A stroke is a medical emergency. Quick intervention may increase a person’s chance of survival and reduce the risk of long-term disability.
If someone is having a stroke, quick action is vital. Call 911 immediately or have someone else make the call.
After calling 911:
- Remain calm.
- Ensure the surrounding area is safe and that there is no imminent danger, such as from moving vehicles.
- Talk to the person. Ask them their name and other questions. If the individual is unable to speak, ask them to squeeze your hand in response to questions. If the person does not respond, they are likely unconscious.
If the person is conscious:
- Gently place them into a comfortable position. Ideally, they should be lying on their side with their head and shoulders slightly raised and supported with a pillow or item of clothing. After this, try not to move them.
- Loosen any tight clothing, such as buttoned-up shirt collars or scarves.
- If they are cold, use a blanket or coat to keep them warm.
- Check that their airway is clear. If there are objects or substances, such as vomit, in the mouth that may be hindering breathing, place the person on their side in the recovery position (see below).
- Reassure the person. Tell them that help is on the way.
- Do not give them any food or liquids.
- Note the person’s symptoms and look for any changes in condition. It is important to give the emergency personnel as much information as possible about the situation.
- Try to remember the time that the symptoms started, look at a clock if possible. It is hard to estimate the passage of time when you are in a stressful situation.
If the person is unconscious:
- Move them into the recovery position (see below).
- Monitor their airway and breathing. To do this:
- lift the person’s chin and tilt their head slightly backward
- look to see if their chest is moving
- listen for breathing sounds
- place a cheek over their mouth and try to feel their breath
- If there are no signs of breathing, begin CPR (cardiopulmonary resuscitation)
Current practice for CPR is chest compressions only. 911 can instruct you how to do this if you do not know how.
The recovery position
If someone is unconscious, or if their airway is not completely clear, place them in the recovery position. To do this:
- Kneel beside them.
- Take the arm that is farthest away and place it at a right angle to their body.
- Place the other arm across their chest.
- The leg that is farthest away should remain straight. Bend their other knee.
- Support their head and neck and roll the person onto their side, so that their bottom leg is straight and their top leg is bent at the knee, with that knee touching the ground.
- Tilt their head slightly forward and down so that vomit in the airway can drain out.
- Manually clear out the person’s mouth, if necessary.
Performing cardiopulmonary resuscitation (CPR)
CPR is a lifesaving technique which can be performed to help people whose breathing and heartbeat have stopped. If someone who has had a stroke is not breathing, performing CPR until the emergency services arrive, may save their life.
The American Heart Association (AHA) recommend that those who have not received formal CPR training initiate hands-only CPR on teenagers and adults.
This type of CPR involves using the hands without giving mouth-to-mouth resuscitation. It consists of two steps:
- Calling 911.
- Pushing hard and fast in the center of the chest.
If an automated external defibrillator device (AED) is available, it can be used to check heart rhythm and deliver an electric shock to the chest, if necessary.
Recognizing the signs of a stroke is a vital component of reacting to an emergency situation caused by someone having a stroke. Some symptoms can be very subtle while others are quite obvious.
Use the FAST acronym to recognize stroke symptoms:
- Face. Is there weakness or drooping on one side of the person’s face? Asking them to smile or stick out their tongue can show a subtle weakness or droop.
- Arms. Are they able to raise both arms?
- Speech. Is their speech slurred or difficult to understand?
- Time. If any of the above apply, call 911 without delay.
Other symptoms of stroke include:
- paralysis on one side of the face or body
- sudden blurring or loss of vision, especially in one eye
- difficulty talking
- difficulty swallowing
- loss of bowel or bladder control
- appearing “drunk” with unexplained falls or loss of balance
- sudden headache
- loss of consciousness
These symptoms may be a warning sign of future stroke.
Emergency first aid treatment is the same for all strokes, regardless of their cause.
- Ischemic stroke: This is the most common form of stroke. It is caused by a blockage or narrowing of the arteries that carry blood to the brain. The blockages may be caused by blood clots or fatty deposits.
- Hemorrhagic stroke. These are caused when arteries in the brain leak blood or burst open. This blood damages brain cells and reduces blood supply to the brain.
- Transient ischemic attack. With this form of stroke, blood to the brain is briefly interrupted, usually caused by a blood clot. Symptoms of transient strokes may resolve quickly, but they commonly serve as a warning sign of more serious strokes in the future.
The following factors increase the risk of stroke:
The risk of stroke increases with age.
At the hospital, doctors will examine the person and may carry out tests such as a magnetic resonance imaging (MRI) scan or a computed tomography (CT) scan to help confirm the diagnosis. These imaging techniques can also help doctors discover the cause of the stroke.
Treatment options include:
- physical therapy
- speech therapy
- lifestyle changes
If the stroke happened within the last few hours, doctors might administer certain medications to address blood clots and reduce the risk of long-term effects.
The outlook for people who have had a stroke varies. Also, having associated medical conditions, such as diabetes and high blood pressure, can increase the risk of future stroke and may hinder recovery.
According to the Centers for Disease Control and Prevention (CDC), stroke is the fifth leading cause of death in the U.S, black people are nearly twice as likely as white people to have a stroke, and someone dies of a stroke every 4 minutes.
Speedy intervention following stroke symptoms is vital. The CDC advise that people who arrive at the emergency room within 3 hours of the appearance of stroke symptoms are less likely to experience disability than those who received delayed care.