Emergency medical care for stroke. Emergency care for hemorrhagic stroke. How to help yourself

Help provided in the first seconds after the attack, and health care during the first three hours is tantamount to saving a life.

A stroke is a sudden disruption or interruption of the blood supply to the brain. If there is a blockage of a blood vessel in the brain by a thrombus, an ischemic stroke develops. Rupture of a blood vessel leads to a hemorrhagic stroke. Both types of circulatory disorders in a stroke can lead to brain cell death or death. Therefore, it is so important to be able to provide people with first aid for strokes before the ambulance arrives.

Stroke ranks fifth in the list of all types of death from the disease. But the worst of all are the consequences that this pathology entails: paralysis, loss of vision, impaired speech, changes in thinking and consciousness.

The first signs of a stroke may occur among women aged from 18 to 40 years old. Ignoring these "bells" increases the risk of having a stroke. In men, the disease often occurs by the age of 40, they suffer a stroke more easily than women, and recover faster.

The development of a stroke can be prevented if its precursors are recognized in time, consult a doctor and do not forget about prevention.

Harbingers of a stroke:

  • sudden weakness, rapid fatigue;
  • severe headache;
  • change, double vision (even short-term);
  • feeling of numbness of the hand;
  • severe dizziness;
  • sudden, momentary disturbances in spatial orientation;
  • speech difficulties, the simplest, familiar words are forgotten;
  • impaired ability to concentrate thoughts.

These symptoms can be signs not only of a stroke, but also of other pathologies. But in any case, you should consult a doctor, because often such symptoms are associated with insufficient blood supply, which can lead to a stroke, cause irreversible damage to the nervous tissue of the brain.

Ischemic stroke

Ischemic stroke clinic:

  • occurs in the morning or during a night's rest;
  • the patient's consciousness is not impaired;
  • there is weakness of the limbs on one side of the body;
  • there are signs of speech impairment, facial distortion.

Hemorrhagic stroke

When a brain vessel ruptures, a person may temporarily lose their hearing and may lose consciousness.

Symptoms:

  • severe headache, hearing loss;
  • occur with high psycho-emotional or physical stress;
  • the patient is unconscious;
  • there is a strong tension of the occipital muscles;
  • blood pressure is very high;
  • convulsions, paralysis of the limbs develop.

Calling an ambulance is required. A stroke cannot be cured at home. It is necessary to take the person to a medical facility as soon as possible within the first 3 hours in order to reduce brain damage after a circulatory failure.

At-risk groups

Stress and prolonged emotional overstrain can lead to a stroke at a fairly young age.

People of working age most often fall into the risk group for the likelihood of developing a stroke. The main causes leading to the development of a stroke:

  • arterial hypertension;
  • violation of cerebral circulation;
  • cardiovascular pathologies;
  • stress and prolonged emotional overstrain;
  • atherosclerosis, high blood cholesterol;
  • diabetes mellitus, obesity, genetic predisposition;
  • smoking, use of contraceptive pills by women;
  • elderly age.

How to recognize a stroke

Face - hand - speech - test. These are not just words, but criteria that need to be evaluated if a stroke is suspected. In the Russian-language literature, the test was called "UPZ", which means "smile, raise both hands, speak":

signsWhat to pay attention to.
Ask the patient to smile, show teeth.
Alarm signal:
The appearance of facial asymmetry, weakness of facial muscles on the affected side.
Ask to raise both hands palms up, parallel to the floor, hold them for 5 seconds, then lower them. If the person is lying down, the arms can be raised 45 degrees.
Alarm signal:
Lowering one of the arms due to the weakness of the muscles that has appeared.
Ask to say any simple phrase, for example, FIRST NAME
Alarm signal:
Unintelligible speech, misunderstanding of words in simple commands or phrases signals speech disorders.

Important: If there are no symptoms, but the patient's condition is alarming, you need to call an ambulance without delay or take the person to the doctor.

Emergency first aid for stroke

For the provision of the first, prehospital stage of first aid, only 5-10 seconds so there is no need to panic. It is necessary to immediately call an ambulance - the faster qualified assistance is provided to the victim, the greater the chance of saving life and restoring health.

General instruction

How to provide first aid for a suspected stroke

ActionDescription
Call an ambulance
Check the presence of consciousness: gently shake the person, ask a question.
Determine if the victim is breathing: bend your ear low to your face, listen for sounds, catch if the chest is moving.
Check on the carotid artery for a pulse. If possible, measure the pressure - these data will be needed by ambulance doctors.
If there is no spontaneous breathing, start.
If there is a pulse, take 12 breaths per minute.
Position the patient carefully. To prevent cerebral edema, raise your head a little by 20-30 cm, placing a pillow, rolled towel or other object under it.
Tilt your head back a little, grab your lower jaw with your fingers and push it forward a little. If necessary, clean the mouth of dentures.
During vomiting, carefully turn the patient on the right side.
Unfasten your clothes so that nothing constrains your neck and chest. Ensure flow fresh air.
With convulsions, you need to hold your head so that the person does not hit, does not choke on the foam that comes out of the mouth.
It is impossible to move, shift to another place a person with a stroke - a rupture of blood vessels may occur.
From the moment the first signs appear, assistance should be provided within 3 hours.

Help with hemorrhagic stroke

In hemorrhagic stroke, two rules are added to the standard prehospital care:

  1. To ensure the outflow of blood, be sure to put a pillow, a roller from a jacket, a bag under the patient's head.
  2. Apply an ice pack (bottle of cold water) to the head (presumably on the side where the hemorrhagic stroke occurred).

At ischemic stroke first aid is standard, according to the algorithm.

Help on the street

If you saw a person on the street who had a stroke:


Assistance in enclosed spaces

When providing assistance in enclosed spaces (in offices, shops, at home), in addition to the standard algorithm for providing assistance to the victim:

  • you need to create an influx of fresh air - open the door, window, balcony;
  • measure blood pressure (you can ask for a device at your nearest pharmacy).

