Managing Stroke at Workplace - Handling Emergency

Introduction

A stroke is a medical emergency that occurs when the blood flow to the brain can get blocked due to a block (blood clots, plaque, fatty deposits) or rupture of the major blood vessels supplying the brain. Bleeding in and around the brain can also lead to stroke. In addition, the brain cells get damaged due to oxygen and nutrition depletion and die within minutes if treatment is not initiated. The brain damage caused by stroke is permanent, and thus it can lead to long-term disability and death. The warning signs of stroke include sudden numbness, blurred vision, severe headache, weakness, paralysis, vision disturbances, trouble speaking, confusion, and trouble understanding speech. If a person experiences the sign of a stroke, call for emergency help immediately or rush to the emergency department for prompt treatment. Time is a crucial factor in stroke management that can save lives.

What Are the Factors That Increase the Risk of Stroke?

The various risk factors for stroke and transient ischemic attack (mini-stroke) include the following:

• Age greater than 55.

• A family history of stroke.

• Men have a higher risk.

• Ethnicity or race (African Americans and Hispanics are at greater risk).

• Hypertension (increased blood pressure).

• Increased blood cholesterol levels.

• Diabetes (insulin resistance).

• Physically inactive people.

• Patients with heart disease.

• Smoking.

• Heart rhythm problems.

• Drug abuse (such as cocaine).

• High-risk diet.

• Stress and depression.

• Increased risk of blood clots (hypercoagulability).

• Obesity.

What Are the Symptoms of a Stroke?

During a stroke, time plays a crucial role. The sooner the treatment is initiated, the better the survival rate. In addition, we can save lives by being aware of the symptoms and warning signs of stroke. The symptoms come on abruptly and include the following:

• Vision disturbances and blurred vision make seeing from one or both eyes difficult.

• Difficulty speaking (strange or slurred speech).

• Dizziness (lightheaded or vertigo).

• Loss of coordination and balance.

• Muscle weakness.

• Sudden confusion.

• Memory loss.

• Difficulty in walking.

• Difficulty understanding words.

• Difficulty swallowing.

• Sudden severe headache (without a known cause).

How to Recognize Stroke Symptoms?

The hardest thing in case of a stroke is recognizing its warning signs. If there is doubt that a person is having a stroke, do the following F.A.S.T test (face, arm, speech, and time) :

• Face: Ask the patient to smile. Check if one side of their face droops when the patient smiles.

• Arm: Ask the patient to lift a hand. Drooping of the hand is evident in case of a stroke.

• Speech: Ask the patient to repeat some words or a simple phrase. Note if they can understand when spoken to and check if their speech is strange or slurred.

• Time: If the patients have problems in any of the above (drooping face, drifting of one arm, or slurred speech), call for emergency medical services right away.

What to Do if Someone Has a Stroke?

One can do the following to help someone having a stroke:

• First, quickly assess the patient using the F.A.S.T test (Facial drooping, Arm weakness, Speech difficulties, and Time).

• Call for emergency medical services. In case the person is experiencing stroke symptoms, get help.

• It is preferred to call for an ambulance to get to the hospital. Do not drive the patient in the car. Emergency medical personnel start life-saving interventions and treatment on the way to the emergency department. They also ensure the hospital is well-equipped with medications and treatments to handle the stroke patient on arrival.

• Stay calm and focused until emergency help arrives.

• It is important to note the time when the symptoms started. This is crucial in stroke patient management. If the patient reaches the hospital within three hours of the first stroke symptoms, a clot-busting medicine (thrombolytic drugs such as plasminogen activator) can be administered to break up the clot in the brain’s blood supply. This markedly improves the chances of survival and recovery without disability. Such patients are also less likely to need long-term nursing home care.

Thus, the emergency personnel must be informed about when the stroke symptoms start. If the patient was found already with the symptoms, inform when the person was last seen without any symptoms so that treatment options can be decided.

• Make sure the patient is in a safe and comfortable position. For example, the patient can lie down (on one side) with the head slightly raised (to prevent aspiration of vomit and other secretions) and well-supported.

• Check the patient’s breathing, airway, and circulation (blood flow). If the patient has breathing difficulty, loosen any tight clothing (scarf, tie). Check the patient’s airway (air passage to the lungs) is clear. If the patient is not breathing, initiate cardiopulmonary resuscitation (repeated chest compressions and rescue breathing) to ensure blood flow to all body parts.

• Reassure the patient in a calm and soothing voice.

• If the patient is cold or their body temperature is dropping, cover them (with a blanket) to keep them warm.

• Do not give the patients anything to drink or eat.

• Do not move the person, especially if the person shows weakness in a limb.

• Carefully observe the patient for any worsening of symptoms.

• Be prepared to inform the emergency personnel about the patient’s symptoms and signs and when they started. Also, inform the health care personnel if the patient falls or hits their head.

How Are Strokes Treated?

The patient’s survival and recovery depend on how quickly the symptoms are recognized and treated. The emergency medical team quickly assesses the patient and initiates life-saving treatment and medications on first contact. Once at the hospital or emergency department, the patient may receive emergency care, medications or surgery, treatment to prevent another stroke, and rehabilitative measures to manage the stroke’s side effects.

• Ischemic strokes - Strokes caused by a lack of blood supply to the brain (ischemic strokes) are treated with medications such as clot-busting or thrombolytic drugs (within three hours of symptoms), blood thinners, and surgery to remove the clot blocking the brain’s blood supply.

• Hemorrhagic strokes - If the stroke is due to a rupture of a blood vessel or bleeding in and around the brain (hemorrhagic stroke), medications, invasive interventions to repair the break or weak spot in the blood vessels, and surgical treatment may be done to stop the bleeding and to prevent brain damage.

Thus, it is important to treat any underlying cause of the stroke. These include heart disease, high blood cholesterol, raised blood pressure, diabetes, and irregular heart rhythms. The patients are given medications and are advised to modify their diet and adopt healthy lifestyle habits. At times, surgery may also be done to treat the underlying cause.

Conclusion

Call for emergency medical help if having a stroke. Do not drive to the hospital. Instead, call for an ambulance so that life-saving medical interventions can be initiated on the way to the emergency department. Every minute counts in a stroke. The quicker the treatment is initiated, the better the chance of survival. The emergency team will assess the patient and initiate life-saving interventions. Stroke is managed with medicines, invasive procedures, or surgery. Recovery depends on the severity of the stroke and on how soon the treatment was initiated. With quick first aid, prompt emergency treatment, and a proper rehabilitation plan after discharge, the patient can return to work without disability.