Education needed on stroke symptoms and prevention
Deaths and disabilities may be reduced
Stroke is the third leading cause of death, yet many of these fatalities could be prevented, according to the National Stroke Association based in Centennial, CO. Statistics tallied by this organization find about 80% of the 780,000 strokes occurring annually could have been avoided.
In addition, stroke is the leading cause of adult disability. During a stroke, two million brain cells die each minute; therefore, recognizing symptoms and quickly seeking medical attention will limit disabilities, as well as save lives.
To address these issues, Susan M. Gaunt, RN, MS, CCRN, CNRN, a neuroscience clinical nurse specialist at Gwinnett Medical Center in Lawrenceville, GA, regularly speaks to groups about stroke prevention and the importance of early intervention.
"My goal was to get out to the community and educate them, because most of the time stroke doesn't hurt like chest pain, so people sit at home and don't come in until a day later when they can't move one side of their body," says Gaunt.
One man, age 54, waited 24 hours to seek medical attention, even though he noticed he dropped items he picked up with his left hand, and each time he reached for his face his arm would turn. One of the warning signs of stroke is problems with coordination.
However, one week after Gaunt spoke at an independent living facility for seniors, a woman came to the hospital with a transient ischemic attack. A TIA is also called a mini-stroke, because the symptoms go away in a few minutes. It is an important time to seek medical attention, because a person who has had a TIA is 10 times more likely to have a major stroke within the first few days up to three months following the episode.
"The woman told me she would not have come in for medical help if she had not heard my presentation. It could have prevented her from having a big stroke," says Gaunt.
The most obvious stroke symptom is sudden numbness or weakness of the face, arm or leg, especially on one side of the body. Yet people will wait to seek medical attention thinking they pinched a nerve or slept wrong, says Gaunt.
Common stroke symptoms according to the National Stroke Association also include:
- Sudden confusion, trouble speaking or understanding.
- Sudden trouble seeing in one or both eyes.
- Sudden trouble walking, dizziness, loss of balance or coordination.
- Sudden severe headache with no known cause.
Gaunt often speaks to older people about stroke prevention and early intervention, because those over the age of 55 are more likely to have one. However, she wants to get into more schools to teach teens because there have been cases at Gwinnett Medical Center where teenagers have recognized that someone was having a stroke and called emergency services.
Because it is important to get a stroke victim to the emergency department quickly, the National Stroke Association devised a simple test to help people act quickly. It is called Act F.A.S.T. and is based on this acronym.
F=Face: Ask the person to smile. Does one side of the face droop?
A=Arm: Ask the person to raise both arms. Does one arm drift downward?
S=Speech: Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?
T=Time: If you observe any of these signs, it's time to call 9-1-1 or get to the nearest stroke center or hospital.
Teaching about stroke prevention
Almost 85% of strokes are ischemic and are triggered by blocked arteries, according to the National Stroke Association. Arteries can be blocked by blood clots or plaque and other fatty deposits. When a blood vessel in the brain breaks, a hemorrhagic stroke occurs.
While some risk factors are beyond a person's control, there are certain lifestyle changes people can make to reduce their chance of having a stroke. The risk of stroke is higher for those who are older, males, African-Americans, those with diabetes or who have a family history of stroke.
Risk factors that people can target to lower their risk of stroke include smoking. Those who smoke double their risk of stroke.
High blood pressure, or hypertension, is a leading cause of stroke. It is important for people to know their blood pressure and work with their physician if it is high, says Gaunt. She tells people that a diet low in sodium and fat, as well as exercise and medications can all help lower an elevated blood pressure.
According to Gaunt, nutrition is a big focus, because an unhealthy diet contributes to many health problems that increase the risk of stroke. High cholesterol is one of those problems, therefore everyone needs to know their cholesterol number. If the total level (LDL and HDL) is over 200, a person may be at increased risk for stroke.
People with diabetes must keep it under control to reduce the risk of stroke, says Gaunt. Also, a history of cardiac problems, including an irregular heartbeat, are risk factors, and people with these conditions need to be under a doctor's care, says Gaunt.
Although older people are more likely to have a stroke, Gaunt sees patients in their 20s, 30s and 40s. These strokes could be lifestyle related, she says. That's because many young people are developing hypertension and other health problems as a result of a poor diet and obesity.
When a person knows something is a risk factor they need to address it, says Gaunt. Yet she sees people with high blood pressure stop taking medication. Within a couple days to a year they could be seeking medical attention for stroke, she adds.
Education on stroke prevention and early intervention is needed, says Gaunt. Gwinnett tracks data on the number of people who seek medical attention within three hours of the onset of stroke symptoms and within six hours, and the numbers are not changing.
She's hoping to educate enough people in her area to see the data change, with more patients seeking medical intervention within three hours.
SOURCES
For more information on providing community stroke education contact:
- Susan M. Gaunt, RN, MS, CCRN, CNRN, Neuroscience Clinical Nurse Specialist, Gwinnett Medical Center, 1000 Medical Center Blvd., Lawrenceville, GA 30045. Telephone: (678) 312-2504. E-mail: [email protected].
- National Stroke Association, 9707 East Easter Lane, Suite B, Centennial, CO 80112-3747. Telephone: (800) 787-6537. Web site: www.stroke.org.
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