First aid for stroke briefly. Providing first aid for a stroke. What to do with a stroke before the ambulance arrives

An infarction of the substance of the brain that occurs as a result of a sudden circulatory failure is called a stroke. This is a deadly pathological condition for humans. First health care(pmp) in stroke helps a person save a life, as well as avoid its severe consequences.

It is especially important to know what to do with a stroke for each person to provide first aid - sometimes the bill can go literally “for minutes”.

Causes of a stroke

With a stroke, there is a decrease or cessation of blood flow in certain areas of the brain. It is customary to distinguish two variants of the disease - ischemic, when a plaque prevents full blood flow, and hemorrhagic - when the vessel wall is ruptured.

Causes of plaque:

• Formation of atherosclerotic or thrombotic obstruction - thrombosis.
• The entry of a foreign particle into the vascular duct is an embolism.

Causes of rupture of the vascular wall:

• Arterial hypertension.
• Aneurysms are congenital thinning of a section of the vascular wall.

Provoking factors:

• Tobacco smoking.
• Abuse of excessively fatty foods.
• Obesity.
• Alcoholism.

Signs of an acute condition

Everyone needs to know how to recognize a stroke. It could one day save another person's life. The main symptoms of pathology include:

1. Sudden, excruciating, severe headache, accompanied by severe nausea and repeated vomiting, flashing of foreign points in front of the eyes - the first symptoms of increased intracranial pressure.
2. Significant fluctuations in individual blood pressure parameters.
3. Possible violation of coordination of movements, up to loss of consciousness.
4. A significant violation of facial expressions and speech - "verbal porridge".
5. The appearance of double vision, a drop in visual acuity, more often in one eye.
6. A person suddenly stops recognizing familiar objects, surrounding people, does not remember dates and what day of the week is outside.
7. Unilateral paresis and paralysis of the limbs, half of the face.
8. Tremor of the tongue, its pathological deviation to the side.

Any of these signs, or a combination of them, should be alarming - only a specialist will be able to determine the root cause of the condition and prescribe an adequate treatment strategy.

Signs of a stroke in women, often ignored, and in the meantime they already need first aid:

• Increasing headaches.
• Accompanying habitual pains in the head with numbness of the face and limbs.
• Increased forgetfulness, not characteristic of a woman before.
• Violation of coordination of movements.

Signs of a stroke in men, which should be paid close attention so that first aid is provided in time:

• Misunderstanding of speech addressed to him.
• Sudden onset of sweating and weakness.
• Numbness in limbs.
• A sharp decrease in hearing or vision on one or both sides.
• Bradycardia.
• Disorientation in time, personality, space.

Many do not understand how to determine a stroke in a person. To this end, you can carefully ask him to repeat a few simple steps:

1. Introduce yourself to a person, and ask him to give his data in response - last name, first name, address, phone number.
2. Smile and watch how a person smiles back - if certain muscle groups have ceased to participate in a smile, a stroke is quite possible.
3. To ask a person to raise his hand up and hold it for some time on his own - with muscle weakness, this simple action is impossible.
4. When you open your mouth, your tongue may reflexively move to the side - one of the signs of a stroke.

First aid

As early as possible, medical care for a stroke helps to avoid the development of irreversible processes in the human brain, and also saves lives. A well-known fact is that the therapeutic window, when it is possible to stop the pathological process as much as possible, lasts only three hours.

If emergency care for a stroke was provided correctly and within this limited period of time, there is a high probability of a favorable outcome of the disease and optimal restoration of all body functions.