Caution: Never give any medication to a sick person unless you are a doctor. Do not bring the person to life with ammonia - it can cause respiratory arrest.

If you are confused and do not know what specific assistance you need to provide to a person:

  • ask someone again call back by phone 103 or 112;
  • describe the patient's condition and get recommendations for your next steps.

Watch the video at the link in this article: the author briefly talks about first aid for a stroke.

Chinese technique: needle for stroke

Chinese doctors, in order to help a person with a stroke, offer to bleed all 10 fingers and earlobes with a sterile needle. The punctures need to be made small so that only blood flows.

But not all doctors agree with the effectiveness of this method:

  • earlobe piercing can only be done by an acupuncturist;
  • bloodletting can only help as an emergency treatment for high blood pressure.

Chinese medicine suggests using a sterile needle to puncture all 10 fingertips on the hands and both earlobes, and squeeze out a drop of blood.

After the ambulance delivered the patient to the hospital, the treatment of stroke symptoms takes place in several stages:

  • intensive care in the intensive care unit to reduce, reduce brain damage, risk of death,
  • conservative therapy in the neurological or cardiology department;
  • rehabilitation treatment in a rehabilitation center;
  • physical therapy, speech exercises, massage, water procedures at home.

According to statistics, competent first aid in the first three hours after a stroke saves the lives of at least 50-60% of patients, even with severe forms of stroke. The disease is very rejuvenated, affecting both the elderly and young, twenty-five-year-old people. Therefore, you need to be prepared to, if necessary, be able to recognize a stroke, provide quick and competent assistance to the victim.

Urgent care with hemorrhagic stroke should be carried out in a neurological or intensive care unit, according to the principles formulated by B. S. Vilensky (1986):

1. Normalization of vital functions (see the topic GENERAL ISSUES OF REANIMATOLOGY).

2. The patient should be put to bed with raised head end.

3. With hemorrhagic stroke means having the properties of hemostatics and angioprotectors are shown. The drug of choice for this purpose is dicynone (synonyms: etamsylate, cyclonamide). The hemostatic effect of dicynone with intravenous administration begins after 5-15 minutes. the maximum effect occurs after 1-2 hours, the action lasts 4-6 hours or more. Enter in / in 2-4 ml of 12.5% ​​solution, then every 4-6 hours, 2 ml. It can be administered intravenously by drip, adding to conventional infusion solutions (MD Mashkovsky, 1997).

4. For normalization of blood pressure at the emergency stage, you can use intravenous injections of dibazol (2-4 ml of 1% solution), clonidine (1 ml of 0.01% solution), droperidol (2-4 ml of 0.25% solution) . In the absence of effect, ganglioblockers are indicated - pentamine (1 ml of 5% solution) or benzohexonium (1 ml of 2.5% solution), but the introduction of these drugs should be done with caution and constant monitoring of blood pressure.

5. Due to the sharp increase fibrinolysis cerebrospinal fluid shows epsilon-aminocaproic acid from 20 to 30 g / 24 hours during the first 3-6 weeks (F. E. Gorbacheva, A. A. Skoromei, N. N. Yakhno, 1995).

6. Relief of cerebral edema and intracranial hypertension - see topic BRAIN EDEMATION.

7. Relief of hyperthermic syndrome(if any); convulsive syndrome (if any).

8. In the absence of consciousness, preventive antibiotics are prescribed to prevent the development of pneumonia.

9. Care aimed at preventing trophic complications (pressure sores).

10. Control of bowel function.

11. Symptomatic therapy.

Note. The listed activities are adapted to the specific situation.

First aid for stroke

First aid for a stroke begins in the first few minutes after the disease. This will help to avoid the development of irreversible processes in the brain and prevent death. It is known that the next three hours after a stroke are a crucial period of time and are called the therapeutic window. If first aid for a stroke was provided correctly and within these 3 hours, then there is hope for a favorable outcome of the disease and a normal subsequent restoration of body functions.

Types of strokes:

  1. Ischemic stroke is a cerebral infarction. It accounts for more than 75% of all cases.
  2. Hemorrhagic stroke - bleeding in the brain.

Stroke - symptoms and first aid

Signs of a hemorrhagic stroke:

  1. Sharp severe headache.
  2. Hearing loss.
  3. Vomit.
  4. Paralysis of the limbs.
  5. Distorted expression.
  6. Increased salivation.

Symptoms of ischemic stroke:

  1. Gradual numbness of the limbs.
  2. Weakness in an arm or leg on one side of the body.
  3. Speech disorders.
  4. Facial numbness.
  5. Headache.
  6. Dizziness.
  7. Loss of coordination.
  8. Visual impairment.
  9. Seizures.

First of all, emergency medical care should be called for a stroke or when its obvious symptoms appear. It should be noted that when calling, it is necessary to describe in detail the signs of the disease and the patient's condition.

Emergency care for a stroke

After calling the neurological team, it is necessary to provide first aid to the victim of a stroke.

Hemorrhagic stroke - first aid:

  • lay the patient on the bed or on the floor so that the shoulders and head are slightly raised (about 30% of the surface). It is important not to move the victim too much and not allow him to go home if the stroke occurred on the street;
  • remove or unfasten all squeezing items of clothing (collar, tie, belt);
  • if there are prostheses in the mouth, they must be removed;
  • provide access to fresh air;
  • the head of the victim should be slightly tilted to one side;
  • when vomiting, thoroughly clean the oral cavity with gauze or other natural tissue;
  • put something cold on the head (a bottle of water or a frozen product). The compress is applied to that side of the head, which is opposite to the numb or paralyzed limbs;
  • maintain blood circulation in the arms and legs (cover with a blanket, put a heating pad or mustard plaster);
  • monitor salivation, clean the oral cavity from excess saliva in time;
  • with paralysis, rub the limbs with any oil-alcohol mixture (you need to mix 2 parts vegetable oil and 1 part alcohol).

