CVA (Stroke) and TIA - ONLINE FIRST AID

Lesson no. 10

CVA (Stroke) and TIA

Cerebral Vascular Accident/Stroke – CVA

Strokes are the leading cause of disability in the Western world. This is a condition where there is inadequate blood flow to part of the brain, which causes an interruption of the oxygen supply to the cells in that area.

Strokes can be divided into two categories:

Ischemic stroke: blockage of cerebral blood vessels which causes ischemia (blood supply deficiency) and brain cell death (85% of all cases)
Hemorrhagic stroke: a cerebral vascular (brain vessel) rupture that causes ischemia and brain cell death (15% of cases).

**How can we distinguish between the two types of strokes? Only a CT scan and blood tests can identify the type of stroke!! When in the field – we cannot diagnose the type of stroke**

Signs

A stroke has many signs because the brain is involved in most of the body’s processes:

Confusion and speech impairments, facial paralysis, declining level of consciousness, changes in behavior (agitated/apathetic), most often with hypertension, nausea, slow pulse, loss of motor ability (lateral signs), uneven pupils, seizures, vomiting, weakness/paralysis of half of the face and half the body, etc.

Tests

Tests for stroke will include:

Ask the patient to speak (to see if the patient is able to speak clearly and logically).
Ask the patient to smile (to see if one side of the lips drops down).
Ask the patient to hold our hands and squeeze firmly, with both hands in parallel (and then with both legs), and see if the patient is able to squeeze hard and whether the pressure applied from both sides of the body is the same.
Ask the patient to close their eyes and extend their hands forward at chest level with palms facing up, and see if one of the hands begins to slowly fall downward.

Treatment

The responder should record the time at which the signs were observed and take the patient to the hospital as quickly as possible.

In the field, there is no real treatment for a stroke other than supportive care and administration of oxygen through a mask.

At the hospital, the patient can be given thrombolytic treatment (which dissolves blood clots) or brain catheterization.

FAST

Medical teams use a scale called FAST:

Face	Facial asymmetry: a crooked smile, “drooping” of the eye and cheek
Arms	A person’s ability to hold hands using the same force with both hands, or ability to lift their hands to the same height when their eyes are closed
Speech	The way in which they speak: Are they logical? Are they clear?
Time	When was the patient last seen without these signs?

TIA – Transient Ischemic Attack

An ischemic brain event that passes, usually with its symptoms passing from after a few minutes up to 24 hours. The main cause of TIA is a blood clot in a cerebral blood vessel that has dissolved.

The signs are the same as those of a stroke and may disappear by the time the patient arrives at the hospital.

As first aid responders, we will suspect the worst-case scenario – a stroke.

If you have identified a stroke – call an ambulance hotline immediately! The patient needs to be rushed to a hospital. If the person is diabetic, we will ask him to measure his blood sugar level. This is because hypoglycemia may have symptoms similar to a stroke.

did you know?

At the onset of a stroke, thirty-two thousand cells in the brain die with every second that passes. The most severe form of stroke is due to the obstruction of the basilar artery, one of the main arteries that pump blood to the brain and especially to the pons region. The pons is involved in motor regulation and sensory information analysis. For example, the information from the ear enters the brain through the pons. In addition, the pons is involved in sleep processes, especially the REM phase during which we dream. One of the possible side effects of this stroke, if the person survives it, is complete paralysis of the body except for pupil movement. This outcome is rare, but possible and is called “locked-in syndrome”. This syndrome is famous for being described in detail in the book “The Count of Monte Cristo” and sometimes referred to as “Monte Cristo Syndrome”.

28-Hour Course