First aid for a stroke is an emergency call of the resuscitation medical team. If the request was submitted in time, the person's life will be saved. While the ambulance staff rush to the place of the call, it is recommended to perform a number of important actions:

• Reassure the patient as much as possible - fear and excitement only exacerbate his condition.
• Loosen the squeezing elements of clothing - the belt of trousers, shirt collars and blouses.
• The person's head should be higher than the body.
• Ensure the greatest possible flow of air masses (if the action takes place indoors).
• If a person is aware of the presence of hypertension, and there is a tonometer at hand, be sure to check the numbers, if they are significantly exceeded, antihypertensive drugs will be required (for hypertensive patients they should always be with them).
• First aid for a stroke at home will consist of distracting procedures - foot baths with boiling water, applying mustard plasters to the calf muscles, etc.
• In case of loss of consciousness, the person should be carefully laid on his side - in order to prevent aspiration of possible vomit. If the gastric contents come out, the oral cavity needs to be cleaned. Track the location of the tongue - it should not sink deep inside, otherwise the person may suffocate.
• It is strictly forbidden to give a person vasodilating drugs, drink or feed him before the arrival of the EMS staff. You can only wipe your face with a damp cloth, lightly massage the scalp.

First aid for suspected hemorrhagic stroke

1. Lay the patient on a hard surface - table, floor, etc., so that the shoulders and head are in an elevated position. It is not recommended to move the victim over a considerable distance.
2. Loosen tight clothing.
3. Remove dentures, if any.
4. Provide a massive influx of air masses.
5. Tilt the person's head to the side. After vomiting, clean the mouth with a piece of gauze or a clean handkerchief.
6. A container with an icy liquid should be attached to the head - to the opposite side of the numb limbs.
7. Maintain optimal blood circulation in all limbs - cover with a warm blanket, apply a heating pad or mustard plasters.
8. Prevent aspiration - monitor salivation, remove everything from the oral cavity in time.
9. With paresis, lightly rub the limbs with an oil-alcohol solution.

First aid for suspected ischemic stroke

1. Place the person on a hard surface, in a position on the side.
2. Ensure maximum peace, do not move anywhere.
3. Maintain the victim in a clear mind with a cotton swab with ammonia.
4. Monitor the function of breathing - the tongue should not sink.
5. Do not allow the victim to take any medicines, food or liquids.
6. Wipe the head and neck area with a damp cloth every thirty minutes.
7. Rub the torso and limbs with a soft cloth or hands.
8. With high numbers of individual pressure and in the absence of antihypertensive drugs, lower the person's legs into a hot liquid (at home).

First aid for stroke and bloodletting

When providing first aid to a person with a suspected stroke, one of the most controversial points to date is bloodletting. It consists in piercing the fingertips with a needle disinfected over the flame - until the first drops of blood appear. If there is asymmetry of facial features, you can intensively rub the auricles, and then pierce each earlobe until a drop of blood appears.

It is not recommended to perform it without the recommendation of a specialist. With the help of this measure, you can get a twofold effect - a person's condition stabilizes, or worsens significantly. In the opinion of medical specialists, this method has no sufficient grounds.

Prevention

Preventive measures designed to prevent the development of this severe pathology include:

• Attentive attitude to the parameters of individual blood pressure.
• Regular passing medical examinations and not only in old age, but in the most able-bodied - a stroke is much - "younger".
• A complete, fortified diet.
• Regular walks in the fresh air.
• Sufficient physical activity visiting swimming pools, fitness centers.
• Attention to the slightest deviations in well-being - not characteristic forgetfulness, imbalance of movements, numbness in the limbs.
• Compliance with the prescriptions issued by the attending family doctor.

Timely noticed deviations require a specialist consultation, and then a stroke can be avoided.

"Stroke" is a terrible word familiar to every modern person. It often seems that it occurs quite suddenly, provoking serious consequences - from simple slurred speech to death. The main feature of the disease is the speed of its development - when it enters the acute phase, doctors have only three hours to start resuscitation.

If time is lost, brain cells begin to change and die, which can lead a person to paralysis, to the state of a “vegetable” or even to death.

The cause of a stroke varies depending on the species to which it belongs. It is generally accepted to distinguish two main groups:

• . It is he who is tolerated by 80% of all patients. With the timely start of treatment and the absence of aggravating circumstances, the prognosis is favorable. It develops due to stagnation of blood: one of the vessels is blocked, around it the tissues are deprived of vital oxygen and begin to die. Stagnation can begin due to:
  • stenosis - narrowing of large vessels;
  • thrombosis - blockage of a large vessel, in which a blood clot acts as a plug;
  • embolism - blockage of a large vessel, in which a clot of fat cells acts as a plug.
• . It occurs much less frequently and has a much worse prognosis: more than 80% of patients die. It occurs due to a rupture of a blood vessel in the brain, in which blood splashes out uncontrollably, forms a clot, blocking intact vessels, squeezing tissues and causing extensive necrosis.

