Health & Wellness for Port Ludlow

Stroke:

Prevention, Management Protocols and Rehabilitation

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Port Ludlow Stroke Forum: May 10, 1 p.m. Bay Club (Click!)


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In anticipation of "Stroke Month" in May 2014 and our Educational Forum on "Stroke Prevention, Management Protocols and Rehabilitation", on May 10th (1 - 3:30 pm in the Bay Club), the Resource Center featured during January 2014 the following Health Audio and Videos on Stroke:
  1. Swedish Classes & Resources: Stroke Video
  2. New Information on Stroke Prevention and Treatment Andrew Schorr (Patient Power) interviews Professors Kyra Becker and David Tirschwell from Harborview and the University of Washington
  3. Scroll down to Swedish Telestroke Program: Dr. Wlliam Likosky [Telestroke links experts at the Swedish Neuroscience Institute with emergency department physicians throughout the state to evaluate stroke patients.]
Forum Focusing on Medical and Geographic Complexity of Stroke

May is “Stroke Awareness Month”. The Village Council's Health Committee has used this opportunity to schedule its second Spring Forum, “Stroke: Prevention, Management Protocols and Rehabilitation,” for May 10 (1 p.m. at the Bay Club) to discuss another health issue for which residents should be prepared even without any current symptoms or risks factors (other than age). Our experience with stroke typically starts with a highly time-sensitive emergency and ends, hopefully, with relatively few long-term repercussions for which rehabilitation may be needed. Thus, it involves quite a few branches of the healthcare system as well as choices between organizations, locations and modes and routes of transportation, especially since we happen to live in Port Ludlow.

Our forum will focus on what happens to the brain during and after a stroke and how to respond quickly to minimize the debilitating consequences. Dr. David Tirschwell, co-director of the University of Washington’s Stroke Center at Harborview, is our featured speaker covering risk factors, warning signs, early recognition and treatment of different types of strokes. Panelists will then discuss what is happening before and during EMS transportation, and at local hospitals, as well as under what circumstances Airlift NW may whisk us to Harborview or Swedish (should we sign up with “Aircare” as insurance?). Attendees may also want to understand and compare the differences in protocols for tele-stroke diagnosis, emergency treatments and monitoring of patients at or on the way to and from the Jefferson ER (by neurologists at the Swedish Stroke Center) and Harrison Medical Center (by physicians at Harborview). We may also be interested in how recent medical innovations and changes in hospital organizations may have affected various stroke protocols.

The forum organizers plan to have educational handouts available for all types and disease stages of stroke. Residents are also encouraged to visit the stroke page on the Committee's website (plhealth.org/stroke.html) for preparation and follow-up. Sign up sheets are posted at both clubs. Parking space is limited. Car pooling is critical and much appreciated.


Explaining Stroke: Types and Diagnoses of Stroke


Stroke Prevention

  • National Institute of Neurological Disorders and Stroke [NINDS / NIH]
      Brain Basics: Preventing Stroke [8pp.] If you're like most Americans, you plan your future. When you take a job, you examine its benefit plan. When you buy a home, you consider its location and condition so that your investment is safe. Today, more and more Americans are protecting their most important asset—their brain. Are you?

  • Center for Disease Control:

  • Guidelines for the Primary Prevention of Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association; Stroke. 2011;42:517-584; originally published online December 2, 2010. This guideline provides an overview of the evidence on established and emerging risk factors for stroke to provide evidence-based recommendations for the reduction of risk of a first stroke.Well-documented and modifiable risk factors include hypertension, exposure to cigarette smoke, diabetes, atrial fibrillation and certain other cardiac conditions, dyslipidemia.... physical inactivity, and obesity and body fat distribution


Stroke Risk Factors & Warning Signs

  1. National Stroke Association: Learn the sudden warning signs of stroke so you can recognize and respond to stroke FAST: Cut out wallet card. Fold in half. Then fold in half again.
    FAST: Face -- Arms -- Speech -- Time