First aid for ischemic stroke:

Emergency care for strokes

Strokes are acute circulatory disorders in the brain (cerebral) and spinal (spinal) cord. Main clinical forms: I - transient disorders (a - transient ischemic attacks, b - hypertensive cerebral crises); II - hemorrhagic strokes (non-traumatic hemorrhage in the brain or spinal cord); III - ischemic strokes (brain infarctions) with thrombosis, embolism, stenosis or compression of blood vessels, as well as with a decrease in general hemodynamics (non-thrombotic softening).

With the embolic nature of cerebral stroke and with vein thrombosis, hemorrhagic cerebral infarction often develops; IV - combined strokes, when at the same time there are areas of softening and foci of hemorrhage.

Transient cerebrovascular accident (TIMC) is the most common variant of cerebral stroke or hypertension, atherosclerosis of cerebral vessels and the impact on these vessels of pathologically altered cervical vertebrae (spondylogenic circulatory disorders in the vertebrobasilar basin). This option includes only such observations in which cerebral and focal neurological symptoms disappear after 24 hours.

Symptoms. They are characterized by general cerebral and focal disorders. Of the cerebral symptoms, headache, dizziness of a non-systemic nature, nausea, vomiting, noise in the head, disturbances of consciousness, psychomotor agitation, and epileptiform seizures are possible. Cerebral symptoms are especially characteristic of hypertensive cerebral crises. Hypotensive crises are characterized by less pronounced cerebral symptoms and are observed against the background of low blood pressure and weakening of the pulse.

Focal symptoms most often manifest as paresthesia, numbness, tingling in local areas of the skin of the face or extremities. Motor disorders are usually limited to the hand or only fingers and paresis of the lower mimic muscles, speech disorders, dysarthria are observed, deep reflexes on the limbs increase, pathological signs appear. With stenosis or blockage of the carotid artery, the transient crossed oculopyramidal syndrome is pathognomonic: decreased vision or complete blindness in one eye and weakness in the arm and leg opposite the eye. In this case, the pulsation of the carotid arteries may change (weakening or disappearance of the pulsation on one side), during auscultation, a systolic blowing noise is heard. In case of circulatory disorders in the vertebrobasilar basin, darkening before the eyes, dizziness, coordination disorders, nystagmus, diplopia, impaired sensitivity on the face and tongue are characteristic. Transient disturbances in the large radiculomedullary arteries are manifested by myelogenic intermittent claudication (when walking or physical exertion, weakness of the lower extremities, paresthesias in them, transient disorders of the function of the pelvic organs appear, which disappear on their own after a short rest).

Diagnostics. When examining a patient, it is immediately impossible to determine whether a real cerebrovascular accident will be transient or persistent. This can be concluded only in a day.

Urgent care. The patient must be provided with complete physical and psycho-emotional rest. The difference in the pathogenetic mechanisms of PNMK also determines various therapeutic measures. In atherosclerotic cerebrovascular insufficiency, cardiotonic ones are used (1 ml of a 0.06% solution of cortico or 0.025% solution of strophanthin is administered with glucose intravenously, 10% solution of sulfocamphocaine, 2 ml subcutaneously, intramuscularly or intravenously slowly, 1 ml cordiamine subcutaneously), vasopressor (with a sharp drop in blood pressure, 1 ml of a 1% solution of mezaton is administered subcutaneously or intramuscularly, 1 ml of a 10% solution of sodium caffeine benzoate subcutaneously) to improve cerebral blood flow (10 ml of a 2.4% solution of eufillin intravenously slowly with 10 ml saline, 4 ml of 2% papaverine solution intravenously, 5 ml of 2% trental solution in a dropper with saline or 5% glucose) preparations. Sedatives are prescribed (bromocamphor 0.25 g 2 times a day, motherwort tincture 30 drops 2 times a day) and various symptomatic remedies aimed at relieving headaches, dizziness, nausea, vomiting, hiccups, etc.

Hospitalization. to a neurological or specialized neurosurgical hospital (angioneurosurgical department).

hemorrhagic stroke.

Hemorrhage develops by two mechanisms: by the type of diapedesis and due to rupture of the vessel. Diapedetic hemorrhage occurs with hypertensive crisis, vasculitis, leukemia, hemophilia, acute coagulopathic syndrome, uremia. Hemorrhage due to rupture of the vessel occurs when arterial hypertension and local defects of the vascular wall (atherosclerotic plaque, aneurysm, etc.). Intracerebral hematoma is most often localized in the region of the basal ganglia and the internal capsule. Less commonly, a primary hematoma forms in the cerebellum and brainstem.

Symptoms. For hemorrhagic stroke of any localization, cerebral symptoms are characteristic: severe headache, nausea and vomiting, bradycardia, and rapid depression of consciousness. Focal symptoms depend on the location of the hemorrhage. More often, hemorrhagic stroke develops in middle-aged and elderly people, it occurs suddenly, at any time of the day. The patient falls, loses consciousness, vomiting appears. On examination, the face is purple, breathing is snoring (stertorous), urinary incontinence. Blood pressure is often elevated. Given the predominance of the lesion in the internal capsule of the brain, hemiplegia, hemihypesthesia can also be detected in the unconscious state of the patient. In the case of a breakthrough of blood into the subarachnoid space, meningeal symptoms join. With a breakthrough of blood into the ventricles of the brain, hormetonic convulsions develop, disorders of consciousness deepen to atonic coma, pupils dilate, body temperature rises, respiratory disorders, tachycardia increase, and death can occur in a few hours. Subarachnoid hemorrhage usually develops suddenly (aneurysm rupture), with physical exertion: a severe headache occurs, sometimes radiating along the spine, followed by nausea, vomiting, psychomotor agitation, sweating, eye symptoms, consciousness is depressed.

Diagnostics. Based on characteristic clinical symptoms and CSF study data.

Urgent care. In hemorrhagic stroke, the following are necessary: ​​strict bed rest, stopping bleeding, lowering blood pressure to normal, lowering intracranial pressure, combating edema and swelling of the brain, eliminating acute disorders respiration, the fight against cardiovascular disorders and psychomotor agitation.