The chances of developing a stroke in different populations are different. There are factors that increase the risk:

• bad habits - smoking and alcohol not only negatively affect the brain as a whole, but also make the development of thrombosis more likely;
• high blood pressure - both caused by diseases and provoked by the systematic use of drugs;
• diabetes mellitus - any of the possible types, we have already talked about this in more detail;
• sedentary lifestyle - provokes a decrease in tone and weight;
• from excess weight- often accompanied by high blood pressure;
• stress and frequent worries - if a person is nervous, his pressure may rise sharply, the heart rate may accelerate;
• old age - over time, the vessels wear out, their walls become thinner.

The more factors combined, the more likely a person is to die from a stroke.

Symptoms and early signs of a stroke

Stroke symptoms fall into two broad categories:

• General symptoms of brain damage are found in any disease that affects the brain. It:
  • dizziness, fainting;
  • loss of balance;
  • emotional instability;
  • nausea, weakness, nausea;
  • excited or, on the contrary, a stunned state;
  • Strong headache;
  • epileptic seizure.
• Focal symptoms occur mainly in strokes and depend on which part of the brain was affected. It:
  • violation of sensitivity - decrease, goosebumps, tingling;
  • violation of motor activity - stiffness or complete paralysis, tics;
  • violation of the position of the head - the head is shifted to one shoulder, the tongue may move;
  • disturbances in the work of the nerves that regulate the work of the face - strabismus, bulging of one eye, complete paralysis of facial muscles on one side, lagging of the corner of the mouth on one side;
  • violations of the basic functions - swallowing, breathing, heartbeat.

Not all symptoms can develop at the same time, not all of them can be seen in the same person. Often people who have a stroke look like they're drunk.

To determine if a person is sick, you can conduct a rapid test:

• Ask a person to smile - if he has a stroke, one corner of the mouth will be late with the reaction, perhaps the cheek will sag, the eyelid will not obey.
• Ask him to stretch his arms straight and hold them straight. At the same time, count to ten. If a person has a stroke, one arm will lag behind or not move at all.
• Ask him to repeat a few words, for example: “Tomorrow morning it will rain". With a stroke, speech will be slurred, confused, or absent altogether.

It should be remembered that:

• the disease is characterized by a confused state of consciousness - perhaps a person will not be aware of the severity of his own condition;
• the disease is characterized by the absence of severe pain at the time of the attack - a person can deny that something is wrong with him at all.

If you suspect a stroke, it is better to play it safe, even if the patient himself is not sure that he needs help.

Signs of a stroke in men

Men and women suffer from many diseases in different ways - and a stroke can manifest itself in different ways. Furthermore:

• men enter the risk group for strokes already after 40 years, while women - only after 60;
• young men are less likely to have a stroke than young women;
• for men, the disease is less likely to end in death;
• men recover more easily afterwards.

Despite the fact that according to statistics, the average man survives a stroke more easily than average woman, the disease for him will remain just as serious. Most often in men occurs:

• weakness and headaches;
• difficulty swallowing;
• disorder of coordination and speech;
• hearing and vision impairments;
• fainting.

Strokes for men are more often caused by bad habits than anything else.

Not all men who appear drunk are actually drunk. The absence of the smell of alcohol is a reason to suspect a stroke.

Signs of a stroke in women

While men are more likely to suffer from alcohol and smoking abuse, women are more likely to be victims of strong emotional experiences and have a harder time coping with the consequences. Their risk of having a stroke may be increased due to specific factors, which include:

• pregnancy, in which the body experiences constant stress and blood pressure rises;
• uncontrolled use of hormonal contraceptives, which may cause unwanted and unexpected side effects;
• genetic predisposition to vascular complications, which, according to statistics, is higher in women.

