featuring:
Mary Jarschke, RN, SCRN
Mary Jarschke, RN, SCRN, was born in Salinas, CA and grew up in Napa, CA. She completed her education at San Bernardino Valley College and has worked in the ICU for most of her career. In 2011, Mary was part of a team to get Oroville Hospital’s Stroke Program started. Mary obtained her SCRN certification (Stroke Certified Registered Nurse) in 2014 through the American Board of Neuroscience Nursing. Mary’s passion and mission are to educate the community and hospital staff to treat stroke patients using the latest evidence based medicine and technology. Since the program started in 2011, the hospital has won multiple Gold Plus awards from the American Stroke Association. When Mary has time off she enjoys beekeeping, gardening, kayaking, and playing with her French Bulldog Tank. Transcription:
Melanie Cole (Host): Stroke is the fifth leading cause of death in the US, and it's important for you to know the signs of a possible stroke, to learn your risk factors, and to identify what you need to do if you suspect that you or a loved one is having a stroke. My guest today is Mary Jarschke. She's a Registered Nurse and the Stroke Program Coordinator at Oroville Hospital. Mary, tell the listeners- let's educate a little bit first. What is a stroke, and are there different types?
Mary Jarschke, RN, SCRN (Guest): Yes. A stroke- most strokes are a blockage in the brain, in a vessel in the brain, that prevents oxygenated blood from getting to your brain. That's one type, an ischemic stroke. The other type of stroke, not as common, is the hemorrhagic stroke where a vessel would burst in the brain and bleed into the brain. And luckily, most strokes are ischemic strokes that are caused by a blockage of some type.
Host: Who's most at risk for stroke?
Mary: Actually a stroke can happen to anyone at any time. Of course as we age, we become more at risk for a stroke, but there are certain risk factors that enter into that. Certainly things like high blood pressure, being diabetic, smoking, drinking too much, not exercising. So there's- just leading a healthy lifestyle is a good preventative, but really everyone is at risk. It can happen to older people and younger people.
Host: If you've had a stroke, are you now at a higher risk of having another one?
Mary: Unfortunately yes, and that's why even if you've had a stroke, we really work on trying to reduce your risk factors by taking good care of yourself and taking all the proper medications.
Host: Well, it is so important to take good care of yourself and live that healthy lifestyle, however it's also important, Mary, if someone can recognize the symptoms of a stroke whether it's in themselves or in a loved one. Tell us about the acronym FAST, and what you would like people to know that this means for the possible symptoms of a stroke.
Mary: So the acronym FAST is- it's a little acronym to help us recognize the most common presentation of stroke. So that would be- the F stands for facial droop, the A is for arm drift, the S is for speech problems, and the T reminds us that if you see these symptoms in someone, it's time to call 911. Most strokes present that way, but certainly not all strokes. So there are other symptoms that we should talk about that are not as common. I'd say the atypical stroke presentation, or not as common, could be something like a sudden onset of confusion, a loss of balance, or a vision problem. So these aren't as common but they are definitely stroke symptoms, and more common with a bleeding type stroke, or a hemorrhagic stroke, or things like a sudden onset of a really bad headache, and often accompanied by nausea and vomiting.
So I always recommend that if people recognize any sudden onset of any neurological event, it's good to get checked out and let us decide is this a stroke or could it be something else? Because we don't want to miss a stroke.
Host: Mary, why is time so important? We've heard the phrase 'time is brain,' so why is time so important, and should the person call 911 or drive their loved one? Is there something that the EMS can do in the interim of getting to the hospital that can possibly help with the reaction to someone suffering a stroke?
Mary: It is really important to call EMS because they are equipped to assess the patient, they may be able to give some initial medication. The really important thing to remember is there is a medication that is available for some patients, but it's time sensitive. So the sooner that you can get to the hospital and get assessed, the sooner we can give the clot-busting drug that can reverse the effects of the stroke. So that has time limits and often people - if they have symptoms - will kind of think, "Well, maybe I should wait. Maybe this will go away. It'll resolve." But that is definitely not the thing to do because every minute that treatment is delayed, they estimate that we are losing almost 1.9 million neurons. So minutes count, and EMS can get someone to the hospital much quicker than driving in an automobile.
Host: And what happens at the ER? What is that like, and tell us a little bit about that clot-busting drug, TPA.
Mary: TPA has been used to treat strokes for over twenty years, and like I said, it does have a time limit. So when a patient comes to the emergency room, the very first thing that happens is they get a quick assessment. If they're stable, they go straight to our CT scanner, and what we're looking for at that point in that initial CT is to make sure that the patient is not having a hemorrhagic stroke. We want to make sure they're not bleeding into their brain, because that would be a contraindication for giving the clot-busting drug.