Transportation of the patient to the neurological hospital is carried out in the most early dates from the moment of the onset of a cerebral stroke in compliance with all precautions: careful laying of the patient on a stretcher and bed, maintaining a horizontal position during transportation, avoiding shaking, etc. Before transportation, hemostatic agents (vikasol, dicynon, calcium gluconate) are administered to the patient, a venous tourniquet is applied on the thighs to reduce the volume of circulating blood. In case of threatening respiratory failure, transportation from the IVP, oxygen inhalation are advisable. In the early stages, the introduction of epsilon-aminocaproic acid (100 ml of a 5% solution intravenously drip) with 2000 IU of heparin is indicated. To reduce intracranial pressure, active dehydration therapy is carried out: Lasix 4-6 ml of a 1% solution (40-60 mg) IM, mannitol or mannitol (200-400 ml of a 15% solution IV drip). justified as early as possible the use of "metabolic protection" of the brain tissue and antioxidants (sodium oxybutyrate 10 ml of a 20% solution intravenously slowly - 1-2 ml per minute; piracetam 5 ml of a 20% solution IV; tocopherol acetate 1 ml 10-30 % solution intramuscularly; vitamin C 2 ml of 5% solution in/in or/m. Inhibitors of fibrinolysis and proteolytic enzymes are also administered in the early stages: trasilol (kontrykal) 10,000-20,000 IU intravenously.

It should be remembered that the development of spontaneous subarachnoid hemorrhage in young people is more often due to rupture of arterial aneurysms.

Hospitalization. urgent to the neurosurgical hospital.

Ischemic strokes.

Three groups of main etiological factors leading to ischemic stroke can be distinguished: changes in the walls of blood vessels (atherosclerosis, vasculitis), embolic lesions and hematological changes (erythrocytosis, thrombotic thrombocytopenia, hypercoagulability, etc.).

Symptoms. Patients gradually develop headache, dizziness, numbness and weakness in the limbs. The disease usually develops against the background of coronary heart disease and other signs of atherosclerosis, diabetes. At a young age, ischemic stroke is often the result of vasculitis or blood disease. Focal symptoms come to the fore of the clinical picture of the disease; cerebral symptoms develop somewhat later and are less pronounced than in hemorrhagic stroke. The face of such patients is usually pale, blood pressure is normal or elevated. With embolism of the cerebral vessels, the disease resembles a hemorrhagic stroke in the clinical picture, short-term clonic convulsions are characteristic before the development of paralysis of the limb, depression of consciousness (apoplexy) is rapidly increasing.

Urgent care. Basic principles: containment of thrombus formation and lysis of fresh thrombi, limitation of areas of ischemia and perifocal cerebral edema, improvement of function of cardio-vascular system, elimination of acute respiratory disorders In case of thrombosis or thromboembolism of the vessels of the brain or spinal cord, it is necessary to immediately begin treatment with heparin or fibrolysin (in / in up to 20,000 IU of heparin with normal blood pressure). Together with anticoagulants, antiplatelet agents, vasodilators (5 ml of a 2% solution of pentoxifylline, intravenous trental) should be administered, hemodilution with rheopolyglucin (400 ml intravenously at a rate of 20-40 drops / min) should be administered. With a crisis rise in blood pressure, it should be reduced to a "working" level due to impaired autoregulation of cerebral circulation during this period and the dependence of cerebral blood flow on the level of blood pressure. Microcirculation is improved using dipyridamole (curantyl, persanthin - 2 ml of a 05% solution in / in or in / m), trental (0.1 g - 5 ml of a 2% solution in / in drip in 250 ml of saline or 5% solution glucose), cavinton (2-4 ml of 05% solution in 300 ml of physiological saline intravenously).

In ischemic stroke with severe cerebral edema, cerebral embolism and hemorrhagic infarction, more active use of osmodiuretics is required. With psychomotor agitation, seduxen (2-4 ml of a 05% solution in / m), haloperidol (0.1-1.0 ml of a 05% solution in / m) or sodium hydroxybutyrate (5 ml of a 20% solution in / m or / in).

Violations of the rhythm and force of contractions of the heart can be both a background against which a stroke has developed (often as an embolism), and a consequence of impaired central regulation of the heart. In the first case, urgent measures are carried out according to the same principles as for cardiac arrhythmias without cerebrovascular accident. In this case, it is desirable to avoid large doses of beta-blockers, especially anaprilin, and severe arterial hypotension. With myocardial ischemia, the full amount of appropriate assistance is provided, which, as a rule, is also useful for cerebral ischemia. If possible, agents that cause a sharp dilatation of the cerebral vessels, in particular nitroglycerin, should be avoided. Against the background of high blood pressure, this can lead to increased cerebral edema and the emergence of a persistent focus of ischemia.

Hospitalization. For all cerebral strokes, hospitalization of patients in the intensive care unit or neurological department (specialized neurovascular department) is indicated. The exception is cases with severe violations of vital functions and in a state of agony, when the transportation itself is dangerous. Respiratory resuscitation is effective enough only for small-focal lesions of the brain stem.

A sharp violation of the blood circulation of the brain, as a result of which vital areas nervous system do not receive blood, and neurons die, causing a stroke. The disease manifests itself in a number of life-threatening symptoms. Every year, the disease is diagnosed in every 5 inhabitants of Russia, while death occurs in a third of all cases.

The sooner first aid is provided for a stroke, the greater the chance that a person will remain alive. In this case, the patient must be transported to a medical facility within three hours from the onset of the attack.

Classification

First aid for a stroke at home is an important step to save a person's life.

However, you should be aware that the consequences of an attack can be prevented and the functions of depressed blood circulation can be fully restored only in medical institutions. Therefore, if a stroke is suspected, first of all, you need to call an ambulance team, and then proceed to provide emergency care.

To help the patient, it is important to know the types of the disease and their symptoms.