In addition, in the case of a stroke, women may experience atypical symptoms:

• neurotic - weakness, hiccups, feeling of weakness;
• dry mouth;
• sharp pain in the face, in the chest, in one side of the body;
• palpitations and shortness of breath.

were held special studies, which showed that half of the women develop at least one atypical symptom.

Strokes are more susceptible to nervous, sensitive natures who are constantly experiencing stress - especially the risk increases if emotions do not find expression.

First aid for stroke

First aid - milestone in the treatment of stroke. 3 hours after the onset of an attack, the patient's brain cells begin to change and die - which is why it is so important that everyone knows how to identify a stroke and what to do with a person who has an attack.

What you need to know and do in the first place to save a life

When a rapid test is performed and there is some confidence that a person has a stroke, you can proceed to resuscitation.

The general rules are simple and there are only three of them:

• calmness. A person who is trying to help should not panic himself, should not fuss and rush, this will only increase the likelihood of a mistake. Therefore, first you need to take a deep breath and count to ten.
• No help is better than unqualified help. If you can’t calm down and a reminder doesn’t pop up in your head, it’s better not to do anything, just call an ambulance.
• The first step is to call the experts. Even if a person is not breathing, you must first call the doctors, then start artificial respiration. When calling, it is better to immediately inform the dispatcher that the patient has a stroke - the team will need specialized equipment to immediately start working.

When the first steps are completed and the ambulance is on its way, you can begin. If the patient is conscious, you should:

• Calm and distract him - even if he is not capable of articulate speech, there is a chance that he understands other people. The less the patient is nervous, the slower his pulse and the less tension in the brain. A soothing tone, rhetorical questions are well suited. It is worth noting that help is on the way.
• Lay him flat on his back. Raise your legs - this will help improve blood circulation - you can put a folded jacket under them.
• Provide better air access. Open the window, unbutton the patient's clothes, loosen the tie, take off the shoes. If the action takes place on the street - ask passers-by to disperse and give a place.
• Do not give the patient any food or drink. Do not give him any medicines - even those that are normally taken "from the heart."
• If you have a tonometer at hand, measure the pressure. If it is increased - give a pill to drink. If there is no tablet, apply cold under the lower jaw from the side and heat to the legs. Despite the fact that the body tries to compensate for the lack of oxygen in the brain by increasing pressure, pressure is more harmful than helpful and can provoke a blood clot.
• Follow the sick. Don't let him move. If vomiting starts - help, hold your head, clear the airways if something goes wrong.

The main thing in this situation is to prevent deterioration.

If the patient is unconscious, first aid becomes more difficult, but the basic principles - calmness, nothing is better than wrong, the primary call for an ambulance - do not change. First you need:

• check for breathing - you can see if the chest rises, evaluate if the nostrils tremble, if the lips turn blue, bring a mirror to your mouth, listen;
• check for a pulse - the easiest and most reliable way to check is through the carotid artery in the neck.

If there is no breathing and pulse, resuscitation should begin immediately:

If the patient's lips turn pink, he breathes again, the heart beats - or did not stop beating - you can proceed to simple first aid:

If an epileptic seizure starts - definitely not worth it:

• trying to unclench the patient's teeth in order to prevent tongue injuries - it is much more likely to cause injury on their own;
• trying to keep the patient in one position is a very high chance of injuring him.

It is worth moving away all solid objects that the patient can hit and detect the time of the onset of the attack. Then this information should be reported to the ambulance.

Two basic rules: "no panic" and "calling specialists is the main task."

Ambulance and hospital

Before the ambulance reaches the place, the task of the first aid provider is to hold out without allowing the condition to worsen. During this time, you should be inseparably with the patient.

When the ambulance arrives, you should:

• tell the doctors everything that is known about the sick person, describe the condition and hand over the documents - if the first aid provider has them;
• if necessary, help bring the patient into the car;
• follow him to the hospital - this is necessary for control.

If the patient is a relative, you should collect in advance everything that you may need - documents, hygiene items, a change of linen.