  2. News about Warning Signs and Risk Factors [e.g. New Guidelines for Women]

  3. Stroke: Challenges, Progress and Promise [pdf, February 2009, National Institute of Neurological Disorders and Stroke, Pub # 09-6451: 32 pg booklet available in print free at 1-800-352-9424]

  4. Video on Stroke Risks (Emory University)

    http://youtu.be/SMxQ4jty_3Y

  5. New guidelines for reducing stroke risks unique to women:
    American Heart Association/American Stroke Association Scientific Statement

    Other Stroke Links February 06, 2014: Statement Highlights:
    •For the first time, guidelines have been developed for preventing stroke in women.
    •Stroke risk in women is influenced by pregnancy, birth control pills, migraine headaches with aura and other factors

  6. Knowing the Signs (National Institute of Neurological Disorders and Strokes)

    Uploaded by rosaryfilms on Jul 11, 2010: "Knowing the Signs of Having a Stroke".
    National Institute of Neurological Disorders and Strokes (NINDS).

  7. Perform a FAST Assessment: [American Stroke Association]


    "Stroke treatment is time-critical – the sooner a patient is treated, the better their chances of survival. Fast treatment can mean less disability, too. For strokes caused by a blood clot in the brain (ischemic), clot-busting medication must be adminis-tered within 4.5 hours from the time they first have symptoms. For bleeding strokes (hemorrhagic), time is also critical. As an emergency responder, you play a crucial role in getting patients to treatment in time. [Source]


Stroke Management Protocols

  • Port Ludlow Fire & Rescue: EMS Page (Stroke)

  • Triage and Destination Procedures (stroke) [Source: WS Dept of Health]

  • Protocol Guidelines (Stroke)

    • Suspected Stroke Prehospital Protocol Guidelines (PDF)
    • 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association These guidelines deal with the acute diagnosis, stabilization, and acute medical and surgical treatments of acute ischemic stroke, as well as early inpatient management, secondary prevention, and complication management....The guidelines support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit. The guideline discusses early stroke evaluation and general medical care, as well as ischemic stroke, specific interventions such as reperfusion strategies, and general physiological optimization for cerebral resuscitation.

    • Washington State: Prehospital Stroke Triage Destination Procedure

      Protocol Guidelines: Purpose

      The purpose of the Stroke Triage and Destination Procedure is to help you identify stroke patients in the field so you can take them to the most appropriate hospital. Like trauma, stroke treatment is time-critical – the sooner a patient is treated, the better their chances of survival. Fast treatment can mean less disability, too. For strokes caused by a blood clot in the brain (ischemic), clot-busting medication must be adminis-tered within 4.5 hours from the time they first have symptoms. For bleeding strokes (hemorrhagic), time is also critical. As an emergency responder, you play a crucial role in getting patients to treatment in time.

      Assess Applicability for Triage
      Report from patient or bystander of one or more sudden: Numbness or weakness of the face, arm or leg, especially on one side of the body Confusion, trouble speaking or understanding; Trouble seeing in one or both eyes; Trouble walking, dizziness, loss of balance or coordination; Severe headache with no known cause.

      Perform F.A.S.T. Assessment:
      Face: unilateral facial droop? Arms: unilateral drift or weakness? Speech: abnormal or slurred? Time last normal (determine time patient last known normal)
      Yes to any one sign (Face, Arms, Speech) = YES

      Washington State: Prehospital Stroke Triage Destination Procedure

    • 2014 Application for Level I Stroke Center Categorization (Washington State) [docx]


Stroke Centers & Partnerships


Stroke Rehabilitation


  • Stroke Ambulances and Mobile CT Scanners



    OTHER STROKE RESOURCES


  • Navigate & Search!


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    May is Stroke Awareness Month!


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    "Act in Time:
    Stroke is a medical emergency. Every minute counts when someone is having a stroke. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save people’s lives and enhance their chances for successful recovery." [ Source]


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