Circulatory disorders in stroke can be of 2 types:

  1. The ischemic type is called the infarction state of the brain. It develops due to the fact that the arteries that provide the brain with the necessary substances are clogged with a thrombus. In this case, a blood clot can develop in the heart, leg arteries, or any other vessels. As a rule, the main causes of ischemic are vascular atherosclerosis and. It is most often diagnosed in people over 60 years of age.
  2. The hemorrhagic type of circulatory disorders appears due to rupture of the cerebral artery. Hemorrhagic stroke is a consequence of hypertension, when weakened cerebral vessels cannot withstand and rupture. For this reason, hypertensive patients must strictly adhere to the treatment prescribed by the doctor. And in case of increased pressure or arrhythmias at home, strictly adhere to the algorithm to eliminate alarming symptoms. ). This type of stroke mostly affects people between 40 and 60 years of age.


Symptoms

It is difficult to diagnose one or another type of cerebrovascular accident at the time of emergency care for a stroke, however, for physicians, the distinction between types is very important, since the type of therapy depends on them.

In order to understand that a person has a stroke, you can use a special technique that will reveal important symptoms of the disease.

  • U is a smile. The patient's facial expressions change: he can only smile with one half of his face;
  • D is movement. After the patient raises both limbs, it will be seen that one of them is much lower than the other;
  • A is articulation. A person affected by a stroke cannot speak clearly;
  • R is the solution. If at least one of the symptoms appears, emergency care for a stroke should be provided and doctors should be called.

Note!

A "male" stroke has several differences in its manifestations from a "female" one.

The exact sequence and time of manifestation of symptoms cannot be predicted, since each organism reacts to an attack in different ways. In addition, symptoms may vary from different types brain circulatory disorders.

With an ischemic stroke, the symptoms are more pronounced, and the attack itself is difficult: a person can. In addition, with ischemia, the first signs begin to appear a few days before the attack itself, while the hemorrhagic appearance occurs suddenly.

First aid

If you do not have experience in determining the type of attack, first aid for a stroke is carried out subject to these recommendations.

If the person has not lost consciousness, the algorithm of action before the ambulance arrives is as follows:

  • Reassure the victim;
  • Lay it comfortably, giving a higher position to the head and shoulder area;
  • Provide free flow of fresh air in the room;
  • Remove or unfasten the pressing elements of clothing;
  • Promote complete rest of the patient.

Note!

First aid for stroke does not allow the use medications before the medical examination of the patient!

What not to do when a stroke occurs:

  • Independently move the victim or ask him to move;
  • Apply ammonia;
  • Give a person food or drink;
  • Use drugs containing acids to bring the patient to consciousness.

Note!

The patient's life depends on how quickly a team of doctors is called and first aid is provided.

Important Details

If you can distinguish the symptoms of an ischemic type of stroke from a hemorrhagic one, then help is differentiated:

Note!

If a person has hypertension, it is necessary to measure his pressure before the medical examination. Report the results of the study to the doctors. Before their arrival, lower the victim's legs into a bath of hot water.

What to do if the patient is unconscious?

Turn his head to the side so that the tongue does not fall or the vomit enters the pharynx, warm the legs and arms, and provide fresh air.

If a patient has a stroke, accompanied by an extremely serious condition, which has symptoms of clinical death (no breathing and heartbeat, the pupils of the eyes are dilated), it is necessary to provide emergency assistance:

  • Tilt the patient's head to the side;
  • If necessary, free the oral cavity from mucus or masses and foreign objects;
  • Grasp the edges of the lower jaw with your fingers and push it forward;
  • Do ;
  • Perform a heart muscle massage.

Statistical data show that the first, competently rendered assistance, and the patient during the first three hours in a medical institution, helps to save a life in 60% of cases. 90% of patients fully restore their health and lead a full life. In 70% of patients, irreversible processes in the blood circulation of the brain will not occur.

Medical help

First aid for a stroke is provided by a team of doctors who arrived at the call.

After a diagnostic examination, doctors carry out a series of measures aimed at restoring or maintaining impaired respiratory or cardiac work.

Honey. help consists in the use of medications, which are used depending on the symptoms and type of stroke. What to do with a stroke in a patient after hospitalization, doctors decide medical institution.

Prevention and recovery

Many are not ready for the manifestation of a stroke: people ignore the appointments of doctors, they do not systematically treat chronic diseases of the heart and blood vessels.

In addition, regular stressful situations, bad habits and poor nutrition increase the risk of disease several times.

Therefore, in order to prevent the occurrence of this extremely dangerous condition for life and health, you must adhere to the following rules:

  • Eat right;
  • Give up bad habits;
  • Follow all the recommendations of the attending physician;
  • Monitor your blood pressure;
  • Watch your weight;
  • Alternate periods correctly physical activity and rest;
  • Avoid stressful situations and prolonged depression;
  • Get outdoors more.

When a stroke occurs, there is little time to save a person. The account goes literally for seconds. The main factor that has a beneficial effect on treatment is the timely provision of qualified medical care to the patient. Therefore, the first action of any person who is close to the victim will be to call an ambulance. But this requires basic knowledge about the symptoms, signs of a stroke and the correct algorithm of actions while waiting for doctors.

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    Stroke Symptoms

    The development of a stroke condition is accompanied by the following general symptoms:

    • sudden severe headache;
    • fainting;
    • weakness;
    • violations of speech, vision, hearing;
    • convulsions;
    • nausea;
    • vomit;
    • asymmetry on the face;
    • paralysis (with damage to the right hemisphere of the brain, taken away left-hand side body and vice versa).

    Signs of a stroke

    But it should be noted that men and women often have their own characteristics in the event of a stroke.

    Features in men

    If a man has a stroke on the street, passers-by often make the assumption that he is intoxicated. This is due to the similarity of some signs:

    • uncontrolled bowel movements or urination;
    • increased salivation;
    • impaired coordination of movements;
    • problems with orientation in space;
    • coma.