When the patient enters the hospital, nothing else is required from the assistant, the doctors will do the rest:

• examine, take tests and take an ECG;
• perform computed tomography;
• evaluate the results of analyzes and tomography;
• start basic therapy.

Basic therapy includes:

• with ischemic stroke - improving blood circulation, accelerating metabolism, increasing tissue resistance to oxygen starvation;
• with hemorrhagic stroke - removal of edema, correction of the level of pressure in the arteries and inside the skull.

At this time, the patient is in intensive care, doctors are trying to reduce the consequences for the body. When the pressure stabilizes, the patient begins to breathe on his own and regains the ability to communicate, he is transferred to a hospital. How long he stays there depends solely on the severity of the stroke.

After discharge, the patient will need to:

• limit yourself in bad habits and junk food;
• start engaging in gentle physical activity;
• go to physical therapy
• do physical therapy exercises.

If the stroke was not too strong and the first aid was provided correctly, he has every chance to recover.

If a relative has suffered a stroke, the task of his relatives is to ensure that he minimizes the likelihood of a second stroke.

Folk methods of help

Folk remedies seem dubious to doctors, but they can also help - the main thing is not to prefer them to treatment by a doctor, especially when it comes to a stroke.

Really working ways folk treatment and popular recommendations at the first sign of a stroke DOES NOT EXIST.

The most valuable thing you can do to help is to immediately call an ambulance.

Folk methods can be useful in order to prevent strokes. But we will talk about this in other articles.

Brief memo "algorithm of actions - first aid for a stroke before the ambulance arrives"

Long descriptions are good, but in a critical situation they can fall out of memory. It is easier to rely on a short memo:

1. Call an ambulance.
2. Determine if the person is conscious
   1. Does it breathe?
   2. Is there a pulse.
3. If conscious:
   1. Calm down.
   2. Lay so that the legs are higher than the head.
   3. Do not let move, do not give food and drink.
   4. Measure the pressure, give a pill if it is high.
4. If unconscious and not breathing:
   1. Clear the airways.
   2. Deliver a precordial blow.
   3. Begin chest compressions and artificial respiration.
5. If unconscious but breathing:
   1. Lay on the side.
   2. Tilt your head back and down a little.
6. Wait for the ambulance.

Stroke is not treated at home. A stroke is not treated if too much time has passed. A stroke is not treated if the first aid was given incorrectly.

That is why it is so important to follow the plan step by step, to act carefully and confidently, clearly remembering the signs and rules.

Perhaps one day this will save a life.

A video that explains as clearly and intelligibly as possible how to provide first aid for a stroke.

Stroke is an acute disorder cerebral circulation. Most strokes are caused by hypertonic disease and atherosclerosis, less often - valvular heart disease, myocardial infarction, congenital anomalies of cerebral vessels and arteritis.

At the prehospital stage it is necessary:

Free the airways from vomit; introduce an air duct, if necessary - a ventilator;

Give the head an elevated position to reduce intracranial pressure, put ice on the head. With urinary retention, it is necessary to drain the urine with a catheter; cleanse the intestines with a cleansing enema;

First aid for stroke

Stroke is one of the most dangerous diseases of cardio-vascular system. According to statistics in Russia, every minute someone has a violation of cerebral circulation - stroke. including microstroke. Stroke occurs even more often than myocardial infarction.

Mortality from stroke in the first month is 20-25%, in the first year more than 1/3 of patients die from complications caused by impaired cerebral circulation, and 30-40% become disabled. Such depressing statistics are caused not only by the severity of the disease, but also by untimely (unqualified) assistance. Patients who received qualified medical care in the first three hours (maximum 6) have a chance to fully (as far as possible) restore all the functions lost as a result of a stroke. This period (3 hours) even got its name "therapeutic window", then irreversible pathological changes begin.

All patients with such a diagnosis should be hospitalized - especially if cerebrovascular accidents occurred at work, on the street, in transport. The doctor, having made a Computed or Magnetic Resonance Imaging, must determine what caused the violation of cerebral circulation: blockage of blood vessels or hemorrhage. If this is a hemorrhage (Hemorrhagic stroke), then in which place it occurred, it is also necessary to restore the work of the vessels as soon as possible and remove the blood. If there is a blockage of blood vessels, then the doctor will inject a drug that dissolves the blood clot.