But if they meet the criteria- and there is some inclusion and exclusion criteria that the person has to meet, and our emergency room team is trained and ready to do that. I might also mention that we do have access to expert neurological support through telemedicine because we are a rural hospital. And so together, our stroke team in the emergency room and with our expert neurological support, we're able to make the determination, is that person eligible to get the clot-busting drug, and get that in as soon as possible because the sooner we get the medication in, the better it works, and the less chance of any bad side effects that could happen.
Host: Then based on obviously the time that somebody gets in, and the brain function that is maintained based on the TPA and the treatments available, what have you seen? As the Stroke Coordinator, what have you seen life is like after stroke, and the rehab, and what is that like for patients and their families?
Mary: Well, I always say stroke is probably one of the most devastating things to happen to a person and their family because it's often unexpected and so sudden, and they can- some strokes can be really severe. So we begin, not only our treatment in the ER with the clot-busting drug, but we also follow up with rehabilitation starting right away, because we know that the sooner rehabilitation is started, the more successful it is, and then continued rehabilitation after the hospital stay. And then we also have a stroke support group that meets once a month to help the patients and their families cope and adapt to life after stroke.
Host: It's such important information, Mary, for people to hear, to recognize those symptoms of a possible stroke and possibly even to prevent their risk- reduce their risk or prevent a stroke altogether. Wrap it up for us with your best advice. As the Stroke Program Coordinator at Oroville Hospital, what would you like people to know about stroke? What's the take home message today?
Mary: The take home message is if you or a loved one experiences the signs and symptoms of stroke like the sudden onset of a facial droop, arm drift, or speech problem, if they have a sudden onset of confusion, a sudden onset of disequilibrium or vision problem, call 911 and get here and let our team assess them and make a determination so that we can start treatment right away.
The other part of that is we would like it if we didn't have to ever treat a stroke, so the more that we can encourage people to live their best life as healthy as possible. I always say we all know what we should do, we don't always do it, so doing things like quitting smoking, and monitoring your blood pressure, take those medications that your doctor recommends, exercising, and just leading your most healthy life. Eat real food that's not- like fast food and junk food is just not good. So a healthy lifestyle, eating lots of fruits and vegetables, exercising, and just living that healthy lifestyle is the very best protection that we have against stroke.
Host: Mary, thank you so much for being on with us today. It's so important that people recognize the symptoms of a stroke should they or a loved one be suffering from one. Thank you again for sharing your expertise. And for more information on Mary's outreach and community education on stroke prevention, you can call (530) 538-3070. That's (530) 538-3070. You're listening to Growing Healthy Together - a podcast by Oroville Hospital. For more information, please visit www.OrovilleHospital.com. This is Melanie Cole, thanks so much for tuning in.
Melanie Cole (Host): Stroke is the fifth leading cause of death in the US, and it's important for you to know the signs of a possible stroke, to learn your risk factors, and to identify what you need to do if you suspect that you or a loved one is having a stroke. My guest today is Mary Jarschke. She's a Registered Nurse and the Stroke Program Coordinator at Oroville Hospital. Mary, tell the listeners- let's educate a little bit first. What is a stroke, and are there different types?
Mary Jarschke, RN, SCRN (Guest): Yes. A stroke- most strokes are a blockage in the brain, in a vessel in the brain, that prevents oxygenated blood from getting to your brain. That's one type, an ischemic stroke. The other type of stroke, not as common, is the hemorrhagic stroke where a vessel would burst in the brain and bleed into the brain. And luckily, most strokes are ischemic strokes that are caused by a blockage of some type.
Host: Who's most at risk for stroke?
Mary: Actually a stroke can happen to anyone at any time. Of course as we age, we become more at risk for a stroke, but there are certain risk factors that enter into that. Certainly things like high blood pressure, being diabetic, smoking, drinking too much, not exercising. So there's- just leading a healthy lifestyle is a good preventative, but really everyone is at risk. It can happen to older people and younger people.
Host: If you've had a stroke, are you now at a higher risk of having another one?
Mary: Unfortunately yes, and that's why even if you've had a stroke, we really work on trying to reduce your risk factors by taking good care of yourself and taking all the proper medications.
Host: Well, it is so important to take good care of yourself and live that healthy lifestyle, however it's also important, Mary, if someone can recognize the symptoms of a stroke whether it's in themselves or in a loved one. Tell us about the acronym FAST, and what you would like people to know that this means for the possible symptoms of a stroke.
