Stroke Cerebro Vascualar Accident CVA Stroke A stroke
Stroke Cerebro. Vascualar Accident (CVA)
Stroke A stroke is when an artery taking blood to the brain becomes blocked or bursts. 01 February 2022 Coffs Harbour Divisional Training 2
Stroke Often health professionals refer to these two types of strokes as dry and wet 01 February 2022 Coffs Harbour Divisional Training 3
Stroke 01 February 2022 Coffs Harbour Divisional Training 4
Stroke 01 February 2022 Coffs Harbour Divisional Training 5
Stroke In most cases, a stroke is a result of a clot at a part of an artery narrowed by long-term build-up of fatty deposits (plaque) 01 February 2022 Coffs Harbour Divisional Training 6
Blood clot 01 February 2022 Coffs Harbour Divisional Training 7
What is the result? As a result of a stroke, brain cells are damaged and functions controlled by that part of the brain become paralysed. 01 February 2022 Coffs Harbour Divisional Training 8
What is the result? • Paralysis of the body or speech problems are common after a stroke. • Although many people make a good recovery a stroke can be fatal. 01 February 2022 Coffs Harbour Divisional Training 9
What is the result? 01 February 2022 Coffs Harbour Divisional Training 10
Why so suddenly? • The symptoms of stroke begin suddenly because they are caused by an abrupt interruption of blood flow to an area of the brain. • When this happens it only takes a few seconds for that part of the brain to stop functioning. 01 February 2022 Coffs Harbour Divisional Training 11
Why so suddenly? • So people suffering a stroke can go from feeling fine to a life-threatening situation very quickly. • As a first aider, we need to be aware of this. • It is crucial that we respond promptly and call 000 for a suspected stroke victim. 01 February 2022 Coffs Harbour Divisional Training 12
Headaches? • Only a small proportion of strokes produce headache symptoms. • However, the sudden onset of a severe headache makes doctors suspect that there is bleeding inside the brain. 01 February 2022 Coffs Harbour Divisional Training 13
Headaches? Because of the high risk of death in these cases, people complaining of a severe headache at hospital are rapidly screened for the presence of blood in the brain. 01 February 2022 Coffs Harbour Divisional Training 14
Permanent? • Whether or not the symptoms of a stroke will be permanent depends on how long the affected part of the brain remains without blood flow. • While brief events of poor blood flow (ischemia), lead to a complete recovery, longer events can leave permanent damage. 01 February 2022 Coffs Harbour Divisional Training 15
Permanent? 01 February 2022 Coffs Harbour Divisional Training 16
Permanent? For instance, strokes that affect areas of the brain which have minimal importance in day to day brain activity typically produce mild or unnoticeable symptoms. 01 February 2022 Coffs Harbour Divisional Training 17
Permanent? By contrast, strokes that affect areas of the brain which are very important in day to day brain activity cause the most debilitating and noticeable symptoms. 01 February 2022 Coffs Harbour Divisional Training 18
Permanent? • For example strokes affecting one of the smell areas of the brain rarely cause noticeable symptoms. • By contrast strokes affecting one of the speech areas of the brain nearly always do. 01 February 2022 Coffs Harbour Divisional Training 19
Why one side of the body? • The left side of the brain controls the right side of the body while the right side of the brain controls the left side of the body. • When a blood vessel that carries blood to a given part of the brain is blocked, only the side of the brain where the blood vessel is located is affected. 01 February 2022 Coffs Harbour Divisional Training 20
Why one side of the body? This causes symptoms in the opposite side of the body. 01 February 2022 Coffs Harbour Divisional Training 21
Mini-strokes (TIA’s) • Sometimes the person will get warnings of a future stroke. • These mini-strokes (also called TIA’s) are due to spasm of the blood vessels, or are the result of a temporary blockage in smaller arteries supplying oxygen-carrying blood to the brain. 01 February 2022 Coffs Harbour Divisional Training 22
Mini-strokes (TIA’s) • These are associated with the same symptoms as a stroke but are temporary and do not cause long-term harm to the brain. • They are caused by temporary disruptions to the brain’s blood supply. 01 February 2022 Coffs Harbour Divisional Training 23
Mini-strokes (TIA’s) Seek medical attention as a future stroke is preventable. 01 February 2022 Coffs Harbour Divisional Training 24
Who are at risk? • The elderly • Smokers • People who have: – High blood pressure – Heart disease – Diabetes 01 February 2022 Coffs Harbour Divisional Training 25
Signs & Symptoms • Sudden decrease in level of consciousness • Weakness or paralysis, especially on one side of body • Feeling of numbness in face, arm or leg 01 February 2022 • Difficulty speaking or understanding • Unexplained dizziness • Disturbed vision • Loss of balance • Confusion Coffs Harbour Divisional Training 26
Remember a stroke is a life-threatening emergency! 01 February 2022 Coffs Harbour Divisional Training 27
