September 24, 2008
A stroke is a life-threatening medical emergency that can cause paralysis, coma and death. It is the brain's version of a heart attack.
A stroke occurs when a blood clot blocks a blood vessel, interrupting blood flow to an area of the brain (ischemic stroke) or a vessel bursts and blood leaks into brain tissue (hemorrhagic stroke).
When either of these occurs, brain cells begin to die and brain damage occurs.
Where the damage to the brain occurs and how much of the brain is damaged will determine which symptoms the person will display.
The Cincinnati Stroke Scale is a system used to help diagnose if someone is having a stroke. It tests signs for abnormalities that may indicate the patient is having a stroke. If any one of the three tests shows abnormal findings, the patient may be having a stroke and should be transported to a hospital as soon as possible.
1. Facial droop. Ask the person to smile or show his or her teeth. If one side doesn't move as well as the other so it seems to droop, that could be sign of a stroke.
2. Arm drift. Ask the person to close his or her eyes and hold their arms straight out in front for about 10 seconds. If one arm does not move, or one arm winds up drifting down more than the other, that could be a sign of a stroke.
3. Speech. Ask the person to say, "You can't teach an old dog new tricks." If the person slurs the words, gets some words wrong, or is unable to speak, that could be sign of stroke.
Though it is not part of the test, note the time when the symptoms first began. Some medication for stroke victims only work if given within three hours of the stroke.
Strokes can and do happen anywhere. Doing a quick scan of the U.S. Coast Guard's Web site, I found numerous examples of people being medevaced for suspected stroke. Just this summer six people in their 50s and 60s “ and one 21-year-old man “ were medevaced with symptoms of stroke.
According to the National Stroke Association, about 600,000 Americans have strokes every year. And 80 percent of them have the type of stroke that can be helped by clot-busting medication if they reach a hospital within three hours.
This clot-busting medication dissolves the blockage and restores blood flow to the brain.
The only way to tell if a person has a bleed or a clot, though, is by doing a CT scan of the brain. The clot-busting drug cannot be administered in the field because it may cause bleeding in the brain. If a clot-busing drug is used on a hemorrhagic stroke, the drug may make the bleed worse and possibly kill the person.
According to the National Stroke Foundation, 80 percent of all strokes are preventable. Some of the risk factors include high blood pressure, heart disease, high cholesterol, diabetes, smoking, previous history of stroke or TIA “ transient ischemic attack, also called a mini stroke.
Recognizing that a person may be having a stroke and getting the person to a hospital as quickly as possible is the best way to help. You should stay with the person, place him or her in a comfortable position, and monitor their breathing and consciousness.
To learn more about stroke warning signs and other medical emergencies you should take a CPR, AED and First Aid class. Everyone should take a refresher class at least every two years.
Often classes can be conducted on your vessel. Shipboard classes are helpful because they allows crew to develop plans, review first aid supplies, and talk about medical emergencies as they relate to their crew, passengers and the various ports of call.
A former Florida firefighter EMT, Keith Murray is the owner of The CPR School, a mobile training company that provides CPR, AED and First Aid training. He also sells and services automated external defibrillators. Contact him at +1-561-762-0500 or Keith@TheCPRschool.com . Comments on this column are welcome at editorial@the-triton.com .
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