There are about 2 million new strokes in China each year, and less than 10% of patients currently present to the hospital in a timely manner, of which only 1% are treated and benefit within an effective time window. There are currently about 7 million stroke patients in China, and about 75% of these patients result in death or are left with varying degrees of disability. The 4.5 hours after a stroke attack is called the “golden window of emergency”, and every second must be spent within this window to avoid death or disability to the greatest extent possible. How can families detect a stroke in the first place and take first aid measures within the 4.5-hour window?
A. Understanding the “stroke aura”
Although strokes have a rapid onset, many patients have some early warning signs, called “stroke aura”, during the days or hours before the onset of stroke. Patients who have had a stroke in their immediate family or who have high blood pressure, high blood cholesterol, diabetes, or obesity should be more alert to the following symptoms
1. Frequent headaches of unknown origin. (cerebral aneurysm, cerebrovascular malformation)
2.Short-term unexplained rapid loss of vision, double vision or droopy eyelids. (Cerebral aneurysm)
3.Tinnitus, intracranial murmur. (Cerebrovascular malformation)
4.Seizures. (Cerebrovascular malformation)
5.One side of the limb numbness and weakness or vertigo. (cerebral ischemia)
Second, determine whether “stroke”
If you miss this window of time, you may miss the opportunity to reopen the blood vessels and the ischemic brain tissue may die irreversibly.
1.Simultaneous weakness, paralysis or numbness of one upper and lower limb or face (not bilateral).
2.Inability to make sounds (dysarthria), difficulty in speaking or inability to understand the intention of others to speak.
3.Adequate limb strength in the upper and lower extremities, but inability to stand, walk or vertigo.
4.Blurred vision, double vision or visual field defects in one eye.
5.A severe headache that has never been experienced before may be accompanied by nausea and violent vomiting.
6. Disorders of consciousness (drowsiness, coma, restlessness) or seizures.
First aid measures at the scene before hospitalization
1.First of all, ensure that you are calm and carefully observe your condition, and do the following steps.
(1) Use bedding and other tools to move the patient to an easily resuscitated, well-ventilated place and avoid direct sunlight.
(2) Always maintain the horizontal position of the head and body, because elevation of the head will affect cerebral blood perfusion and may lead to deterioration of the condition.
(3) Untie the patient’s collar, tie, socks, belt, and remove items such as watches, glasses, and dentures.
(4) If there is difficulty in whistling, place clothing under the shoulders and elevate the shoulders, do not elevate the head with pillows, etc., leading to increased difficulty in whistling or even asphyxiation.
(5) If the patient is vomiting, he/she should lie on his/her side to prevent asphyxiation due to vomit, and the limb on the paralyzed side should be turned upward when lying on the side.
(6) When the patient has impaired consciousness or seizures, he/she should not hug, shake, stimulate, or shout. (Unnecessary stimulation may aggravate the condition or induce a grand mal seizure)
(7) When the patient has a seizure or has difficulty in whistling, the patient’s jaw should be dragged and lifted upward to prevent choking or biting the tongue and lips; chopsticks or towels should not be used to stuff the mouth.
(8) Never feed water or food to the patient. Such behavior will affect the surgery and anesthesia after admission.
2.You should immediately call the emergency number, explain your condition in detail and choose the appropriate hospital for consultation and treatment.
(1) When calling the emergency number, give a detailed description of the patient’s age, gender, and previous medical history and the symptoms observed so far.
(2) Give details of the patient’s address and nearby landmarks, and send someone else to meet the ambulance crew.
(3) Prepare the documents and items needed for hospitalization. Patient’s ID card, health insurance card, admission fee, previous medical records (medical records, imaging data, etc.).
(4) After the ambulance personnel arrive, you should explain the patient’s condition in detail to the medical staff and propose to go to the nearest hospital with emergency and treatment capabilities (you need to know the treatment capabilities of the nearest hospital, we recommend tertiary hospitals or above), otherwise the second referral will waste a lot of valuable emergency time. In addition, do not blindly pursue the best hospital in your opinion.
(5) Notify other relatives and friends to come together as much as possible. This is because when you arrive at the hospital and need to carry the examination, it will greatly shorten the consultation time.