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Time is of the essence

Every year in the United States, 795,000 people suffer a stroke. Of these strokes, 610,000 are new or first-time strokes. Unfortunately, 140,000 of these patients will die — that is 1 out of 20. To break this down further, every 40 seconds someone has a stroke and every four minutes someone will die. Women are more likely than men to have a stroke (55,000 more women than men). According to the latest statistics from the North Carolina Department of Health and Human Services, State Center for Health Statistics, in 2001-2005 Beaufort County’s stroke death rate per 100,000 was 67.9, and in 2011-2015, the death rate per 100,000 was 41.7. This shows 26.2 less deaths over the 10-year period as more importance has been placed on stroke care and prevention.

A healthy lifestyle is the key to stroke prevention. Eighty percent of all strokes are preventable. You can prevent a stroke by having yearly check-ups with your primary care provider, monitoring and controlling your blood pressure, blood sugar, cholesterol and weight. Other ways to prevent strokes are to exercise, eat healthier and stop smoking. Risk factors for stroke that are out of your control are age, race, gender and family history. African-Americans, Hispanics and Asian/Pacific Islanders have a higher risk for stroke than people of other races.

A stroke occurs when the blood vessels (arteries) in the brain become blocked by a clot or burst as a result of high blood pressure. Once an obstruction in an artery occurs the brain cells past the clot die and this causes permanent irreversible damage. There are two types of strokes: ischemic and hemorrhagic. The ischemic stroke occurs when the blood flow through vessels become blocked. These strokes account for 87 percent of all strokes. The hemorrhagic stroke occurs when the vessels in the brain rupture which leads to swelling and pressure. This swelling and pressure causes damage to the brain tissue.

Strokes have many signs and symptoms. The symptoms that everyone is familiar with are weakness or lack of movement of arms and legs, facial drooping and slurred speech. Strokes of the brainstem will have symptoms of dizziness, confusion, difficulty with understanding, blurred vision, partial or complete hearing loss, sudden onset of a severe headache, problems with balance and/or problems with chewing and swallowing. The term dizziness is a very vague term that may refer to vertigo, lightheadedness, presyncope, anxiety or “just not feeling well.” These symptoms should be taken seriously until a stroke is ruled out by your primary care provider or the emergency department staff.

B.E.F.A.S.T. is an acronym that you should remember when trying to decide if you are having a stroke.

B-balance

E-eyes

F-face

A-arms

S-speech

T-time.

If you or a loved one are exhibiting any of these symptoms you should seek medical attention immediately by calling 911 or having a family member drive you to the local emergency department. Once you arrive in the emergency department, you will be evaluated by a triage nurse and taken to the treatment area where you will be evaluated by a physician, have a CT scan of the brain and blood will be obtained for lab studies. If it is determined that you are having a stroke, the staff will connect with a neurologist via Tele-medicine, and you will be evaluated by that neurologist. This evaluation will determine if you meet the criteria for the “clot busting” drug, Alteplase. If you meet this criteria, you will receive the medication and then be transferred to Vidant Medical Center where you will be further evaluated for removal of the clot by a surgical procedure called a thrombectomy.

Vidant Beaufort Hospital recently received a grant from the NC Stroke Association and is in the process of applying for Primary Stroke Center certification. We have formed an Interdisciplinary Stroke Team that are working together to create standard workflows for the care of stroke patients at our hospital. The creation of these work flows are driven by data collection.

Remember: Time is Brain and the quicker you seek medical attention for yourself and others the greater the chances of saving brain tissue, preventing irreversible brain damage and preventing permanent disability.

Wanda Taylor, RN, BSN, is the stroke coordinator of Vidant Beaufort Hospital’s Emergency Department.