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Straight, No Chaser: Stroke Recognition

By Jeffrey Sterling, MD November 14, 2018

strokerecog

Let’s talk about strokes, aka Cerebral Vascular Accidents (CVA) and Transient Ischemic Attacks (TIA), and specifically about recognition and treatment. If you don’t remember anything else here, commit the mneumonic FAST to memory. (Details follow.)
A stroke (CVA) is an insult to some part of your brain, usually due to an inability of the blood supply to deliver needed oxygen and nutrients to that part of the brain. The brain actually approximates a “body map,” so depending on what part of your brain is affected, different parts of your body will be predictably affected. Technically, a stroke isn’t a stroke until the symptoms have been there for more than 24 hours; until then and/or if the symptoms reverse within that timeframe, the same scenario is called a TIA or a “mini-stroke.”

Think FAST, Act Faster

Here’s how the layperson can recognize a possible stroke:

  • Face: Ask the affected person to show you his/her teeth (or gums). In a stroke the face often droops or is otherwise noticeably different.
  • Arms: Ask the person to lift and extend the arms so the elbows are at eye level. In a stroke one side will often be weak and drift downward.
  • Speech: Ask the person to say any sentence to you. In a stroke the speech will slur or otherwise be abnormal.
  • Time: If any of the above occur, it’s recommended that you call 911 immediately, but if it’s my family, I’m getting in a car and going to the nearest MAJOR medical center—not the nearest hospital, which is where the ambulance will take you. There are important differences in hospitals when it comes to stroke treatment (which you won’t know offhand), because some are designated stroke centers and others are not. Friends, this is not the situation where you should wait hours or overnight to see if things get better. Time is (brain) tissue.

It is VERY important that you act on any of the above symptoms (F-A-S) within three (3) hours of symptom onset. Important treatment options are available within the first four and a half (4 ½) hours that are otherwise unavailable.
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0 thoughts on “Straight, No Chaser: Stroke Recognition

    1. Thanks, Shaun. I actually recommend that if you have elderly family members (in particular), you practice FAST. That way when there’s a deviation from their norm, you and/or your family will be better able to recognize the difference.

  1. More great information. Question: What would be the difference in going to the hospital vs a medical center?

    1. Many ‘bigger’ hospitals have gone through the process of becoming ‘stroke centers’. This designation comes after a lot of work has been performed to prepare the hospital to perform at it’s best level when a patient presents with a possible stroke. Designated stroke centers have neurologists, intensive care physicians and radiologists (in addition to the emergency physician) poised to address concerns as literally the highest priority in the hospital. This means when you present with typical symptoms, care is expedited so you will get your CT scan virtually immediately and based on the results, the hospital is primed to act. This is especially important given the time considerations in place for various treatment options, most notably clot-busting medication that may be used if that’s thought to be the cause of the stroke. Most non-designated stroke centers are able to provide excellent care, but this is about giving yourself the absolute best chance for the best outcome. The hospitals that have put in the time to be designated as stroke centers are poised to do just that.

  2. Thank you for this information! One of my Great-Grandmothers had a stroke, which slurred her speech a little and affected her bowels. No one payed attention to the slightly slurred speech. By the time it was revealed she had experienced a stroke, gangrene had set in her intestines and she never recovered after surgery. Paying attention to the warning signs can be a life saver!

  3. Wow! Committing FAST to memory. My mind is still reeling over your point about hospitals versus medical centers. I had no idea there was such a difference. Thanks for breaking it down!

    1. You might not be as exposed to the difference living in the metropolis you do as much as rural communities where specialists are less likely to reside. It wouldn’t hurt to check things out, though!

    1. Hi, Stephanie. Interesting question. All hospitals are equipped to care for patients. Certain facilities have additional specialty designations that indicate a specialized or advanced expertise in certain areas. Some hospitals are stroke centers and trauma centers. Some emergency departments have chest pain centers. Some hospitals are cancer centers. It might take some work, but it would be a good thing for your family to know these things. Thanks for your comment, and thanks for following Straight, No Chaser.

  4. This post is very personal to me. My father suffered a major stroke at home and never regained consciousness…..he died a week later. I wish I’d had a chance to use any of the FAST principles…..thank you for posting such great information.

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