| Stroke
Stroke happens when the blood supply
to part of the brain is suddenly interrupted or when a blood
vessel in the brain bursts, spilling blood into the spaces
surrounding brain cells. Brain cells die when they no longer
receive oxygen and nutrients from the blood or there is sudden
bleeding into or around the brain. Limiting the extent of
brain damage caused by a stroke depends on rapid diagnoses
and treatment in the hospital. This requires the patient,
family members or bystanders to quickly recognize the signs
and symptoms of stroke and activate EMS. To reduce brain Injury
and get the best recovery, EMS must be rapidly dispatched,
quickly Identify the potential stroke patient, and rapidly
notify and transport the patient to a Designated Stroke Center
(if available)
Risk Factors for Stroke
- High blood pressure
- Diabetes
- Smoking
- High cholesterol level
- Heart disease
Stroke Signs and symptoms
- Sudden Numbness or weakness of the
face, arm, or leg, especially on one side of the body.
- Sudden Confusion, trouble speaking
or understanding.
- Sudden trouble seeing in one or
both eyes.
- Sudden trouble walking, dizziness,
loss of balance or coordination.
Sudden, severe headache.
- Mini-Stroke (transient ischemic
attack-TIA), same symptoms as a stroke, but they only last
for a few minutes. May lead to a stroke.
Note: Patients of a stroke are sometimes
mistaken for being drunk.
Stroke Treatment Guidelines
If you suspect a stroke, ask the patient
to :
1 smile
2 raise both arms
3 speak a simple sentence
- If the patient has any trouble
with these 3 tasks, they may be having a stroke. Alert
EMS or activate your emergency action plan immediately.
- Administer supplementary oxygen
as trained or according to doctors orders.
- Comfort, calm, and reassure.
Caution: Stroke treatments are time
sensitive!
Sudden
Cardiac Arrest
SCA occurs when the heart's electrical
system malfunctions and the heart abruptly stops working without
warning. Sudden cardiac arrest (SCA) is one of the leading
causes of death among adults m North America. When SCA occurs,
most patients have an abnormal heart rhythm called ventricular
fibrillation (VF) The most common cause of VF is a poor supply
of oxygen to the heart, most commonly caused by heart attack.
After a heart attack, low oxygen can cause the heart's natural
electrical signals to become disorganized. This causes twitching
of the heart muscle (VF) and prevents coordinated contraction.
The heart stops pumping blood and oxygen to Itself and to
the brain. The lack of blood flow and oxygen supply to the
brain causes the patient to lose consciousness immediately.
Unless a shock is delivered to the
heart to restore its regular rhythm, brain death can occur
within minutes. SCA often occurs in active, outwardly healthy
people with no known heart disease or other health problems,
but most patients have heart diseases or other health problems
(although they may not know it) The most Important risk factors
are a previous heart attack and coronary artery disease (CAD
- narrowed or blocked arteries supplying blood to the heart)
Automated External Defibrillator (AED)
An AED is a small, portable computerized
device that diagnoses and treats VF. It is attached with wires
and pads to the chest of the patient. It checks the person's
heart rhythm, decides lf the rhythm is VF, and gives the heart
an electric shock. If this shock is delivered promptly after
collapse, many patients can survive without brain damage.
If an AED is available, immediately attach it to the patient.
Listen and follow the machine's Instructions.
SCA Signs and Symptoms:
- Sudden collapse without warning
(some people may experience a racing heartbeat or feel dizzy
or faint).
- Unconscious, unresponsive.
- May make abnormal grunting,
gasping, or snoring noises.
- Looks dead
SCA treatment guidelines
- Perform CPR and defibrillate
as soon as possible with an AED
Chain
of Survival in Adults
The chain of survival is a concept
that is used to communicate the key factors that must be in
place to survive sudden cardiac arrest (SCA) from ventricular
fibrillation. The links in the chain of survival include early
identification of SCA, early CPR, early defibrillation, and
early advanced life support. (ALS)
Early Identification of SCA and activation
of Emergency Action plan or EMS.
The faster SCA is identified and the
response system activated, the better the chances the patient
will survive. Dispatcher-assisted telephone CPR instruction
can increase the proportion of SCA patients who receive bystander
CPR, and has been associated with improved survival.
Early CPR
Patients in cardiac arrest need immediate CPR. CPR provides
a small but vital amount of blood flow to the heart and brain.
CPR increased the chances that a shock will allow the heart
to start working effectively.
Early Defibrillation
No more than three minutes from collapse
to defibrillation is necessary to achieve the highest survival
rates.
Early ALS
Advanced life support involves medical procedures and medications
used by paramedics, nurses and doctors to manage a patients
vital signs and organ systems to increase the chances of survival
and recovery.
If any one of these links is weak
or missing, the result will be poor survival. Some organizations
have added further links to the chain. These include making
healthy choices that reduce the risk of heart attack, stroke
and injury, and restoring the patient to the highest possible
level of functional ability (early rehabilitation)
Chain
of Survival in Children
The chain of survival in children emphasizes prevention, basic
CPR, early identification of an emergency with rapid activation
of an emergency action plan, including EMS, and early pediatric
advanced life support. Except for those with heart problems,
a child's heart does not usually stop suddenly, as is often
the case in adults. Rather, the heart slows and then stops
only after the child has not been breathing for an extended
time. Breathing stops because of a lack of oxygen in the blood.
This can be caused by respiratory diseases, injuries, and
conditions such as drowning and SIDS.
Prevention
Injuries
Injury is a leading killer of children aged 14 and under Worldwide.
Most injuries can be prevented by taking simple safety measures.
Drowning
Death rates are highest in children less than 5 years old.
Pool fencing significantly reduces the risk of drowning. Pool
fences with a secure, self-latching gate should be installed
around all public, semi-public and private pools.
SIDS
Placing ingants on their backs to sleep and giving them a
pacifier
significantly reduces the risk of Sudden Infant Death Syndrome
(SIDS).
Basic CPR
When an infant or child stops breathing,
but their heart continues to beat and rescue breathing is
quickly provided, survival with normal (or near normal) brain
function is much higher, reportedly as much as 70%. Giving
infants and children rescue breaths that make the chest visibly
rise is very important.
Early Access
When a rescuer finds a child unresponsive
and not moving, the provider should give 2 minutes of CPR
before calling 9-1-1 or attaching an AED. If another rescuer
is present, he or she should alert the EMS system or activate
the emergency action plan
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