If you have a stroke, getting medical care as quickly as possible can help prevent death or minimize the lasting effects of stroke.
Michelle Irving discusses why it is important for you to know the signs and symptoms of a stroke, risk factors and identify what you need to do in case you or a loved is suffering a stroke.
The Important Warning Signs of a Stroke
Featured Speaker:
Michelle Irving
Michelle Irving is a RN and the Stroke and Sepsis Coordinator at Palmdale Regional Medical Center. Transcription:
The Important Warning Signs of a Stroke
Melanie Cole (Host): It’s really important for you to know the signs of a possible stroke. It could save your life or that of a loved one. My guest today is Michelle Irving. She’s a registered nurse and the Stroke and Sepsis Coordinator at Palmdale Regional Medical Center. Michelle what is a stroke? Are three different types? Give us some little stats about what stroke is.
Michelle Irving, RN (Guest): Yes. So, there are three different types of stroke. But just to go into the overview of stroke, a stroke can occur when the blood supply to an area of the brain is cut off. So, depending on the region where the blood is cut off, depends on the severity of your disability. For the different types of stroke, there’s one the TIA which is a transient ischemic attack and it is somewhat called, or people call it a mini stroke and usually with that one, you have a blood clot that causes blood to be cut off, however, somehow the symptoms resolves itself. You don’t need any further treatment. You would want to follow up your physician or neurologist, but you won’t need any further treatment. We will just monitor you. An ischemic stroke is where the blood is cut off and so it’s kind of like if you have a long hose and something blocks part of that hose, there is no blood flowing to the remaining part of your brain. So, that’s from our body is oxygen so at that point, there is no oxygen getting to that part of your brain and so that’s how we have some severity and depending on the part of the brain it is in or it occurred. The next is a hemorrhagic stroke and that is a bleed in your brain. So, it is just like a water hose where the water is supposed to come out of spout, however, in this, in the middle of the hose it breaks and then blood is flowing throughout your brain, a more specific part or region of your brain. So, still blood is not flowing, it is not perfusing to your brain, it is just kind of overflowing.
Ischemic strokes make up 80-90% of strokes and hemorrhagic are the other percentage. Or it could be a TIA. So, we usually find most patient have ischemic stroke and then with hemorrhagic those patients we are going to be monitoring really closely because of the severity of the bleeding and making sure we can stop the bleeding.
Melanie: Who is most at risk for stroke?
Michelle: So, really anyone unfortunately it at risk. I mean you have certain groups or populations. African Americans are usually the highest who are at risk of stroke. Those who have diabetes, hypertension or high blood pressure, high cholesterol.
So, I just want to give you some data. Because stroke can affect you, it can affect me. We all probably know someone that has been affected by a stroke whether it’s family members, coworkers, friends. Or we know someone that knows someone that has had a stroke. So, in the US, someone has a stroke about once every 40 seconds. Stroke accounts for one of every 19 deaths in the US. Stroke kills someone in the US about every 3 minutes and 45 seconds. Stroke is ranked number 5 among all causes of death in the US killing nearly 133,000 people a year. Each year, about 795,000 people experience a new or recurrent stroke. Stroke is the leading cause of serious long-term disability in the US and in 2005; stroke deaths accounted for 11.8% of total deaths worldwide, making stroke, the second leading global cause of death behind heart disease.
So, really anyone can be affected by it, however the is the risk factors of stroke; high blood pressure that’s uncontrolled, that’s not being treated appropriately. A lot of times, if you are a smoker, diabetic, and if you are not exercising and if you are not eating appropriately, if you have a history of a family member, your mother, your father that has high blood pressure or if they have had a history of stroke or high cholesterol issues. So, those individuals who are more at risk. But looking at the numbers, we really just need to take care of ourselves, keep our blood pressures under control, if we are diabetic, monitor our blood sugar to make sure that it is under control. If we have high cholesterol, making sure we are on a proper medication or change in diet and if we are smoking to quit.
Melanie: So, we have heard the acronym FAST and that time is brain when it comes to stroke. Explain a little bit about why it’s so important to know this acronym, what it means, so that people can spot it because it can be kind of confusing. You could think somebody has been drinking or that these signs are not quite as clear, but FAST lays it out pretty well. So, Michelle, tell us what that means.