The acronym F A S T 01 February 2022 Coffs Harbour Divisional Training 28
Communication • Inability to communicate when otherwise alert can cause anxiety in the patient. • Grasp both hands and ask the patient to squeeze. • Usually the patient will respond with one or the other hand. 01 February 2022 Coffs Harbour Divisional Training 29
Communication • Then communicate by hand squeezes • One for yes and two for no. • Be calm and reassuring. 01 February 2022 Coffs Harbour Divisional Training 30
Management 1. DRSABCD (ask them to squeeze your hands) 2. Call 000 3. Loosen tight clothing 4. Reassure the patient 01 February 2022 Coffs Harbour Divisional Training 31
Management 5. Place on stretcher if available (possibly use carry sheet) 6. Support head and shoulders 7. Oxygen therapy 8‐ 15 LPM via Face Mask 8. Maintain body temperature 9. Maintain an airway 01 February 2022 Coffs Harbour Divisional Training 32
The traditional golden 3 hour • Researchers in the 1990 s came up with tissue plasminogen activator (t. PA), for the treatment of ischemic stroke. • Over 80% of all strokes are ischemic. • t. PA acts by dissolving the strokecausing blood clots. 01 February 2022 Coffs Harbour Divisional Training 33
The traditional golden 3 hour • Unfortunately, if given later than three hours after a person first realizes he/she is having stroke, t. PA has been known to cause dangerous bleeding in the brain. • It is only safe to give t. PA within 3 hours of the beginning of stroke symptoms. 01 February 2022 Coffs Harbour Divisional Training 34
The traditional golden 3 hour This is why physicians have thought of this time as the: "golden three hour t. PA window" 01 February 2022 Coffs Harbour Divisional Training 35
1 September 2010 THE use of “clot-busters” used to break up blood clots – will be recommended for use for up to 4. 5 hours following a stroke, a change from three hours as previously recommended. 01 February 2022 Coffs Harbour Divisional Training 36
1 September 2010 “These updated guidelines reflect international research that indicates therapy can be useful beyond the established three-hour window, up to 4. 5 hours – but we still urge that the sooner you get to medical treatment following stroke the better – every minute counts. ” (Stroke Foundation CEO Dr Erin Lalor) 01 February 2022 Coffs Harbour Divisional Training 37
Questions 01 February 2022 Coffs Harbour Divisional Training 38
BREAK 01 February 2022 Coffs Harbour Divisional Training 39
Scenario You are on duty at the local show. You hear an announcement over the PA for St John Ambulance to come to the exhibition hall immediately. Two of you respond with the Oxygen and an AED. 01 February 2022 Coffs Harbour Divisional Training 40
Scenario Upon arrival at the hall you find a 60 year old female lying out in the car park in between two cars. Demonstrate the correct management of this patient including the completion of an OB 12 and the handover. 01 February 2022 Coffs Harbour Divisional Training 41
Management 1. DRSABCD (ask them to squeeze your) 2. Call 000 & reassure the patient 4. Place on stretcher if available (use carry sheet) 5. Oxygen therapy 8‐ 15 LPM via Face Mask 6. Loosen tight clothing 01 February 2022 Coffs Harbour Divisional Training 42
Management 7. Maintain body temperature 8. Wipe away any secretions from mouth. 9. Ensure airway is clear and open 11. Head to toe assessment 12. Maintain privacy and comfort 13. Complete 2 sets of observations 14. Completed OB 12 in total and Handover
patient information You are attending the annual show at your local show grounds. While viewing some of the exhibitions in one of the halls you feel dizzy and unstable on your feet. You tell your partner your not feeling well. They suggest they bring the car around to the front of the hall where you can be picked up and head home. 01 February 2022 Coffs Harbour Divisional Training 44
patient information While you are waiting for the car you feel like your going to pass out and lean on a car next to you. The next thing you remember you are on the ground between two parked cars with a security person asking you ‘are you ok’. 01 February 2022 Coffs Harbour Divisional Training 45
patient information There is a feeling of numbness in the right side of your face, arm and leg and you are unable to move these parts of your body. You can hear the security person but are having difficulty responding to them and your vision is blurry. 01 February 2022 Coffs Harbour Divisional Training 46
patient information An announcement is placed over the PA for St John Ambulance to attend. Your partner returns and is distressed at seeing you lying on the ground. A member of the St John Ambulance appears next to you. 01 February 2022 Coffs Harbour Divisional Training 47
patient information • Medical problems: Hypertension • Medications: Coversyl • Allergies: Nil Obs Pulse Resp BP AVPU Other info 1 st set 90 20 145/70 V Difficulty speaking 2 nd set 86 01 February 2022 18 140/70 V Coffs Harbour Divisional Training Difficulty speaking 48
Questions 01 February 2022 Coffs Harbour Divisional Training 49
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