I. What is the “golden 3 hours” of stroke?
The best time to save a stroke is within 3 hours, and 4 and a half hours is the limit of effective resuscitation. The risk of thrombolysis increases greatly once 4 and a half hours have elapsed. Therefore, if a stroke patient can get medical attention faster and more efficiently, it will undoubtedly help him/her to recover later.
3 hours is the golden time to save
Stroke is an emergency, so it is important to save time. 3 hours is the best time for stroke treatment. If treated with thrombolytic drugs within this time, 42% of patients are able to return to work or self-care.
If it takes more than 3 hours, especially after 6 hours, the patient’s nerve cells will become necrotic. Even if measures are taken at this time, the condition of the blood vessels is so bad that it can even be said that it is not helpful.
Therefore, when signs of stroke are detected, call 120 immediately, while keeping the patient in a head-down position. After arriving at the hospital, the specialist is allowed to receive laboratory tests within 20 minutes, and CT is done in 40 minutes, followed by immediate thrombolysis.
Second, where is the precious rescue time wasted?
Missing the golden time of rescue “In China, more than 98% of stroke patients do not receive thrombolysis treatment, mainly because of the delay in pre-hospital and in-hospital.” This leads to a missed golden time for treatment. The most important time, are wasted in which link?
1. Calling 120 should be timely. The typical symptoms of stroke are crooked eyes and slanted mouth and weakness of half of the limbs. However, sometimes the symptoms of stroke are not very typical and may only be dizziness and vomiting, which are common symptoms that can be easily ignored by family members. Therefore, if you have an elderly person with a history of stroke, or a “high-risk group” for stroke such as hypertension or heart disease, you should think of dizziness and vomiting once you have a stroke, and call the emergency number at the first opportunity.
2. Sending the right hospital is the key. Thrombolysis is the only effective treatment for ischemic stroke, but it is important to note that not all hospitals are able to do it. Therefore, if you know in advance which hospital can do thrombolysis, you will not be sent to the wrong hospital and avoid the waste of time.
3. Be decisive at the critical moment. Doing thrombolysis, there is about 3% risk of disability or death. Therefore, some patients’ families are hesitant to sign, or even refuse to sign. Such a delay is often encountered. The earlier the thrombolysis, the greater the benefit of stroke treatment to seize the “golden hour”, the earlier the thrombolysis, the greater the benefit. “Stroke” is often referred to as “stroke”, “stroke” means sudden, “stroke “Stroke is a metaphor that shows the suddenness and danger of stroke. Data show that on average, one person has a stroke every 12 seconds and one person dies of stroke every 21 seconds in China. Stroke resuscitation should seize the “golden time”, preferably within 3-4.5 hours after the onset of stroke and within one hour after arrival at the hospital, and “the earlier the thrombolysis, the greater the benefit to the patient”.
Third, the focus of stroke rescue is on early symptom recognition
FAST assessment method
The FAST assessment method is recommended for early identification of stroke in yourself or your family, and timely treatment can save the lives of stroke patients. To improve the quality of life.
F(Face): Are you (he/she) able to smile? Do you feel weakness or numbness on one side of your face?
A(Arm): Can you (he/she) lift both hands smoothly? Does one hand feel weak or unable to lift it at all?
S(Speech): Can you (he/she) answer fluently? Do you have difficulty speaking or are your words slurred?
T(Time): If any of the above three are present, please call the emergency number 120 immediately.
Learn to recognize a stroke quickly by mastering the simple “Fast” rule. Time is life, less delay, more recovery! Please immediately send the patient to a hospital that has experience in thrombolysis and is capable of treating the patient.
Fourth, seven types of people should pay special attention to stroke
Hypertension is the most important risk factor for stroke. Controlling blood pressure levels below 140/90 mmHg can significantly reduce the incidence of stroke, so patients with hypertension should monitor their blood pressure and keep good records of it on a daily basis, and provide them to the doctor for reference at the clinic. Patients with dyslipidemia and atherosclerosis have a close relationship between elevated total serum cholesterol, triglycerides, LDL and lower HDL and cardiovascular disease. Diabetes mellitus is an important risk factor for ischemic stroke. Atrial fibrillation and heart disease All types of heart disease are prone to stroke, with atrial fibrillation being a very important risk factor for stroke. Smoking often affects the blood vessels and blood system, such as thickening arteriosclerosis, increasing fibrinogen levels, promoting platelet aggregation, lowering HDL levels, etc. It is especially associated with stroke in middle-aged and young people. Excessive alcohol consumption and alcoholism are risk factors for stroke in young people. Overweight or obese overweight or obese patients are prone to hypertension, hyperlipidemia and hyperglycemia.
V. Do not take medication intermittently
The main problem for patients who have had a stroke is how to improve their symptoms and prevent a recurrence of stroke. The goal of secondary stroke prevention is to reduce recurrences and reduce death and disability. The two main measures of secondary stroke prevention are control of risk factors and reliable and continuous drug therapy. Secondary prevention of stroke should focus on the following major aspects.
1. Rational use of anti-hypertensive drugs: Hypertension is the first risk factor for atherosclerosis. High blood pressure can accelerate and aggravate the development of atherosclerosis and Chengdu, the higher the blood pressure, the greater the chance of stroke recurrence. Effective antihypertensive treatment can prevent the recurrence of cardiovascular disease. Generally speaking, blood pressure should be controlled below 140/90mmHg, and for diabetic patients, it should be below 130/80mmHg.
2.Take anti-platelet drugs: For example, aspirin and other drugs can resist platelet agglutination and release, improve the balance of prostaglandin and thromboxane A2, and prevent thrombosis. A large body of evidence-based medical evidence suggests that antiplatelet therapy, especially aspirin, can prevent about 25% of serious vascular events in patients who have had a previous ischemic stroke.
3. Take lipid-regulating drugs: Abnormal lipids make the blood viscous, slow blood flow, reduce the amount of blood supplying the brain, damage the endothelium, and deposit atherosclerotic plaques in the vessel wall, which directly leads to the development of cardiovascular disease. The LDL cholesterol should be controlled below 2.59 mmol/L or reduced by 30% to 40% in people who have already had a stroke.
4, secondary prevention advocates “double effective”, that is, effective drugs, effective dose. Eating and stopping is a taboo for secondary prevention of stroke.
Six, how to calculate the time of stroke onset
1. Generally speaking, the time of onset of symptoms is the time of onset;
2.If the patient is found to have symptoms, and the patient cannot recall the exact time, the time should be calculated from the last time the patient is still normal.