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I  know the Daily Kos is about politics and community, I would argue for better Health as well.
Sometimes people at a party or at work have a medical problem and you may not know how to help. The fact that you read this paper tells me you would never just stand and watch a person hurting and not try to help.
You should be able to tell if someone is having a stroke. You need to know stroke
During a BBQ a woman stumbled and took a little fall. She assured everyone that she was just fine. Folks offered to call 911. She declined, got cleaned up and had more food.
she did appear a bit shaken.
At 6:00 p.m. shortly after leaving the party, the husband called to report his wife, the lady who said she was fine, had just DIED.
She had a Stroke. Doctors will tell you if they can reach the victim within 3 hours of the stroke event, they can totally reverse ALL negative effects of the stroke!
Here are things YOU should do if you feel a person may have had a stroke:
1.  Ask the person to smile.
2.  Ask the person to talk and say a simple sentence in a coherent manner.
3. Ask the person to stick out their tongue at you. If the tongue points left or right
that is not good.
If the person can not do ANY of your requests, call 911 even if they say no.
The lady at the BBQ might have been saved if anyone knew what I just wrote.
"Life is but a day at most."
-Robert Burns

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Comment Preferences

  •  The mnemonic I was taught is (7+ / 0-)
    S Ask them to Smile

    T Ask them to Talk

    R Ask them to Raise both arms


    If any of the three are off, 911 immediately!

    Is it true? Is it kind? Is it necessary? . . . and respect the dignity of every human being.

    by Wee Mama on Wed Oct 02, 2013 at 10:49:11 AM PDT

    •  Raising the arms (3+ / 0-)
      Recommended by:
      Wee Mama, churchylafemme, chimene

      The new research says your tongue is a better
      indicator. I worked in nursing homes and many times
      I never got to the raise your arms part. Raise your arms is fine to use,but don't forget to do the tongue first.
      Thanks for writing!

      •  Thing is, it's best to have a list of indicators, (2+ / 0-)
        Recommended by:
        Wee Mama, chimene

        so that there are multiple things to look at if any one indicator or couple of indicators are already out of the question due to other conditions.

        Arms are bad for a relative of mine. Shoulder injury, healed wrong, too old for fixing it to be worth it. Can't raise one arm half as high as she can get the other, and she's been told by doctors not to try.

        Tongue is bad for my friend with Bell's Palsy. His is always likely to drift to one side unless he thinks about it and forces it to center.

        But combine the two on the same list, and each has one workable indicator that means something and another that simply shows that they still have the same medical histories they already had.

        Talking coherently is a huge issue as an indicator, because people with some developmental disorders simply can't - but the physical 'do something' indicators can still work for them.

        •  your message (2+ / 0-)
          Recommended by:
          Wee Mama, churchylafemme

          I mentioned if the person can not do ONE of the requests,
          call 911.Never would I say  wait for all requests to be done. When in 911!
          I have called 911 15 times this year because of Diabetes.
          Some day I will write a post on Diabetes. I have 21 years

          •  By your rules, (0+ / 0-)

            I have a friend who could not have graduated high school, earned a GED, or gone to a regular doctor's appointment after the age of 16, instead of even having a hope of going to college, because the moment another human being saw him they'd dial 911!

            I have a family member with ongoing health concerns who would not be able to go to church, get her hair done, go to her regular doctors offices, or do any other thing that keeps her from being completely homebound because of a shoulder injury a decade ago! And she does actually have risk factors for strokes, so everyone around her for long keeps track of what her actual normal is and is prepared to make the call if anything changes.

            When someone tells you they cannot do a stroke indication test because of a pre-existing condition, you will be keeping the EMTs away from someone who actually needs emergency care because they will be too busy dealing with someone who is already under extended medical care for the non-acute condition you are calling a health emergency requiring a trip to the front of the triage line.


            •  your message (2+ / 0-)
              Recommended by:
              churchylafemme, chimene

              I have seen medics in my house many times. They always say even if your not sure ,call us. You are talking about
              a person that 911 probably should not be called. Thousands of people read this. I was giving  suggestions
              for the majority of people. Exceptions are always possible.

        •  Familiarity with the person (5+ / 0-)

          It's very common for stroke symptoms to be noticed by family, friends, or co-workers. Those folks usually know what is normal baseline for that person, and what seems new, unusual, and not right. The diagnostic difficulties that you and others mention can often be confirmed or discounted readily by other folks present at the time. As in the case of this diary's party-goer, stoic victims who downplay their symptoms can make things difficult.