    According to statistics, stroke mainly affects men after 40 years of age.

    Features in women

    In addition to the general symptoms, women have a strange emotional background and severe dizziness. They are much more susceptible to the disease than men. Doctors believe that this is due to the following factors:

    • pathologies during pregnancy;
    • taking hormonal contraceptives;
    • predisposition to diseases of the circulatory system;
    • susceptibility to stress and strong emotionality.

    Women are much more likely to have early signs of a stroke. Most often, this disease affects the weaker sex after 60 years.

    Types of strokes

    Unfortunately, it is not possible to determine which type of disease has developed by symptoms at home. Although it matters a lot. After all, both PMP and subsequent treatment differ significantly depending on the type.

    Major stroke is divided into:

    1. 1. Ischemic.
    2. 2. Hemorrhagic.

    But there is still a microstroke.

    microstroke

    This disease contributes to the development of a massive stroke. Microstroke is called circulatory disorders in the brain tissues, which lead to cell death. Most often this is due to the formation of blood clots.

    microstroke

    The clot clogs the blood vessels and the blood stops feeding the brain cells, which causes their death. If blood flow is not normalized within 6 hours, a stroke occurs. Symptoms:

    • dizziness;
    • headache;
    • sensitivity to loud sounds and bright light
    • sharp jumps in blood pressure;
    • feeling of numbness of the face and / or limbs;
    • general malaise, weakness;
    • loss of consciousness;
    • confusion of thoughts;
    • violations of coordination and balance.

    If you have only a few symptoms, you should immediately consult a doctor. Proper and timely treatment will prevent the appearance of more serious violations.

    Ischemic stroke

    90% of patients are faced with this type. In medical circles, it has another name - cerebral infarction. The reasons for the development of this pathology are:

    • thrombosis;
    • blockage of arteries;
    • vascular insufficiency.

    The risk group includes people who suffer from atherosclerosis and diabetes mellitus, mostly the elderly (after 60 years).


    Hemorrhagic stroke

    The main cause of this disease is hypertension. Unable to withstand high blood pressure, the vessels burst. Through the gap, blood enters the brain tissue, causing a hemorrhage.


    This type of stroke mostly affects people aged 40-60. The risk group consists of patients with obesity, leading a sedentary or wrong (smoking, alcohol abuse) lifestyle.

    Algorithm of actions before the arrival of doctors

    It is important to provide first aid for a stroke in a timely and correct manner. Death due to this pathology does not occur instantly! The patient's condition worsens over several days. But a lot depends on at what stage of the course of the disease to turn to a medical institution. At the first signs, it is necessary to call an emergency and provide first aid.

    Before arrival medical workers follows:

    1. 1. Help the patient to take a horizontal position. The upper part of the body (head and shoulders) should be slightly raised (approximately 30 cm).
    2. 2. Prepare a container in case of vomiting.
    3. 3. Examine the patient for any things squeezing his body. If there are any (tie, scarf, belt), loosen their pressure (unfasten the top buttons on the shirt too).
    4. 4. Provide complete peace.
    5. 5. Ventilate the room in which it is located or turn on the air conditioner.
    6. 6. Measure pressure, if possible. At elevated values, give medicine.
    7. 7. If the patient has a violation of the rhythm of breathing and / or pulse, resuscitation should be started: chest compressions and artificial respiration, even when he is still conscious.

    Further Medical Assistance

    Upon arrival, doctors will try to determine which type of stroke struck the patient and take the necessary treatment measures before hospitalization, if possible. Most often, ambulance doctors lower blood pressure and deliver the patient to the hospital of the neurological department. There, the patient is prescribed and urgently conducts the necessary laboratory tests. Methods of treatment directly depend on the results of the tests. During this period, independent reception of unappointed medicines like death. Among the doctor's prescriptions, the following drugs will definitely be:

    • reducing pressure;
    • antiplatelet agents or anticoagulants;
    • normalizing the level of cholesterol in the blood;
    • B vitamins.

    Even if the crisis situation has been overcome, the consequences of a stroke require long-term rehabilitation. They can be different: loss of the ability to move, impaired speech function, deviations in the functioning of the vestibular apparatus. You should be very attentive to the patient, note everything that he feels and feels.

    During the recovery process, it is important to strictly follow the recommendations of the doctor. After all, 30-40% of patients are diagnosed with a recurrent stroke over the next two years. Its consequences are many times more severe than the first.

    Prevention

    Briefly, then preventive measures can be called maintaining a proper lifestyle. It is necessary to monitor blood pressure, cholesterol and blood sugar levels. Morning exercises and proper nutrition will help keep the body in good shape for many years.

Criteria for the need for medical care for suspected stroke may be the signs shown in the table:

First aid for stroke

Prehospital care for hemorrhagic stroke:

Give the patient a horizontal position with a raised head end, regardless of the degree of impaired consciousness and the severity of the condition;

Remove all removable dentures from the oral cavity;

Make free access to fresh air to the patient;

If the patient is unconscious, it is necessary to turn the head a little to one side, which will ensure the unhindered flow of saliva and mucus. This will prevent it from entering the respiratory tract;

Thoroughly clean the oral cavity from vomit, if there was vomiting;

Applying cold to the head (cold heating pad, ice pack, frozen or cold objects). It is desirable to expose to cold effects that half of the head, which is opposite to the side of paralysis of the limbs;

Cover the patient with a blanket;

Monitor breathing, heart rate and blood pressure;

If there are signs of clinical death (cardiac arrest, breathing and pupil dilation), start resuscitation (indirect heart massage and artificial ventilation of the lungs)

Prehospital care for ischemic stroke

Free your neck and provide access to fresh air;

To carry out control over the main vital parameters;

Rubbing paralyzed limbs with a semi-alcoholic solution, or simply massaging them;

Do not allow drinking water or taking any tablet preparations.

The most important measure of care for any type of stroke, which must be performed at the pre-hospital stage, is the call of a specialized ambulance team. The patient should, as soon as possible, be hospitalized in a medical institution.