The first symptoms of a stroke

The disease proceeds individually for everyone. The symptoms of a stroke depend on what type of stroke the person has and what area of ​​the brain is damaged. The most common symptoms:

• headache;
• dizziness, sometimes accompanied by nausea. vomiting;
• possible loss of consciousness;
• weakness, numbness in half of the face, paralysis in the arm, in the leg;
• violation of speech, memory, ability to reason logically;
• promotion pain in half of the body.

If at least two of the above symptoms appear in you, a family member, a colleague, it is a reason to immediately call an ambulance. Describe the symptoms to the dispatcher so that the ambulance team arrives well prepared, with a planned action plan. Do not self-medicate, remember that you have three hours to return to normal life.

Actions before the arrival of the doctor

The patient must be laid down, putting a pillow under his head, shoulders and shoulder blades, so that the head makes an angle of approximately 30 ° to the bed, floor, bench. Provide access fresh air, to do this, remove tight clothing, unbutton the shirt collar, open the window, if there is an air conditioner, turn it on. Remove removable dentures.

If there is vomiting, turn your head to the side, wrap your hand with a clean handkerchief or gauze and clean your mouth of vomit. Throwing them into the respiratory tract threatens with a severe form of pneumonia, which will then be difficult to fight.

Be sure to measure your blood pressure. It used to be considered: if it is increased, it should be reduced to 120/80 mm Hg. Art. A sharp decrease in pressure is no less dangerous than its high values! What to do? Usually a person knows his "working" numbers. For example, he feels good at 150/80 mmHg. Art. It is necessary to focus on numbers that exceed the "working" ones by 5-10 mm Hg. Art. and give an antihypertensive drug (preferably the one to which the victim is accustomed, uses in everyday life). A sharp drop in blood pressure can increase the focus of ischemia, which in turn will cause new disorders, in particular, paresis can turn into paralysis.

Something to relieve pressure? Are you afraid of overdosing your medicine? Do not be alarmed and consider if blood pressure has increased to 180 mm Hg. Art. in a person who did not suffer from arterial hypertension, and up to 200 mm Hg. Art. - in hypertensive patients, this is not very scary. Better not to correct it at all. You can resort to non-drug methods: ask the patient to inhale deeply and hold the breath for as long as possible. It is very important to measure the pulse. After all, some types of stroke are caused just by atrial fibrillation. If the pulse "breaks", give the patient the drug that he usually takes in such cases. Do not self-medicate, do not inject any drugs that affect the vessels and structures of the brain! Glycine (aminoacetic acid) may be recommended. In a critical situation, it is recommended to give it one gram (10 tablets under the tongue) per dose or 5 tablets 3 times with an interval of 30 minutes. It will not bring any harm and will ease the course of the disease.

If the stroke attack happened on the street, your steps to help are similar. Ask someone to call an ambulance. Lay down the victim. Make sure that he does not choke on vomit, provide air access by unbuttoning the buttons, belt, belt. The decision is always unequivocal - you need to take him to the hospital. If it is not possible to call an ambulance, take the patient by any means of transport, remember the "therapeutic window".

If you use personal transport, then unfold the car seat, lay the patient down (at an angle of 30 °), be sure to remove dentures, turn his head to one side and make sure that he does not choke on his own saliva or vomit. Do not forget the sphygmomanometer, measure your blood pressure and pulse. Even if you have nothing to correct them, information about the changes will help doctors make a correct diagnosis and quickly begin adequate treatment.

First aid for stroke

A stroke is a violation of cerebral circulation. The arteries supplying blood to the brain may become clogged, and then an ischemic stroke occurs, or an artery may rupture and this is a hemorrhagic stroke. Thus, as a result of this vascular catastrophe, part of the brain is left without a normal blood supply, experiencing oxygen starvation. As a result of hypoxia - a lack of oxygen in the tissues, nerve cells die. This leads to a variety of neurological symptoms, it can be a complete or partial loss of speech, memory lapses, paralysis of body parts (hemiparesis).