Mary: So the acronym FAST is- it's a little acronym to help us recognize the most common presentation of stroke. So that would be- the F stands for facial droop, the A is for arm drift, the S is for speech problems, and the T reminds us that if you see these symptoms in someone, it's time to call 911. Most strokes present that way, but certainly not all strokes. So there are other symptoms that we should talk about that are not as common. I'd say the atypical stroke presentation, or not as common, could be something like a sudden onset of confusion, a loss of balance, or a vision problem. So these aren't as common but they are definitely stroke symptoms, and more common with a bleeding type stroke, or a hemorrhagic stroke, or things like a sudden onset of a really bad headache, and often accompanied by nausea and vomiting.
So I always recommend that if people recognize any sudden onset of any neurological event, it's good to get checked out and let us decide is this a stroke or could it be something else? Because we don't want to miss a stroke.
Host: Mary, why is time so important? We've heard the phrase 'time is brain,' so why is time so important, and should the person call 911 or drive their loved one? Is there something that the EMS can do in the interim of getting to the hospital that can possibly help with the reaction to someone suffering a stroke?
Mary: It is really important to call EMS because they are equipped to assess the patient, they may be able to give some initial medication. The really important thing to remember is there is a medication that is available for some patients, but it's time sensitive. So the sooner that you can get to the hospital and get assessed, the sooner we can give the clot-busting drug that can reverse the effects of the stroke. So that has time limits and often people - if they have symptoms - will kind of think, "Well, maybe I should wait. Maybe this will go away. It'll resolve." But that is definitely not the thing to do because every minute that treatment is delayed, they estimate that we are losing almost 1.9 million neurons. So minutes count, and EMS can get someone to the hospital much quicker than driving in an automobile.
Host: And what happens at the ER? What is that like, and tell us a little bit about that clot-busting drug, TPA.
Mary: TPA has been used to treat strokes for over twenty years, and like I said, it does have a time limit. So when a patient comes to the emergency room, the very first thing that happens is they get a quick assessment. If they're stable, they go straight to our CT scanner, and what we're looking for at that point in that initial CT is to make sure that the patient is not having a hemorrhagic stroke. We want to make sure they're not bleeding into their brain, because that would be a contraindication for giving the clot-busting drug.
But if they meet the criteria- and there is some inclusion and exclusion criteria that the person has to meet, and our emergency room team is trained and ready to do that. I might also mention that we do have access to expert neurological support through telemedicine because we are a rural hospital. And so together, our stroke team in the emergency room and with our expert neurological support, we're able to make the determination, is that person eligible to get the clot-busting drug, and get that in as soon as possible because the sooner we get the medication in, the better it works, and the less chance of any bad side effects that could happen.
Host: Then based on obviously the time that somebody gets in, and the brain function that is maintained based on the TPA and the treatments available, what have you seen? As the Stroke Coordinator, what have you seen life is like after stroke, and the rehab, and what is that like for patients and their families?
Mary: Well, I always say stroke is probably one of the most devastating things to happen to a person and their family because it's often unexpected and so sudden, and they can- some strokes can be really severe. So we begin, not only our treatment in the ER with the clot-busting drug, but we also follow up with rehabilitation starting right away, because we know that the sooner rehabilitation is started, the more successful it is, and then continued rehabilitation after the hospital stay. And then we also have a stroke support group that meets once a month to help the patients and their families cope and adapt to life after stroke.
Host: It's such important information, Mary, for people to hear, to recognize those symptoms of a possible stroke and possibly even to prevent their risk- reduce their risk or prevent a stroke altogether. Wrap it up for us with your best advice. As the Stroke Program Coordinator at Oroville Hospital, what would you like people to know about stroke? What's the take home message today?
Mary: The take home message is if you or a loved one experiences the signs and symptoms of stroke like the sudden onset of a facial droop, arm drift, or speech problem, if they have a sudden onset of confusion, a sudden onset of disequilibrium or vision problem, call 911 and get here and let our team assess them and make a determination so that we can start treatment right away.
The other part of that is we would like it if we didn't have to ever treat a stroke, so the more that we can encourage people to live their best life as healthy as possible. I always say we all know what we should do, we don't always do it, so doing things like quitting smoking, and monitoring your blood pressure, take those medications that your doctor recommends, exercising, and just leading your most healthy life. Eat real food that's not- like fast food and junk food is just not good. So a healthy lifestyle, eating lots of fruits and vegetables, exercising, and just living that healthy lifestyle is the very best protection that we have against stroke.
Host: Mary, thank you so much for being on with us today. It's so important that people recognize the symptoms of a stroke should they or a loved one be suffering from one. Thank you again for sharing your expertise. And for more information on Mary's outreach and community education on stroke prevention, you can call (530) 538-3070. That's (530) 538-3070. You're listening to Growing Healthy Together - a podcast by Oroville Hospital. For more information, please visit www.OrovilleHospital.com. This is Melanie Cole, thanks so much for tuning in.