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Stroke care

All patients with suspected stroke, or people with an obvious diagnosis of this, should be treated in the intensive care unit or in intensive care units of a neurological hospital under the supervision of a neuropathologist. In the conditions of a medical institution, they continue all those activities that were provided at the pre-hospital stage.

In addition, they are supplemented by:

Instrumental diagnostics with determination of the exact type and localization of changes in the brain;

Monitoring of vital parameters of the body using modern equipment;

Spinal puncture. It is performed when it is impossible to accurately determine the nature of the stroke (ischemic or hemorrhagic);

The introduction of cerebroprotectors - drugs that restore the structure of damaged brain cells (ceraxon, piracetam, thiocetam, actovegin);

Hemostatic drugs (hemostatics): aminocaproic acid, etamsylate. Shown only with a well-established hemorrhagic stroke;

Blood-thinning agents (heparin, pentoxifylline, cerebrolysin, cavinton). Categorically contraindicated in cerebral hemorrhages and hemorrhagic stroke;

Proper nutrition. It is selected taking into account the consciousness of the patient and the possibility of self-swallowing. It can be represented by intravenous administration of amino acids, glucose and vitamins, tube introduction of liquid mixtures into the stomach, and ordinary nutrition as part of dietary table No. 10;

Prevention of bedsores;

Control of defecation and urination. If necessary, a catheter is inserted into the bladder;

Hygienic care of skin, eyes and mucous membranes.

The story of a sudden stroke

A middle-aged woman, resting in nature, fell, tripping over a stone. She assured everyone that she was fine and she just stumbled as she wasn't used to her new shoes. Despite the desire of those present to call an ambulance, she refused to do so. They helped her up, put herself in order and invited her to the table. And although she continued to enjoy being in nature, her restlessness and agitation were still noticeable.

It would seem that nothing special happened, but in the evening after the call of her husband, it became known that this woman was taken to the hospital and at 18:00 she died. As it was established by doctors, she had a stroke at the picnic, which did not manifest itself immediately in full force, but made itself felt by some symptoms. If this woman's friends knew about them, they would have insisted on calling an ambulance, and perhaps she would have survived.

Neuropathologists claimed that if the patient had been delivered to them within a 3-hour period, then they would have had the opportunity to fully restore the lost functions and the affected brain tissue. They also drew attention to how difficult it is to help such patients on their own at home, and how important this 3-hour period is, as a "golden time" for saving the functioning of all brain structures.

New materials

Science centers

National Medical and Surgical Center named after N.I. Pirogov

One of the largest medical centers in Russia and the CIS. This leading institution of the Federal level is unique in its versatility.

National Stroke Center at the Russian Academy of Medical Sciences

The Scientific Center is included in the list of a few clinics in our country that provide the most modern and high-tech methods for the treatment of cerebrovascular accidents (stroke and other conditions).

Clinical Care for Stroke

The first signs of cerebrovascular accident:

  • loss of sensation in the face, arm or leg, especially on one side of the body, sudden weakness;
  • severe visual impairment in one or both eyes, double vision;
  • difficulty speaking or understanding simple speech;
  • loss of balance or coordination, dizziness;
  • dizziness, severe headache.

If symptoms appear, call an ambulance immediately.

Before the arrival of the doctor, do not forget to take a number of measures to alleviate the patient's condition:

  • the patient urgently on the bed and put a pillow under his head, shoulders and shoulder blades so that the patient's inclination angle with respect to the bed is no more than 30 degrees;
  • remove removable dentures, unbutton the shirt collar, remove the belt;
  • provide access to fresh air by opening a window or window;
  • do not give the patient any drugs except for glycine (if the patient is conscious), which must be given either at once 10 tablets under the tongue or given 3 times five tablets with an interval of half an hour.
  • if the patient is vomiting, immediately clean the oral cavity with gauze or just a clean handkerchief, turning the patient's head to one side;

After the arrival of the ambulance, medical doctors will immediately carry out a set of therapeutic measures aimed at maintaining the cardiovascular system and respiratory organs. After that, the issue of the possibility of urgent transportation to the hospital will be resolved.

Clinical medical care.

Diagnostics.

After a diagnosis using computed tomography of the brain and taking the cerebrospinal fluid for analysis, it is clarified once again whether the stroke was hemorrhagic or ischemic. The presence of blood in the cerebrospinal fluid will immediately indicate a hemorrhagic stroke.

An angiographic examination of the cerebral vessels is also carried out to check whether the patient still has aneurysms, which would be better removed in order to avoid a second stroke.

An ultrasound is done. An echocardiogram is also performed.

If a plaque is detected that narrows the lumen of the vessel by more than 70%, or there is a kink in the vessel, then in case of ischemic stroke, a decision will be made to surgical intervention.

The best methods for clarifying the diagnosis of "stroke" are nuclear magnetic resonance and computed tomography. However, the science of the 21st century does not stand still and a new scanning device has already appeared in the USA, which allows, in the first hours, to detect in the depths of the brain a stroke of even a point size, which was not previously diagnosed in 75% of cases! This, together with the latest drugs, makes it possible to successfully prevent the development of the disease and quickly remove its consequences within the first three hours.

Stationary.

For the first few days after a stroke, it is desirable for the patient to stay in the so-called neuro-reanimation unit or intensive neurology unit or acute stroke unit. Here, doctors will correct the water and electrolyte balance, fight brain edema that occurs around the stroke focus, and provide strict

control of the state of the cardiovascular and respiratory systems.

In the beginning, strict bed rest will be prescribed. To avoid the formation of bedsores, it is necessary to ensure that the mattress is even, there are no wrinkles on the sheet. It is necessary to wipe the body of an immobile patient with camphor alcohol and powder the skin folds with talcum powder. It is advisable to put the patient on a rubber circle, and put on cotton bandages on the heels and sacrum.