Among all strokes, the ischemic variant occurs in 80% of cases. Blockage of the arteries supplying the brain with oxygenated blood is most often caused by cholesterol deposits. Ischemic strokes most often occur against the background of low blood pressure and occur mainly in the morning. If the artery is not very large in diameter, then the clinic of such a stroke develops gradually, begins with weakness, dizziness, numbness of the face, arm and (or) leg on one side, visual and speech disorders may occur, the corners of the mouth become asymmetrical, headache may occur , loss of balance. When blocking a large diameter artery, it is extremely difficult to make a differential diagnosis between ischemic and hemorrhagic stroke at the prehospital stage.

A cerebral hemorrhage (hemorrhagic stroke) occurs when a blood vessel ruptures and the surrounding tissues fill with blood. This disrupts the normal blood flow to the brain, the outflow of blood compresses the brain tissue, leading to further damage. Most often hemorrhagic strokes occur as a result of high blood pressure.

With a decrease in the lumen of the vessels supplying the brain with blood and, accordingly, a deterioration in its nutrition, it is necessary to prescribe drugs that reduce blood clotting (blood thinning) - this may be aspirin, which is used enough long time¼ tablet a day, or newer drugs - warfarin, at a dose prescribed by the attending doctor. The drug clopidogrel or zylt is now being used, which is also recommended by neurologists as a disaggregant, including at the prehospital stage.

What to do

Urgent care in severe stroke at the prehospital stage does not require an accurate definition of its nature (hemorrhage or ischemia). The basic principles of such emergency assistance are to create conditions for the normalization of the vital functions of the body - this is breathing and blood circulation, the fight against cerebral edema. Respiratory disorders during loss of consciousness may be due to impaired airway patency, which means that it is necessary to exclude the retraction of the tongue, the ingress of vomit into the trachea and bronchial tree, and for this the patient's head must be turned to one side. According to modern recommendations of neurologists, blood pressure correction is carried out only if it significantly exceeds normal values, since low blood pressure in stroke patients usually leads to a worsening of its condition and further prognosis.

The patient needs to provide oxygen supply, drugs with antihypoxic action are prescribed. To date, preference is given to the drug - mexidol, which must be administered intravenously, at a dose of 5 milliliters, diluted in saline. Of the drugs that improve cerebral circulation, neurologists today recommend the use of a magnesium sulfate solution at the prehospital stage. From the use of aminophylline in strokes, they have now moved away and are no longer recommended. With the threat of cerebral edema, oxygen therapy continues, diuretics (lasix) are prescribed. In case of seizures - anticonvulsant therapy (Relanium). The patient should be hospitalized in the vascular center, in the primary vascular department, or in the nearest medical institution with an intensive care unit, since quite often such patients require intensive care, including resuscitation.

Prevention measures are to protect the vessels, and this is, first of all, quitting smoking, since nothing destroys the vascular wall as much as the components tobacco smoke(and there are more than three hundred components!), control and treatment of arterial hypertension, diet, regular physical exercise. It is worth recalling that 80% of our health, according to WHO, depends on our lifestyle.

A stroke is a heart attack of the substance of the brain, which occurs as a result of a lack of blood circulation in the pool of any of the cerebral arteries.

With a stroke, there is a decrease or cessation of blood flow in certain structures of the brain. There are two types of strokes: ischemic and hemorrhagic. In the first case, a violation of cerebral circulation occurs due to a lack of blood flow, in the second, a rupture of the vascular wall and a hemorrhage into the brain occur. In both cases, the brain cells suffer due to a lack of nutrients and oxygen, as a result of which their destruction begins, and if first aid for a stroke is not provided on time, then irreversible changes in the brain may occur, followed by disability of the victim. Often, a stroke can result in death.

Causes of a stroke

As mentioned above, cerebrovascular accident can be the result of blockage of the vessel or hemorrhage.

Causes of blockage:

• thrombosis (the formation of blood clots in the vessels of the brain, which is most often the result of atherosclerosis);
• embolism (entry of an embolus (foreign particle) into the cerebral arteries, for example, fatty embolism of the brain in fractures of long tubular bones).

