Think FAST: Recognizing a stroke

Houston Texans football coach Gary Kubiak suffered a “mini stroke” during a game Nov. 3. It surprised many people that a physically fit 52-year-old could experience something so serious.

But strokes are more common than you might think. On average, one occurs every 40 seconds, affecting about 795,000 people each year. That makes it the third leading cause of death in Connecticut and the leading cause of disability nationwide, according to the American Stroke Association.

When it comes to cardiac arrest and strokes, every second truly counts, and as the town’s designated R-1 Responding Agency, the Haddam Volunteer Fire Company has regrettably seen its share of both.

A stroke is a condition in which the brain cells suddenly die because of a lack of oxygen.

About 15 percent of strokes are caused by bleeding in the brain when a blood vessel bursts – known as a hemorrhagic stroke.

The other 85 percent are caused by a blockage in an artery that feeds the brain with blood, often by cholesterol that builds up to form plaque. A blood clot could also break off from somewhere else in the body and lodge itself like a cork in a vessel it can’t pass through.

“When oxygen and glucose can’t reach the brain, cells die within minutes,” said Paramedic and Haddam Fire Capt. Dan Sullivan.

The patient may suddenly lose the ability to speak, there may be memory problems, or one side of the body can become paralyzed. Risk factors include advanced age, high blood pressure, high cholesterol, and prior history of stroke, diabetes and smoking. Recent research has also shown that poor dental hygiene and bleeding gums may allow up to 700 types of bacteria to enter the bloodstream and harden arteries, so brush regularly.

A loved one suffering a stroke can be scary. It can also be subtle, which makes early recognition critical to saving brain function.

There’s a saying in the EMS world: “time lost is brain lost.” Please don’t hesitate to call 911 if you notice any of the following symptoms:

▪    Sudden numbness or “drooping” of the face, arm or leg, especially on one side of the body

▪    Sudden confusion, trouble speaking, or understanding

▪    Sudden trouble seeing in one or both eyes

▪    Sudden trouble walking, dizziness, loss of balance or coordination

▪    Sudden severe headache with no known cause.

One way to remember the major symptoms is the acronym FAST, which stands for Facial drooping, Arm weakness, Speech difficulties and Time.

Some symptoms may not at first seem severe, and there’s a temptation to wait an hour or two in the hopes that they will fade. However, that delay may keep clot-busting drugs from being administered.

When you call, Valley Shore Emergency Communications will dispatch the HVFCo., Haddam Volunteer Ambulance Service and paramedics from Middlesex Hospital skilled in advanced life support. But in order to make the system work, the stroke patient must receive EMS care and transport rapidly.

All of these EMS personnel are trained on performing a rapid neurological exam in a format to identify a candidate for thrombolytic therapy used to dissolve blood clots.

Questions will include the exact time of sign/symptom onset, any history of seizures or hemorrhagic (bleeding) stroke, any history of trauma or stroke within a three-month period, any use of anticoagulant medications, knowledge of suspected pregnancy, no surgery in the past 14 days and no GI or urinary track bleeding in the previous 3 weeks.  The patient will be asked to say, “Today is a sunny day,” to smile and to hold both arms out straight for 10 seconds.

These physical tests help isolate the likelihood of a stroke. If the field exam confirms that conditions are satisfied, the patient will be transported directly to the nearest facility accepting patients for rapid stroke therapy.

As mentioned, there are two causes of strokes. For the lack of oxygen type (ischemia), there are new and effective treatments, but they must be administered within a few hours of onset.

Middlesex Hospital was one of the first in Connecticut to be designated as a stroke center. As soon as the EMS units in the field have completed their exam, the hospital is notified and the request is made for a “Stroke Team Activation.” Paramedics will initiate pre-hospital advanced life support as required.

Upon arrival at the Emergency Department, a specialized team will perform a follow-up assessment and prepare for administering medications that have been shown to improve the stroke patient’s chances to return to a normal life.

The public can help by recognizing the signs and symptoms of stroke early, and without delay, alerting the EMS system by calling 911. Just as when the heart stops beating, precious seconds tick off the clock as soon as parts of the brain begin to go without oxygen.

Our goal is to get you help as quickly as possible, but we need you to make that call.

Do You Have What It Takes? Find more information on the activities of the Haddam Volunteer Fire Co. and ways you can get involved at our website www.HaddamFire.com, or connect with us on Facebook.