Strokes, also known as cerebrovascular accidents (CVAs), occur when blood flow to the brain is interrupted, leading to brain cell damage or death. There are two main types of strokes: ischemic stroke and hemorrhagic stroke. Each type requires different treatment approaches. As a paramedic, understanding the signs and symptoms of stroke is crucial for timely intervention and appropriate care.
1. Ischemic Stroke:
Ischemic strokes account for about 87% of all strokes and occur when a blood clot blocks a blood vessel in the brain, reducing blood flow to that area.
Common causes include blood clots forming within the brain (thrombosis) or traveling from other parts of the body (embolism).
Administer aspirin (if not contraindicated) to help prevent further clot formation.
If the stroke occurred within a specific time window (typically up to 4.5 hours), the paramedic may assess the patient’s eligibility for thrombolytic therapy, such as tissue plasminogen activator (tPA), to dissolve the clot.
Transport the patient to a stroke center for further evaluation and management by a specialized medical team.
2. Hemorrhagic Stroke:
Hemorrhagic strokes make up about 13% of all strokes and occur when a weakened blood vessel in the brain ruptures, causing bleeding into the surrounding brain tissue.
Causes may include uncontrolled high blood pressure, aneurysms, or arteriovenous malformations (AVMs).
Maintain the patient’s airway, breathing, and circulation.
Control bleeding by keeping the patient’s head elevated and administering intravenous fluids judiciously to maintain blood pressure within an acceptable range.
If the patient is on anticoagulant medication, the paramedic may use reversal agents as appropriate.
Transport the patient to a neurosurgical center for specialized care.
3. Transient Ischemic Attack (TIA):
TIAs are often referred to as “mini-strokes” and are temporary blockages that resolve on their own.
They have similar symptoms to ischemic strokes but do not cause permanent brain damage.
Paramedics should treat TIAs as potential warning signs of a future, more severe stroke.
Conduct a thorough assessment, including history and physical examination.
Transport the patient to a medical facility for further evaluation and management to prevent future strokes.
As a paramedic, it’s crucial to recognize the signs of stroke, such as sudden numbness or weakness on one side of the body, difficulty speaking or understanding speech, sudden severe headache, and vision disturbances. Rapid identification and appropriate treatment can significantly improve the outcome for stroke patients and minimize long-term disabilities. Immediate activation of emergency medical services (EMS) and early transport to a specialized stroke center are essential steps in managing stroke patients effectively.