Dean's World

Stroke Signs

Dean

Hmm.

Is this something real, or one of those goofy internet "cough really hard if you think you're having a heart attack" things that float around the internets?

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triticale (mail) (www):

I won't stroke signs, but I will lean up against them.

8.28.2007 8:11pm

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John Eddy (mail) (www):

Looks like a decent poor man's neurological assessment to me. I doubt it would detect a really minor stroke, but who knows?

8.28.2007 8:18pm

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caltechgirl (www):

Yep, it is a decent layman's neuro exam. But a minor stroke might miss all of those symptoms. I'd add two more checks: tracking (can the person follow your finger across their field of vision?), and pupil size. A healthy person's pupils are dilated evenly and react quickly to changes in lighting. A possible third is asking the person to squeeze your hand with each of theirs: grip should be about even in a healthy person.

8.28.2007 8:36pm

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jlb (www):

Looks real to me. I've heard of all of those symptoms before in various first aid classes that I've taken.
Jan

8.28.2007 10:17pm

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willem:

A stroke sufficient to physically destabilize a patient would very likely be observable through the STR approach.

And what a nifty site. I'm adding it. Good to see someone on about the pH dynamic and the acidity issue.

Duesberg may have some interesting things to say about the role of pH in aneuploidy and malignancy. Then there's that interesting dynamic involving hypoascorbemia and acidosis.

8.29.2007 1:35am

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Bryan Costin (mail) (www):

FWIW, Snopes says the three main items are true.

An uncle of mine suffered a stroke not long ago. His symptoms were severe and obvious, but a similar set of signs was given us by the doctor to detect other less obvious ones that might follow.

8.29.2007 9:30am

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Jay Solo (mail) (www):

That's basically what's on the public service posters at the doctor's office. I thought it was four signs and they spelled a word, but the three given are all part of the list. No idea if the anecdote might be true.

Aha! I found the official stroke awareness list, which spells FAST and emphasizes speed:

FACE: Ask the person to smile. Does one side of the face droop?
ARMS: Ask the person to raise both arms. Does one arm drift downward?
SPEECH: Ask the person to repeat a simple sentence. Are words slurred or repeated incorrectly?
TIME: If the person shows any of these symptoms, time is important. Call 911 or get to the hospital fast.

So yeah, technically it's a list of three things like the one you saw, with the fourth being a call to action.

8.29.2007 9:55am

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Mike (mail):

When I had the TIA last winter, I became dizzy and had trouble focussing my vision - things would seem to leap to the side. After finishing the afternoon at work, I went to the hospital. a minor stroke, no known cause (all the tests came back clear and I have very low cholesterol).

The tests the post mentions sound appropriate as a stroke will effect one side of the brain and the inability to perform a physical act in unison with both sides of the body would be telling. Of course, the test would have to go through various areas of the body to try and locate where in the brain the damage occurred.

Having both fingers come in at the same time and touch the nose, pulling another persons hands or pushing them, etc. My limited experience was that these limited physical tests were a good way of finding out what happened and where in the brain.

8.29.2007 10:26am

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Linda Frazier (mail):

EMTs are taught to check for signs and symptoms of a stroke by using the Cincinnati Prehospital Stroke Scale, which includes the three main items in the article - facial droop, arm drift and speech irregularities. It is quite effective and we rely on it often. You can learn more on this at Wikipedia.

As for the "cough really hard if you think you're having a heart attack", you might be surprised to learn there's a bit of truth in that, also.

By coughing really hard, you might stimulate the vagal nerve, which can be effective in slowing down the heart rate. However, coughing isn't a very effective way of stimulating the nerve. Bearing down as though you are having a bowel movement is a more accepted method of vagal stimulation. Vagal stimulation is part of our protocol for tachycardia (rapid heart rate). Other methods of vagal stimulation include applying cold water to the face or stimulation of the carotid artery in the neck. A vagal response can also be seen with persons experiencing pain, fear or excitement.

When used, a vagal response can produce a temporary decrease in heart rate, which may cause the patient to feel light-headed or dizzy, nauseus, sweaty or shaky.

A vagal maneuver should only be used for specific symptoms and should not be done by anyone who is not trained to treat heart problems.

Just FYI

Linda

8.29.2007 12:41pm

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