Michelle: So FAST is the acronym and I will go into that. But with the symptoms of stroke; for some people they don’t know and so FAST is really a great acronym to use in the community, patients in the hospital because once you have had a stroke; you are at risk of having another stroke so this acronym FAST is really important to know, especially if you are taking care of someone that has had a stroke or yourself if you have had a stroke. We have had patients that have come into the hospital who had a stroke and were having a second stroke a year or two later and they used this acronym on themselves to say let me call 9-1-1. And FAST is just really important because like you said, time is brain, just like a heart attack, it’s a brain attack and every second counts to go to nearest emergency room to be treated if you are having a stroke.
So, FAST; F stands for face drooping, if you actually try and smile and the right or left side of your mouth is not able to actually have a smile and it is drooping; that is an indicator. A, arm weakness. Id you raise your arm and your left or right arm is drooping or not drooping; if it is drifting downward, then you are – that could be a sign that you are having a stroke. Or if you are not even able to feel your arm or you are having pins and needles, tingling sensations. Speech, speech difficulty. You are having difficulty with talking. You are having slurred speech. Even difficulty with swallowing. Sometimes you are trying to say something, and you are telling someone something, but what you are saying, they can’t understand. So, it is incomprehensible. And then T is time. It is time to call 9-1-1 and it’s really important to call 9-1-1 if you are having these symptoms because it would be good for you to drive yourself. It would be better to call 9-1-1 because you are not for sure if you are having that weakness in your arm or legs, you can become completely have paralysis and not be able to move and that wouldn’t be good for you if you are on the road driving. And 9-1-1 when they come and get you; the EMS is going to call into the nearest hospital and say heh, we have a code stroke, they are going to check you blood glucose and make sure that you are not hypoglycemic so you are not having low blood sugar because sometimes that mimics a stroke like symptoms. So, they are going to check your blood glucose, your blood sugar and they are going to rush you to the nearest hospital because there, they are going to check and make sure – what’s going on with your brain. So, they are going to do a CT scan. So, it’s really important if you or your family members are having these symptoms and they are not – their last known well was a few hours ago and they are starting to have these symptoms and they are all starting to have the slurred speech, the double vision, not being able to walk, losing balance, losing coordination, call 9-1-1.
Melanie: It is really such important information. Great information Michelle. What happens at the ER? You mentioned that you know people should call 9-1-1 which is so important because EMS does have the ability as you said to call ahead and say code stroke and they do have the ability to start some treatments, but main treatments happen in the emergency room. What happens there? What can people expect?
Michelle: Well when you come in to the hospital and you are having numbness or weakness, whether someone drives you or you are coming in by EMS; they are going to want to know your last known well. Last know well is when was the last time you were at your normal state prior to this incident. So, you are going to come in and they are going to find out when your last know well is. They are going to check your blood glucose and they are going to do a CAT scan of your head and there in the CAT scan of the head, they are going to see if there is a blockage in your brain, if there is a loss of blood perfusion or blood flow and then they will find out what they need to do, if they need to do further treatment and they can do some type of clot busting treatment where they are going to try to dissolve the clot. So, there is going to be treatment involved. They are going to be checking your neuro checks, so they are going to be checking to see how you’re doing, if you can remember your name, if you remember the date and time, if you are able to move any of your limbs; your arms or your legs. If you are going to be able to see clearly, if you are going to be able to swallow any medication or any water; so we are going to be checking and making sure that you are able to swallow, that you are able to speak, that you are able to move your limbs and that you are able to remember or site your name or your date of birth.
Melanie: What would you like to tell people in wrapping up Michelle about possibly preventing a stroke, the importance of knowing that acronym FAST? What do you really want them to know?
Michelle: Well just like we said, time is brain. So, a stroke can happen at any time. It does not have an age. It does not have a color. It does not have a time. However, if you know FAST, if you know that something does not feel right with you or your family member or your friend, go seek medical attention. Go to the nearest emergency room and make sure you get checked out. Because time is brain and if you don’t have the flow going on in your brain; if it is cut off, you are losing brain. You are having a brain attack and it is just as important as if you are having a heart attack. Go and seek medical attention, because this can save your life.
