I attended a CPC (Clinical Pathology Conference) this morning by the A&E (Accidents & Emergencies) Department this morning. And I’ll like to share part of it with you today.
Ages ago, stroke, one’s greatest nightmare, was only managed by rehabilitation, good nursing and physiotherapy. But with today’s technology and new discoveries, note : the fibronolysis drugs and MERCI technology, made it possible to treat stroke or cerebrovascular accidents (CVA) if presented early. Thus, the golden hour is very important.
TIME IS BRAIN.
Every second wasted is lost of brain tissue. For each minute that brain tissue goes without blood flow, 1.9 million neurons die and 14 billion synapses are lost. Synapses are special pathways along which nerve impulses travel. The brain ages 3.6 years for every hour that passes after a stroke begins. The golden hour for stroke is within 6 hours from presentation. However, more than 50% of the patients presented to the hospitals in Malaysia, come to the hospital only after 12 hours!!!
Why you may ask? The answer is late detection. Many people do not know that they had a stroke and time is ticking against them. Fortunately, you do not have to be a medical student or a medical officer to detect signs of stroke. It is something very simple that a layman can do. And today, I shall be teaching you how. So that, someday, if you face this situation, you will be able to identify it and act fast and save someone from disabilities, making a difference in their life.
To make it easy: remember the mnemonic FAST.
Face – check for facial asymmetry. Is there drooping of one side of the face? To elicit more signs for better appreciation of the asymmetry, there is a series of ‘face exercise’ you could do (which can be quite funny).
1. without moving your head, look upwards
2. screw or squint your eyes
3. puff your cheeks (the examiner, with his index fingers, will attempt to pop the air out of your cheeks)
4. show your teeth (grin)
Good job! I see you had excitedly examined yourself. Good, you have great facial muscles and you do not have the facial features of stroke
Arm – ask the person to close his/her eyes. Then, raise both arms, palms facing down. Check whether one of the arm sways down.
Speech – ask the person to say: ‘The sky is blue’ or ‘You can’t teach an old dog new tricks’ or ‘ Pulau Pandan jauh ke tengah’ (in BM). Observed is there is any usual speech.
Time – if there are any positive signs of the above, it is time to act! Dial 999.
p/s: other signs: Sudden trouble walking, dizziness, loss of balance or coordination, Sudden severe headache with no known cause
Perhaps, it is difficult to illustrate in text. Watch this cartoon for a better idea. (from youtube)
*but of course you have to call 999 instead of 911 in Malaysia*
stroke is still one's greatest nightmare. but early detection can make a difference! i hope you benefit from reading this post. :)
Spread the word about the Golden Window of Opportunity. Save your loved ones from stroke~