          If we encounter a stranger in possible distress with no one else to offer information, "better safe than sorry" usually works pretty well as a guide.

          Thanks for your interest!

  •  FAST (7+ / 0-)

    Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have drooped
    Arms – the person with suspected stroke may not be able to lift one or both arms and keep them there because of arm weakness or numbness
    Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake
    Time – it is time to dial for paramedics immediately if you see any of these signs or symptoms

    The signs and symptoms of a stroke vary from person to person but usually begin suddenly. As different parts of your brain control different parts of your body, your symptoms will depend upon the part of your brain affected and the extent of the damage.

    Even if the symptoms of a stroke disappear while you are waiting for the ambulance to arrive, you or the person having the stroke should still go to hospital for an assessment. Symptoms that disappear may mean you have had a transient ischaemic attack (TIA) and you could be at risk of having a full stroke at a later stage.
    After an initial assessment, you may need to be admitted to hospital to receive a more in-depth assessment and, if necessary, for specialist treatment to begin.

    (Adapted from advice given by the NHS - the 999 number is the UK version of 911 although the EU-wide number 112 can also be used) The link also has a video showing these symptoms which is a public service announcement here (a female version is also available)

    We will work, we will play, we will laugh, we will live. We will not waste one moment, nor sacrifice one bit of our freedom, because of fear.

    by Lib Dem FoP on Wed Oct 02, 2013 at 11:05:21 AM PDT

    •  Note (2+ / 0-)
      Recommended by:
      Cassandra Waites, etbnc

      Although indicative of a stroke, the dropped face may be indicative of many things and is called generically Bell's Palsy if not linked to a specific range of problems. The most common cause is driving with the window open and so a left-hand palsy is the more common in the USA. It also causes slurred or unclear speech.

      It often (as it did with me) present overnight so waking up with it can cause a panic. Give re-assurance that it can be something other than a stroke but call for medical assistance in case.

      We will work, we will play, we will laugh, we will live. We will not waste one moment, nor sacrifice one bit of our freedom, because of fear.

      by Lib Dem FoP on Wed Oct 02, 2013 at 11:14:33 AM PDT

      [ Parent ]

    •  your message (0+ / 0-)

      I am not suggesting anything different. Sometimes
      a layperson needs some simple rules to know to call 911.
      I would call 911 no matter what. Error on the side of caution.

      •  On Bell's Palsy (1+ / 0-)
        Recommended by:
        Cassandra Waites

        I am a bit of a lay expert on this having had it twice and gone through a battery of tests. Being a rare case of recurrence, I got to be shown to medical students so I picked up quite a bit. Most of the other than stroke causes of BP manifest gradually - it's the sudden onset of symptoms that is the most worrying and typical.

        As I mentioned, BP often develops overnight so first being aware of the symptoms when waking makes it appear to be sudden.

        The other aspect of BP is that in a patient who has not fully recovered, the facial check can be misleading unless you already know of the pre-existing condition. (In my case for example my left side droops slightly if I am very tired or ill).

        None of this of course means that any of the signs should be ignored. As you may well know the sufferer, your input as to whether their palsy or other pre-existing problems appear worse would be valuable to the paramedics when you brief them.

        We will work, we will play, we will laugh, we will live. We will not waste one moment, nor sacrifice one bit of our freedom, because of fear.

        by Lib Dem FoP on Wed Oct 02, 2013 at 12:12:46 PM PDT

        [ Parent ]

  •  At least one exception - Bell's Palsy. (1+ / 0-)
    Recommended by:
    Lib Dem FoP

    That will create facial weakness or paralysis on just one side -  BUT someone with a diagnosis will know so and say so when approached, and it will not be a sudden onset lack of capacity for someone who already has a diagnosis.

    The sudden lack of capacity is what leads to the initial diagnosis sometimes. And that does need to be treated as a potential stroke, because the initial effects can be startlingly similar.

    I had a friend in high school who ended up with it suddenly. He had to wear an eyepatch for a while to keep the weakened eye in darkness. He's pretty much recovered, but he still talks a bit funny and his smile is lopsided. And the rest of his body wasn't affected, so the 'raise both arms' item Wee Mama mentioned would have still been a good stroke indicator for him even right after it started.

    •  raising of arms (2+ / 0-)
      Recommended by:
      Cassandra Waites, churchylafemme

      I probably should add that. The Doctor who gave me this info says the tongue is as important. Do both if you can. Always be calm with the person and I always told the truth: I cared about them.