Melanie: Thank you so much for being with us today. You’re listening to Palmdale Regional Radio with Palmdale Regional Medical Center. For more information, please visit www.palmdaleregional.com that’s www.palmdaleregional.com . Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks for tuning in.
The Important Warning Signs of a Stroke
Melanie Cole (Host): It’s really important for you to know the signs of a possible stroke. It could save your life or that of a loved one. My guest today is Michelle Irving. She’s a registered nurse and the Stroke and Sepsis Coordinator at Palmdale Regional Medical Center. Michelle what is a stroke? Are three different types? Give us some little stats about what stroke is.
Michelle Irving, RN (Guest): Yes. So, there are three different types of stroke. But just to go into the overview of stroke, a stroke can occur when the blood supply to an area of the brain is cut off. So, depending on the region where the blood is cut off, depends on the severity of your disability. For the different types of stroke, there’s one the TIA which is a transient ischemic attack and it is somewhat called, or people call it a mini stroke and usually with that one, you have a blood clot that causes blood to be cut off, however, somehow the symptoms resolves itself. You don’t need any further treatment. You would want to follow up your physician or neurologist, but you won’t need any further treatment. We will just monitor you. An ischemic stroke is where the blood is cut off and so it’s kind of like if you have a long hose and something blocks part of that hose, there is no blood flowing to the remaining part of your brain. So, that’s from our body is oxygen so at that point, there is no oxygen getting to that part of your brain and so that’s how we have some severity and depending on the part of the brain it is in or it occurred. The next is a hemorrhagic stroke and that is a bleed in your brain. So, it is just like a water hose where the water is supposed to come out of spout, however, in this, in the middle of the hose it breaks and then blood is flowing throughout your brain, a more specific part or region of your brain. So, still blood is not flowing, it is not perfusing to your brain, it is just kind of overflowing.
Ischemic strokes make up 80-90% of strokes and hemorrhagic are the other percentage. Or it could be a TIA. So, we usually find most patient have ischemic stroke and then with hemorrhagic those patients we are going to be monitoring really closely because of the severity of the bleeding and making sure we can stop the bleeding.
Melanie: Who is most at risk for stroke?
Michelle: So, really anyone unfortunately it at risk. I mean you have certain groups or populations. African Americans are usually the highest who are at risk of stroke. Those who have diabetes, hypertension or high blood pressure, high cholesterol.
So, I just want to give you some data. Because stroke can affect you, it can affect me. We all probably know someone that has been affected by a stroke whether it’s family members, coworkers, friends. Or we know someone that knows someone that has had a stroke. So, in the US, someone has a stroke about once every 40 seconds. Stroke accounts for one of every 19 deaths in the US. Stroke kills someone in the US about every 3 minutes and 45 seconds. Stroke is ranked number 5 among all causes of death in the US killing nearly 133,000 people a year. Each year, about 795,000 people experience a new or recurrent stroke. Stroke is the leading cause of serious long-term disability in the US and in 2005; stroke deaths accounted for 11.8% of total deaths worldwide, making stroke, the second leading global cause of death behind heart disease.
So, really anyone can be affected by it, however the is the risk factors of stroke; high blood pressure that’s uncontrolled, that’s not being treated appropriately. A lot of times, if you are a smoker, diabetic, and if you are not exercising and if you are not eating appropriately, if you have a history of a family member, your mother, your father that has high blood pressure or if they have had a history of stroke or high cholesterol issues. So, those individuals who are more at risk. But looking at the numbers, we really just need to take care of ourselves, keep our blood pressures under control, if we are diabetic, monitor our blood sugar to make sure that it is under control. If we have high cholesterol, making sure we are on a proper medication or change in diet and if we are smoking to quit.
Melanie: So, we have heard the acronym FAST and that time is brain when it comes to stroke. Explain a little bit about why it’s so important to know this acronym, what it means, so that people can spot it because it can be kind of confusing. You could think somebody has been drinking or that these signs are not quite as clear, but FAST lays it out pretty well. So, Michelle, tell us what that means.