It is important to provide a normal diet for the patient. With impaired swallowing, he is fed through a tube. If the patient can swallow, in the first days he is given fruit and berry juices, sweet tea. From the second day, the diet is expanded, but it should consist of easily digestible foods: yogurt, broths, vegetable and fruit purees.

Urgent measures in the absence of an ambulance or a doctor.

We have to bleed out. This helps a lot. ethnoscience advises immediately after a brain hemorrhage to put leeches on the ears.

That's how people have always been helped. But unfortunately, not everyone has a jar of leeches and the necessary skills to properly perform bloodletting.

In this regard, being next to a person at the time of the "strike", you should immediately do cold washing of the back, chest and abdomen. After that, so that heat and blood spread throughout the body, wash all other parts of the body evenly. It is better to add a little vinegar or salt to the water. This must be repeated 3-4 times a day.

Then, within the next two days, nothing more should be given and the patient should be given only fruit juices.

When the shock is weak enough and the patient can sit, he can take a 20-minute steam bath for the head and then wash the upper body. After 6 hours, you can start doing 20-minute foot baths, a lower or full wrap. You can wash the numb limb with cold water, even if it seems hopeless to change something. On the second day, two warm baths with washing of the feet and four washings of the upper body should be done. On the fourth day, you can make a lower wrap. The “weaned” limb can also be immersed in a warm bath with salt.

After these procedures, full washings should be done daily, and steam baths for the legs and head once a week. It is necessary to take a warm bath once a week and a cold bath once a week; one steam bath for the head; one foot steam bath; three half-baths with cold washing of the upper and lower extremities lasting one minute each. The course is 2-3 weeks.

Only after that you can proceed to full douche and other water procedures.

You should never lose hope, even if the patient is paralyzed for a very long time.

You need to try and try all the restorative procedures:

  • hot chest wraps;
  • strict fruit and vegetable diet;
  • restriction of salt intake;
  • yellow turpentine baths according to Zalmanov, which cleanse the blood of dead brain cells and heal blood vessels.

Inhalation of valerian tincture is very helpful in cases of cerebrovascular accident. It is necessary to inhale through the nose 3-4 times, taking turns inhaling the right and left nostrils.

Not bad draws blood from the head bath for the feet. You just need to simply immerse your feet in water up to the ankles or up to the calves, and to achieve a greater effect, it is better to alternate between hot, warm and cold baths. In water, based on the general condition of the patient's body, you can add mustard, oat straw, hay color or something else.

First, in order to protect yourself from a recurrent stroke, it is necessary to measure the pressure in the morning and evening (it should not exceed 140/90 mm Hg. Art.) Then, after two months, it is advisable to control the pressure 2-3 times a week and also immediately measure in cases of nausea, headache, sudden unexplained weakness and pain in the heart.

Thus, after suffering a stroke, you should always have a blood pressure monitor with you.

In the case of an increased tendency to thrombosis, you can take aspirin 1/4-1/6 tablets and especially preferably soluble ones.

Many medications also prevent the formation of blood clots. These are Cavinton, Alisat, Trental, Sermion.

Stroke First Aid

Brain damage due to a stroke is a deadly disease that leads to the patient's disability in half of the cases, so it is especially important to start treatment as early as possible, because literally minutes count.

First aid

At the first signs of a stroke - acute headache, dizziness, loss of consciousness, impaired facial symmetry and the ability to speak coherently, be sure to immediately call an ambulance.

At the first suspicion of a stroke, an ambulance

The dispatcher must be informed that the person is likely to have a stroke, and first aid in case of a stroke will be provided immediately, upon the arrival of the doctors, since they will only have to clarify the diagnosis.

Further, if the person is conscious, lay him down so that his head is elevated, unbutton the top buttons of the tight clothing, and, if possible, give him at least ten tablets of Glycine.

Glycine helps to save a significant number of brain cells in the first hours, and does not side effects, dangerous for the patient, and also fully combined with drug therapy, which will be carried out by ambulance staff.

If the patient cannot take the pills due to vomiting or loss of consciousness, then there is no need to insist.

  • Emergency care for a stroke may include immersing the patient's legs in hot water to cause an outflow of blood from the head, but never give any drugs for heart spasms and the like, as in this case they can only aggravate the situation;
  • it is possible, after the pressure is measured, at very high numbers to give the patient his medicine for hypertension, but this is not necessary, since the pill will not work immediately, and the ambulance staff will apply intravenous infusions of antihypertensive drugs upon arrival;
  • PMP during a stroke can save a person's life if he has lost consciousness - in this case, it is necessary to ensure that when vomiting a person does not choke on vomit, for which his head is turned to the side;
  • if breathing stops, you can try to excite it artificially, such first aid for a stroke will save a person’s life;
  • the doctors who arrived at the scene will definitely ask what medications the patient was taking and how quickly the symptoms of a stroke develop - this will help them determine the degree of danger and the speed of the disease.

Punctures

Stroke first aid involves some unexpected and controversial but nonetheless effective reception based on the technique of acupuncture.

Piercing the fingertips for a stroke is an old but effective technique.

If a person loses consciousness, they pierce the fingertips on their hands with a needle disinfected on fire or in alcohol until a few drops of blood appear. This is a prerequisite.

After that, the patient can come to his senses, and his condition stabilizes. If there is asymmetry of the face, then it is necessary to carefully and vigorously rub the auricles with your hands, and then pierce each lobe so that blood comes out.

The puncture is done anywhere, and this action is designed to relieve tension in the area of ​​\u200b\u200bthe brain that has been attacked. These actions during a stroke will help not only stabilize the patient's condition, but also prepare him for transportation to the medical center.

Prevention

Many people do not pay attention to their condition, go on the road or to work, feeling unwell, and it is they who, according to statistics, are the first patients in intensive care units.

Therefore, it is imperative to insist on calling an ambulance for symptoms of a stroke in a person who is nearby, even despite his protests.

First aid for a stroke is more important than ever, because it is on the competent actions of others that not only the health and normal existence of the patient in the future depends, but often first aid for a stroke helps save lives.