    •  Think we crossed. (1+ / 0-)
      Recommended by:
      Cassandra Waites

      There are two "types" of Bell's Palsy really only identified by the short term recovery. In the first, the symptoms will lift within 10 days. In the more serious, improvements start after then.

      I was off work for nearly 6 months because of the eye problem I had. Briefly, without a blink the fluid welled up so when I looked down it acted like a contact lens throwing my vision and balance completely out.

      In about 5% of cases there is no cause found for the onset of the palsy and recurrence only occurs in about 5% of those. (Guess who was in the lucky 0.25%!)

      We will work, we will play, we will laugh, we will live. We will not waste one moment, nor sacrifice one bit of our freedom, because of fear.

      by Lib Dem FoP on Wed Oct 02, 2013 at 11:28:05 AM PDT

      [ Parent ]

  •  "Time is Brain" (3+ / 0-)
    Recommended by:
    Dianna, lurker123, churchylafemme

    I know some stroke physicians quite well. I'm sure they would appreciate your effort to spread the word. One of they phrases they use is, "Time is brain." The longer folks wait to seek treatment, the more brain damage can occur.

    I do want to set expectations about treatment and negative affects.

    There's actually a 4 hour window of opportunity to treat some strokes with a clot-busting drug known as "tPA". In some cases tPA or surgical intervention can occur after 4 hours, but 4 hours is the period that treatment plans are based on.

    tPA works really really well for many patients, but there are situations in which it cannot be used at all. When it's used, it does sometimes result in little or no lasting brain damage. In other cases it reduces stroke severity, but cannot eliminate post-stroke symptoms. And in some cases, unfortunately, it doesn't work as well hoped. It's a wonder drug, but still a limited wonder drug.

    With all that in mind, however, speedy treatment is crucial. Time is brain.

    •  Your thoughts (3+ / 0-)
      Recommended by:
      etbnc, lurker123, churchylafemme

      Thanks for the 4 hour update. I was told to say 3 hours when I told my Doctor friends I was going to write this.
      You  are obviously much more educated on this than I
      I like "Time is Brain"!
      Thanks for the education!

    •  But Not All Strokes are Due to Clots (2+ / 0-)
      Recommended by:
      etbnc, churchylafemme

      If I remember correctly, ~10% are hemorrhagic, and clot busters are not recommended for hemorrhagic strokes.

      •  Indeed (2+ / 0-)
        Recommended by:
        lurker123, churchylafemme

        That's one reason that there are times when tPA cannot be used. I decided to make my explanation simpler for the sake of comment brevity.

        The percentages I usually hear quoted are 20% hemorrhagic (bleeding), 80% ischemic (clot) type strokes. As you said, it would be bad to use a strong clot-busting blood thinner like tPA when bleeding is already occurring. tPA also interacts with some other medications (including other blood thinners, such as warfarin/coumadin), so it may be ruled out for ischemic strokes when patients are on certain meds.

        Because tPA works best when given within a few hours of onset, all that diagnostic and decision-making information has to be gathered very quickly when a person arrives. Some of that precious time is lost on the ride to the hospital, too. With blood tests, imaging, and dealing with other medical issues that might affect stroke treatment (very high blood pressure,for example) it can be quite a scramble to deliver tPA within the four hour window that's currently standard.

        If the stroke is hemorrhagic or tPA is ruled out for other reasons, then four hours stops being a magic number. Still, time is brain, so treatment is performed ASAP, it's just the ASAPness varies a lot more, case by case.

        Here's a link to a web page of the American Stroke Association (which is affiliated with the American Heart Association):
        Stroke Types

        Thanks, lurker123, vet63, and everyone else, for your interest in this important topic.

      •  message (2+ / 0-)
        Recommended by:
        churchylafemme, lurker123

        your getting ahead of me, My story was true. No one bothered to call 911,the lady died. My goal was simply
        to give folks simple tests that would argue for or against calling 911.

  •  I worry about this with my parents (2+ / 0-)
    Recommended by:
    etbnc, churchylafemme

    Thanks you so much for the tips.  Worth saying, worth repeating for elderly.  We need to do all we can for them

    •  message (3+ / 0-)
      Recommended by:
      Dianna, etbnc, churchylafemme

      Your the type of person I was thinking of. I never knew about the tongue being important. Some readers are saying it may not be a stroke. I agree. I just want 911 called if the victim cant do at least one of the things I talked about.
      God Bless!

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