Michelle: So FAST is the acronym and I will go into that. But with the symptoms of stroke; for some people they don’t know and so FAST is really a great acronym to use in the community, patients in the hospital because once you have had a stroke; you are at risk of having another stroke so this acronym FAST is really important to know, especially if you are taking care of someone that has had a stroke or yourself if you have had a stroke. We have had patients that have come into the hospital who had a stroke and were having a second stroke a year or two later and they used this acronym on themselves to say let me call 9-1-1. And FAST is just really important because like you said, time is brain, just like a heart attack, it’s a brain attack and every second counts to go to nearest emergency room to be treated if you are having a stroke.
So, FAST; F stands for face drooping, if you actually try and smile and the right or left side of your mouth is not able to actually have a smile and it is drooping; that is an indicator. A, arm weakness. Id you raise your arm and your left or right arm is drooping or not drooping; if it is drifting downward, then you are – that could be a sign that you are having a stroke. Or if you are not even able to feel your arm or you are having pins and needles, tingling sensations. Speech, speech difficulty. You are having difficulty with talking. You are having slurred speech. Even difficulty with swallowing. Sometimes you are trying to say something, and you are telling someone something, but what you are saying, they can’t understand. So, it is incomprehensible. And then T is time. It is time to call 9-1-1 and it’s really important to call 9-1-1 if you are having these symptoms because it would be good for you to drive yourself. It would be better to call 9-1-1 because you are not for sure if you are having that weakness in your arm or legs, you can become completely have paralysis and not be able to move and that wouldn’t be good for you if you are on the road driving. And 9-1-1 when they come and get you; the EMS is going to call into the nearest hospital and say heh, we have a code stroke, they are going to check you blood glucose and make sure that you are not hypoglycemic so you are not having low blood sugar because sometimes that mimics a stroke like symptoms. So, they are going to check your blood glucose, your blood sugar and they are going to rush you to the nearest hospital because there, they are going to check and make sure – what’s going on with your brain. So, they are going to do a CT scan. So, it’s really important if you or your family members are having these symptoms and they are not – their last known well was a few hours ago and they are starting to have these symptoms and they are all starting to have the slurred speech, the double vision, not being able to walk, losing balance, losing coordination, call 9-1-1.
Melanie: It is really such important information. Great information Michelle. What happens at the ER? You mentioned that you know people should call 9-1-1 which is so important because EMS does have the ability as you said to call ahead and say code stroke and they do have the ability to start some treatments, but main treatments happen in the emergency room. What happens there? What can people expect?
Michelle: Well when you come in to the hospital and you are having numbness or weakness, whether someone drives you or you are coming in by EMS; they are going to want to know your last known well. Last know well is when was the last time you were at your normal state prior to this incident. So, you are going to come in and they are going to find out when your last know well is. They are going to check your blood glucose and they are going to do a CAT scan of your head and there in the CAT scan of the head, they are going to see if there is a blockage in your brain, if there is a loss of blood perfusion or blood flow and then they will find out what they need to do, if they need to do further treatment and they can do some type of clot busting treatment where they are going to try to dissolve the clot. So, there is going to be treatment involved. They are going to be checking your neuro checks, so they are going to be checking to see how you’re doing, if you can remember your name, if you remember the date and time, if you are able to move any of your limbs; your arms or your legs. If you are going to be able to see clearly, if you are going to be able to swallow any medication or any water; so we are going to be checking and making sure that you are able to swallow, that you are able to speak, that you are able to move your limbs and that you are able to remember or site your name or your date of birth.
Melanie: What would you like to tell people in wrapping up Michelle about possibly preventing a stroke, the importance of knowing that acronym FAST? What do you really want them to know?
Michelle: Well just like we said, time is brain. So, a stroke can happen at any time. It does not have an age. It does not have a color. It does not have a time. However, if you know FAST, if you know that something does not feel right with you or your family member or your friend, go seek medical attention. Go to the nearest emergency room and make sure you get checked out. Because time is brain and if you don’t have the flow going on in your brain; if it is cut off, you are losing brain. You are having a brain attack and it is just as important as if you are having a heart attack. Go and seek medical attention, because this can save your life.
Melanie: Thank you so much for being with us today. You’re listening to Palmdale Regional Radio with Palmdale Regional Medical Center. For more information, please visit www.palmdaleregional.com that’s www.palmdaleregional.com . Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks for tuning in.