Stroke Awareness and Immediate Interventions (PDF)
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Dr Ahmed Hawash
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Summary
This presentation covers stroke awareness and immediate interventions, including definitions, types (ischemic and hemorrhagic), risk factors, symptoms (using the FAST assessment), and diagnosis through the NIH stroke scale. It emphasizes the urgency of quick action to prevent permanent brain damage and highlights treatment strategies for ischemic and hemorrhagic strokes, with considerations for prognosis, complications, and community resources.
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Stroke Awareness and Immediate Interventions Dr Ahmed Hawash Understanding Stroke Definition A stroke occurs when blood flow to the brain is blocked or bleeds, causing cell death. Urgency Quick action is crucial. Every second counts in preventing permanent brain damage. Impact Stroke is...
Stroke Awareness and Immediate Interventions Dr Ahmed Hawash Understanding Stroke Definition A stroke occurs when blood flow to the brain is blocked or bleeds, causing cell death. Urgency Quick action is crucial. Every second counts in preventing permanent brain damage. Impact Stroke is a leading cause of death and disability worldwide, affecting millions annually. Types of Strokes Ischemic Stroke Hemorrhagic StrokeTransient Ischemic Attack Caused by blockage in Occurs when a blood Brief, temporary blockage. brain blood vessels. vessel bursts. Warning sign for future Most common type. Less common but more strokes. Risk factors include high dangerous. Requires immediate blood pressure and High blood pressure is a medical attention. diabetes. key risk factor. Risk Factors and Prevention Modifiable Risk Factors for Stroke Non-Modifiable Risk Factors for Stroke Factors such as high blood pressure, smoking, While we can't change non-modifiable factors diabetes, and high cholesterol can significantly like age, family history, or genetic increase the risk of stroke. predisposition, it's crucial to be aware of them. By adopting a healthier lifestyle and managing Understanding these factors can help you and your these factors through medication and lifestyle healthcare provider tailor preventive measures and changes, you can significantly reduce your monitor for potential risks. stroke risk. Recognizing Stroke Symptoms Sudden Weakness Numbness on one side of the body, especially face, arm, or leg. Speech Difficulties Problems speaking or understanding speech, including slurred words. Vision Issues Blurriness or trouble seeing in one or both eyes. Severe Headache Often described as "the worst headache ever" with no known cause. Diagnosis 1. FAST Assessment 2. Advanced Screening Tools A. Glasgow Coma Scale (GCS): B. CT and MRI Scans: Diagnosis 1. FAST Assessment 2. Advanced Screening Tools A. Glasgow Coma Scale (GCS): B. CT and MRI Scans: Diagnosis 1. FAST Assessment 2. Advanced Screening Tools A. Glasgow Coma Scale (GCS): B. CT and MRI Scans: Overview of the NIH Stroke Scale (NIHSS) Purpose: Key Components: (11 items assessed Assess stroke severity and individually) monitor changes in Level of Consciousness (LOC) neurological function. LOC Questions and Commands Guides treatment Gaze Visual Fields decisions, especially in the Facial Palsy acute phase. Motor Arm & Leg (Left and Right) Limb Ataxia Scoring and Interpretation: Sensory 0: No symptoms Language Dysarthria 1-4: Minor stroke Neglect 5-15: Moderate stroke Tip for Nurses: Familiarity with the NIHSS 16-20: Moderate to severe helps nurses in timely stroke recognition, stroke which is essential for effective intervention. Applying NIHSS in Stroke Care Practical Application: Immediate Action: Quick NIHSS assessment helps prioritize care, including potential use of clot-busting treatments. Consistent Monitoring: Use the NIHSS repeatedly to track changes in neurological status over time. Importance for Nurses: Accurate Communication: NIHSS scores give clear, objective data to share with the care team. Enhanced Patient Outcomes: Early recognition and monitoring allow for faster treatment adjustments, improving recovery chances. Remember: Quick, accurate scoring saves brain function! The FAST Assessment Face Arms Speech Time Ask the person to smile. Ask them to raise both Ask them to repeat a If any signs are present, Look for facial drooping on arms. Check if one arm simple phrase. Listen for it's time to call emergency one side. drifts downward. slurred or strange speech. services immediately. Beyond FAST: Additional Assessments Sudden Confusion Trouble understanding speech or following directions. Balance Issues Sudden trouble walking, dizziness, or loss of coordination. Emergency Response Rapid transport to stroke-ready hospitals is crucial for timely treatment. Goal: Restore blood flow to the affected brain area quickly. Main Treatment: Ischemic Thrombolytics (Clot-Busting Drugs): Example: Tissue Plasminogen Activator (tPA) Stroke Function: Dissolves the blood clot causing the stroke. Time Window: Must be administered within 3 to 4.5 Treatment – hours from symptom onset. Additional Interventions: Key Endovascular Procedures: Mechanical thrombectomy Intervention for eligible patients within a 24-hour window, depending on imaging results. s Antiplatelet Therapy: For prevention of further clotting (usually aspirin or clopidogrel). Nursing Implications: Act FAST: Rapid recognition and transfer to stroke centers. Pre-Administration Checklist: Confirm eligibility for tPA (time since onset, absence of bleeding risk). Goal: Prevent further bleeding and reduce pressure on the brain. Main Treatment Approaches: Hemorrhagic Blood Pressure Control: Purpose: Lower high blood pressure to prevent worsening of Stroke the bleed. Medications: IV antihypertensives (e.g., labetalol or nicardipine). Treatment – Surgical Intervention: Indications: Large or life-threatening bleeds. Key Procedures: Clipping or coiling for aneurysms, or surgical evacuation of the hematoma. Interventions Supportive Care: ICP Monitoring: Use of devices to measure and reduce intracranial pressure. Nursing Implications: Medications: Osmotic agents like mannitol to relieve brain Close swelling. Monitoring: Watch for changes in neurological status, blood pressure. Family Education: Explain the risks and need for strict BP control. Factors Influencing Prognosis: Stroke Severity: Greater severity often leads to more extensive damage and a longer recovery. Stroke Age: Older patients generally face more challenges in recovery due to decreased resilience. Prognosis – Timeliness of Treatment: Faster intervention (e.g., What Affects tPA for ischemic stroke) improves recovery odds significantly. Recovery? Underlying Health Conditions: Pre-existing Conditions: Diabetes, hypertension, and heart disease can slow recovery. Lifestyle Factors: Smoking, poor diet, and inactivity can negatively impact prognosis. Long-Term Complications Physical Impairments: Weakness, coordination issues, or paralysis, often affecting one side of the body. Cognitive Changes: Memory loss, trouble with planning, and impaired judgment. Emotional and Behavioral Changes: Risk of depression, anxiety, and personality changes. Increased Risk of Recurrent Stroke: Importance of secondary prevention (e.g., lifestyle modifications, medications). Increased Risk of Recurrent Infections: UTI and Pneumonia. Community Programs and Support Public Health Initiatives Programs educating the public about stroke prevention and early signs. Advocacy Groups Organizations like American Heart Association raising awareness and funding research. Community Education Local health departments providing brochures and materials for community learning. Summary and Resources 1 Key Points 2 Ongoing Learning Recognizing stroke Stay informed about symptoms and using evolving healthcare FAST assessment can practices in stroke save lives. care. 3 Further Resources National Stroke Association and American Heart Association websites offer additional information.