Stroke !!! Think F-A-S-T
By: Stu Willis, MD – Emergency Department Director, Boundary Community Hospital
A drooping face, weakness or numbness on one side, slurred or garbled speech … this might be a stroke! Like heart attacks, a stroke is a life-and-death emergency; time is critical and every second counts, so think F-A-S-T and dial 9-1-1 immediately.
F-A-S-T is a reminder of some of the signs of a stroke:
ARMS – is there weakness on one side; have them raise the arms, test the hand grip;
SPEECH – is there altered speech (slurred or unable to speak); have them say “the sky is blue;”
TIME – every second is crucial; certain procedures and medications must be done quickly.
Other sudden and unexpected signs of a possible stroke include, but are not limited to: confusion or difficulty understanding, numbness on one side or part of the body, trouble seeing with one or both eyes, dizziness, loss of balance or difficulty walking, and a severe headache, with no prior history (ex. migraine).
Stroke is the fifth leading cause of death in the U.S., Idaho, and Boundary County, killing 133,000 persons annually nationwide – about 1 in 20 deaths. Someone in the U.S. has a stroke every 40 seconds. The care for a stroke patient and the consequent disability results in over $34 billion in annual healthcare costs, as well as the anguish for the patient and the family.
There are two basic types of stroke – An “ischemic” stroke is caused by a blood flow blockage, similar to a heart attack clot; “hemorrhagic” is a stroke caused by spontaneous bleeding in the brain (sometimes from a burst aneurysm). An emergency CT scan is needed to determine the difference. If the stroke is ischemic (clot blockage), a “clot-buster” medication must be administered within 3 hours of the onset of symptoms (up to 4 ½ hours in certain instances). So, “TIME is BRAIN!”
The hospital Emergency Department staff stands ready with 24/7 CT scan capability to determine if a stroke is “ischemic” or “hemorrhagic,” and can immediately deliver the “clot-buster” medicine when indicated. But it must start with the recognition of stroke signs and symptoms and dialing 9-1-1.
Worldwide, stroke is the second leading cause of death, after heart disease. Many experts feel enhanced public education to decrease the risk factors leading to stroke and the notable systems in place for early stroke identification and treatment have contributed to the lower death rates in the U.S.
Stroke is not just a disease of “old” people. A stroke can strike at any age, and in the U.S., about one-third of strokes occur in persons under the age of 65. Even persons in their twenties and thirties (or younger) can suffer strokes.
PREVENTION, through public education and intervention, is the key to lowering the stroke risk. The American Heart Association and American Stroke Association have identified seven key health risk factors and behaviors that influence the onset of heart disease and stroke in the U.S. These “Life’s Simple 7” are:
- Smoking – over 15% of the population smokes; in 2014 there were about 5,700 new cigarette smokers every day. If you smoke, STOP!
- Physical Inactivity – 30% of adults do not engage in leisure time physical activity. Even a little EXERCISE helps.
- Nutrition – improvements have recently been made in healthier eating, particularly increased whole grain, fruit, and vegetable consumption, with a decrease in sugar-sweetened beverage intake. The excessive use of sodium (salt) remains problematic. EAT SMART.
- Obesity – alarmingly, obesity is on the rise; the U.S. obesity rate has increased from 30.5 to 37.7% in the past 15 years. LOSE WEIGHT.
- High Blood Pressure – 86 million adults (30%) have hypertension and only 45% have it under control; three of every four first-time stroke patients have blood pressure over 140/90. Get a BP CHECK – 130/80 is nice, 120/70 even better.
- Cholesterol – 95 million adults (40%) have high cholesterol, and many don’t even know it. Have a CHOLESTEROL blood test – it can be treated.
- Diabetes – 31 million adults (12%) have diabetes, and 30% of them don’t know it; in addition, 34% of all Americans have prediabetes. Get a BLOOD SUGAR test – diabetes can be a killer.
As the first Pacific Northwest hospital to receive the Critical Access Hospital designation by the federal government, Boundary Community Hospital plays an essential role in meeting the healthcare needs of Bonners Ferry and the surrounding county. Under the Idaho Time Sensitive Emergency System, the hospital was recently awarded the designation as a TSE Level IV Trauma Center. The hospital is now actively engaged in meeting the stringent criteria required for designation as a Level III Stroke Center.