When stroke strikes, act FAST

Strokes kill more than 100,000 Americans annually and cause permanent disability in hundreds of thousands more. Defined as a problem with blood flow to the brain, a stroke results from blockage of an artery or leakage of an artery in the brain. This interruption of blood flow deprives cells of oxygen and results in brain cell death.

Strokes usually present suddenly, and they may progress over minutes or hours. Optimal treatment requires rapid diagnosis and treatment that may include administration of “clot busters” to dissolve blood clots or surgery to retrieve clots or open an artery. Success requires fast detection — typically within minutes to an hour — for treatment to improve patient outcomes.

A recent American study demonstrated that “Mobile Stroke Units,” ambulances with built-in CT scanners, improved outcome by allowing initial treatment with “clot busters” during the “golden hour” by EMTs in the field instead of delaying treatment until arrival in the ER.

The United Kingdom developed the FAST acronym in 1998 to help first responders recognize signs of stroke. FAST stands for: Face drooping, Arm weakness, Speech slurring, and Time to call.

“F” is for facial drooping. Facial weakness often appears as drooping on one side. If someone having a stroke tries to smile, only one side of the mouth may go up. Victims may awaken with this in the morning or develop it during the day. Other facial signs include drooling from one side of the mouth or unilateral numbness.

“A” is for arm weakness. Strokes often cause one arm to lose strength. An affected arm may exhibit profound loss of strength or only a subtle weakness found when one arm drops down when trying to hold both arms straight out in front of the body.

“S” is for speech abnormalities. Stroke victims may slur their speech or display difficulty speaking in clear sentences. Likewise, individuals may have difficulty saying what they want to say or understanding what is said to
them. Speech problems are quite frustrating as stroke patients are unable to communicate their thoughts, needs, and worries.

“T” is for time to call 911. When someone has any of the symptoms of a stroke described above, take emergency action. Call for an ambulance — minutes make a difference in the options for treatment and in minimizing the injury from a stroke. Medications to dissolve the clot can only be administered within a three-hour window starting with stroke onset.
While stroke is a major cause of injury and death, a FAST response saves lives and prevents permanent damage.

RICHARD ROWE, M.D., is a neurosurgeon at the Georgia Neurosurgical Institute in Macon, GA. He is an active member of the Catholic Medical Association.