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June 29, 2010 > Stroke: Be Prepared, Act Fast

Stroke: Be Prepared, Act Fast

What You Learn Now Could Save a Loved One's Life in the Future

We've all heard stories of people's lives being saved by people who knew what to do in an emergency - whether it was a car accident or a heart attack. In cases like these, it's easy to recognize the emergency: someone is bleeding or having chest pains.

But what happens when time is of the essence and you don't even know there's an emergency unfolding? If you don't recognize the signs and symptoms, this could be the case with stroke, also called a brain attack.

"As a society, we place a lot of value on trying to respond quickly in an emergency," says Doug Van Houten, R.N., clinical coordinator of Washington Hospital's Stroke Program. "If somebody cuts themselves and they're bleeding, people generally know to put a clean dressing on it. If someone has a heart attack, we want people to start CPR. It's a Boy Scout sort of thing - be prepared."

"The question is: if someone close to you has a stroke, do you know what to do? The most important thing is to call 9-1-1, but you need to be able to recognize stroke first."

On Tuesday, July 6, from 6 to 8 p.m., Van Houten and a physician from the Stroke Program will present an introduction to stroke, including what it is, the signs, how to respond if someone is having a stroke, as well as an explanation of the risk factors for stroke.

The free seminar will be held in the Conrad E. Anderson, M.D. Auditorium located at 2500 Mowry Avenue in the Washington West building.

Van Houten, who also facilitates the hospital's monthly Stroke Support Group for stroke survivors and their caregivers, says it's not unusual for people - both stroke survivors and those around them - to not even recognize that a life-threatening event is happening until it's too late.

"With stroke, people might be slurring or not moving well, and they'll say, 'I just need to take a nap,'" Van Houten says. "This is why family members need to be able to recognize the signs and call 9-1-1, because unfortunately a lot of times a patient wakes up with a full blown stroke, and there's little we can do at that point as far as aggressive treatment."

"The reality of stroke is that patients are not always in distress, unlike in other cases when it's very clear there's an emergency, such as a heart attack or an accident. Studies indicate that patients often don't even know what part of the body is affected by stroke. Most times, they think it's the heart. And not many people know that stroke is the third leading cause of death and number one cause of long-term disability. It's one of those disastrous conditions that needs to take its place in the top five of deadly health conditions."

Van Houten emphasizes that while strokes may not feature as often as heart attacks in the medical dramas on TV, they are just as important to know about.

"There's a reason that only a small percentage with ischemic stroke get treated with tissue plasminogen activator (tPA), and that's because one, people don't recognize it and come to the emergency room in a timely manner, and two, they don't come to a certified stroke center."

Once 9-1-1 has been called, Van Houten says emergency responders are trained to recognize stroke and transport patients to a certified stroke center - like Washington Hospital - where the staff is trained in effectively handling stroke cases.

Tissue plasminogen activator (tPA), also known as a clot-busting drug, is the only drug approved by the U.S. Food and Drug Administration for the acute (urgent) treatment of ischemic stroke, which account for almost 90 percent of strokes, according to the American Heart Association and American Stroke Association.

The challenge with tPA is that it is only effective during a very narrow treatment window - which means that the faster stroke patients get to the emergency room, the better their chances are of receiving aggressive and brain-saving treatments.

"In 90 percent of strokes, there's no headache; there's just neurological deficit - for instance, a victim can't speak, swallow, walk or his face is asymmetrical," Van Houten says. "For most people this translates to less of a sense of urgency than in the case of someone vomiting blood or having severe chest or abdominal pain."

"But in the long run - usually within one year - 25 percent of those people with a stroke have died, and that's a pretty high percentage. And that's not counting all those who have been permanently disabled by stroke."

The good news, according to Van Houten, is that by being prepared and knowing the signs of stroke, people can improve the outcome by responding quickly if a family member or friend has a stroke.

"During the seminar, I teach people the Cincinnati Prehospital Stroke Scale," he says.

"It's a 30-second test that 80 percent of the time accurately predicts if a person has had a stroke. To be prepared in case someone goes into cardiac arrest, you might learn CPR; with stroke you learn the Cincinnati Stroke Scale. This is the same test they teach all of the Alameda County paramedics, and the average person can learn it easily."

"This is part of my version of being prepared. Once you've learned to recognize the signs of stroke and can use the stroke scale, then I think you've done the most a layperson can be expected to do for stroke. It's a matter of recognizing right away that it's an emergency and notifying the people who need to know."

Know the signs and be a stroke hero

To hear details about what stroke is and how to identify it quickly and accurately, as well as who is at risk for stroke, join Van Houten and a physician member of the Stroke Program on Tuesday, July 6, from 6 to 8 p.m., in the Conrad E. Anderson, M.D. Auditorium located at 2500 Mowry Avenue in the Washington West building.

To register, visit or call (800) 963-7070.

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