The causes of rupture of the cerebral artery and hemorrhage are:

• arterial hypertension;
• congenital thinning of the vessel wall (aneurysm).

The development of a stroke is also provoked by the abuse of fatty foods, excess weight, smoking, and alcohol abuse.

Signs of cerebrovascular accident

In order to recognize a stroke in time, you need to know its signs, which include:

• a sharp increase or decrease in blood pressure;
• sudden and severe headache, nausea, vomiting, flies flickering before the eyes - symptoms of increased intracranial pressure;
• incoordination or loss of consciousness;
• speech disorder;
• decreased vision or double vision;
• violation of orientation in time and space, in relation to oneself;
• unilateral paralysis and paresis of the limbs or any half of the face;
• tremor (trembling) of the tongue or its deviation in any direction.

First aid for stroke

If you suddenly notice signs of impaired blood circulation in the brain in someone from your environment, then you should act immediately. First aid for a stroke is an ambulance call. If you call an ambulance in time, you will have already done almost everything to save a person from the consequences of a stroke.

While the ambulance is moving, you can do the following:

• reassure the patient, as fear and excitement only exacerbate the symptoms of a stroke; at the same time, you can give the patient valerian tincture and / or moisten it upper lip under the nose;
• loosen the shirt collar or trouser belt;
• give the patient's head an elevated position;
• provide access to fresh air in the room;
• if you caught a stroke at home, and there is a tonometer at hand, then you need to measure blood pressure, and if it is high, give the patient to drink the appropriate drugs prescribed to the patient earlier. In addition, with increased pressure, you can lower the patient's legs into the pelvis with hot water in order to redistribute blood and reduce pressure in the system of cerebral arteries;
• in case of loss of consciousness, lay the victim in such a way that the head lies on its side in order to prevent aspiration of vomit (with a stroke, there may be vomiting). If vomiting still occurs, you need to clear the airways from gastric contents. In addition, you need to pay attention to whether the tongue has sunk, and if this is the case, pull the tongue out;
• no need to give the patient vasodilators;
• no need to drink or feed the patient.

If the case is not particularly severe, then emergency care for a stroke may consist of a massage of the forehead and temples with a gradual transition to the occipital region. You can also massage the collar zone and large joints of the limbs. In addition, with a mild stroke, acupressure may be useful.

It also happens that the victim at the time of the stroke is driving a car. In such situations, due to a violation of cerebral blood flow, not only the driver himself, but also other road users can suffer. Medical assistance here will be as follows:

• call an ambulance;
• open the windows in the car, and it is better to help get out of it;
• measure blood pressure and, if it rises, give the drug that the doctor prescribed to the patient; if the pressure figures are unknown to you, then it is better to avoid taking the drugs and try to take the victim to the hospital;
• if trouble caught you in nature, you can put your feet in a bowl of hot water;
• in case of loss of consciousness, check the adequacy of air access, exercise control over breathing and pulse, in the absence of a pulse, proceed to an indirect heart massage.

After the ambulance arrived at the call, and the first medical aid was provided, it is better to accompany the patient personally to the place of hospitalization (and it is shown to such patients in 100%). Indeed, in a hospital, you can give the attending physician maximum information about the patient and the disease itself. In addition, it is worth making sure that the victim is given a computed tomography of the brain, which will help to reliably determine whether there is a violation of cerebral circulation, as well as a more specific localization of the pathological process.

Remember that if, with symptoms of a stroke, first aid is provided to the patient in the first three hours from the onset of the disease, then the victim has a significantly increased chance of surviving and not remaining a severely disabled person after a stroke.

You also need to know that cerebrovascular accident is better to prevent than to treat later. Therefore, at the first signs of this disease or the presence of arterial hypertension, it is necessary to carefully examine and further adjust the blood pressure figures throughout life.

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 conditions medical institution continue all those activities that were provided at the prehospital 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 involve immersing the person's legs in hot water to drain blood from the head, but never give any medicines from heart spasms and the like, since 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.