First aid algorithm for suspected stroke. Hemorrhagic cerebral stroke - causes, symptoms, diagnosis, treatment and rehabilitation. Identify objective signs of stroke

A stroke is an acute disturbance of blood circulation in the vessels of the brain, resulting from blockage of the brain vessels by a thrombus or plaque (ischemic, about 80% of the total number of strokes) or due to hemorrhage (hemorrhagic).

Urgent Care in case of stroke, it plays an important role in preserving the life and capacity of the patient.

Everyone should know the signs of a stroke and be able to provide first aid. A delay of 10-15 minutes can cost a person his life.

General cerebral (nonspecific) disorders are considered to be those that indirectly indicate a stroke:

sudden short-term loss of consciousness;
state of stupefaction - reaction to external stimuli very inhibited, the person is in a confused state of consciousness;
lack of normal orientation in space and time;
severe headache leading to vomiting;
a feeling of intense paroxysmal heat, chills and excessive sweating (usually characterized as “either hot or cold”);
there is a rapid heartbeat;
bouts of severe thirst, dry mouth.

Stroke is the second leading cause of death in Russia. This is a serious pathology, leading to disability or death in 87% of cases. Only 13% of stroke patients are successfully treated and make a full recovery. But half of people who survive their first stroke develop a second cerebrovascular accident over the next 5 years.

Symptoms of focal (specific) brain damage:

movement disorders (weakness in the limbs, inability to perform simple actions);
paresthesia - sensations of tingling, goosebumps, numbness;
“crooked smile”, when when a person tries to smile, the muscles of only one half of the face contract;
speech pathologies and disorders - a person is unable to speak clearly and coherently;
nystagmus - involuntary frequent oscillatory movements of the eyeball;
various visual impairments, including double vision - diplopia.

For reliable diagnosis, MRI (magnetic resonance imaging) or CT (computed tomography) studies are performed. In the first 12-24 hours, CT results may not show the affected area, so MRI diagnostics is considered more preferable.

Not all hospitals can afford prompt MRI, CT scanning and instant interpretation of the results.

Therefore, in most cases, diagnosis is limited to a general examination of the patient, echoencephalography (EEG) and lumbar puncture.

A lumbar puncture is the removal of a small amount of cerebrospinal fluid for examination through a puncture in the lumbar region.

Differentiated diagnostics are carried out to determine what type of brain damage occurred in the patient:

Symptoms	Ischemic infarction	Hemorrhagic infarction	Subarachnoid hemorrhage*
Start	Slow motion	Fast - from a few hours	Instant - 1-5 minutes
Headache	Minor	Sharp, pronounced	Sharp, strong
Nausea or vomiting	Not typical (only with brainstem lesions)	Accompanying	Accompanying
Increased blood pressure	Very characteristic	Very characteristic	Absent
State of consciousness	Short term loss	Prolonged loss of consciousness	Temporary loss (several minutes)
Increased tension (rigidity) of the neck muscles	Absent	Occurs frequently	Characteristic sign
Paresis and paresthesia		Develop frequently, from the very beginning of the disease	Develop rarely and are not characteristic of the onset of the disease
Speech disorders	Typically (often)	Typically (often)	Rarely, speech is usually preserved
Impurities in the cerebrospinal fluid during lumbar puncture	Colorless	Blood mixed	Bloody
Bleeding in the eye (retina)	Absent	Often missing	Occurs frequently

*common type of hemorrhagic stroke

**transient ischemic attacks - micro-strokes

A person with a stroke is similar to an alcoholic: a state of confused consciousness, cannot speak clearly, staggers when walking and is not oriented in space, and may lose consciousness.

That is why it is very important not to be indifferent to people lying on the ground and try to help them as needed.

We will consider the signs of stroke in men and first aid methods at the link. How to recognize an impending attack in time?

Emergency care: algorithm of actions

It is not entirely correct to talk about emergency care for hemorrhagic and ischemic stroke.

Emergency care is provided for pathologies and conditions that do not directly threaten the patient’s life ( heat, shooting pain in the ear, mild or moderate injuries, toothache, etc.).

Patients with suspected stroke are provided with ambulance or emergency care.

Control of breathing, heartbeat, blood pressure.
Stabilization of blood pressure - intravenous administration of Dibazol, Droperidol, Clonidine.
At hemorrhagic stroke hemostatic agents and angioprotectors are administered: Etamsylate, Cyclonamine, Dicynon.
Relief of convulsive syndrome if present: Diazepam, Sibazon.
Emergency hospitalization to a hospital.

Hospitalization is indicated in 100% of cases. Treatment of stroke at home is impossible, since monitoring the patient's condition is required.

First aid for stroke at home

The first thing to do if you suspect a stroke is to call ambulance.

Algorithm for independent actions when providing first aid:

Ensure influx fresh air. It is necessary to loosen your tie or collar and open a window if this happens indoors.
The victim is placed on a horizontal surface, raising the head end of the body. You can use removed outer clothing, pillows, bags or any other soft cushion. If it is not possible to lay the person down, it is recommended to give him a semi-sitting position.
If vomiting occurs, it is necessary to clear the airways of vomit.
If you are very thirsty, you can give a small amount of water, but carefully ensure that the patient does not choke. This can occur due to paralysis of the muscles of the face, neck and larynx.
In rare cases, convulsions begin, but if this happens, you need to lay the patient down and turn his head to the side. You must try to open your jaws and insert something soft - a napkin, a towel, a sweater sleeve. This will prevent tongue biting, teeth chipping, and jaw fractures.

It is necessary to reduce the victim's movements to a minimum. It’s better not to ask him to move to another place, not to try to move him yourself. This can cause more extensive brain damage.

Hospitalization

If a stroke is suspected, the patient is hospitalized without delay, without fail.

Hospitalization to a neurological or neurosurgical hospital, intensive care unit or intensive care unit is indicated.

The duration of treatment depends on the severity of brain damage, the effectiveness of therapy, and the dynamics of the patient’s condition.

Stroke can affect anyone, especially those over 35 years of age. Excess weight, hypertension, diabetes, smoking and alcoholism increase the risk of stroke.

Video on the topic

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

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Symptoms of a stroke

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

sudden acute headache;
fainting;
weakness;
speech, vision, hearing impairments;
convulsions;
nausea;
vomit;
asymmetry on the face;
paralysis (if the right hemisphere of the brain is damaged, the left side of the body is taken away and vice versa).

Signs of a stroke

But it should be noted that men and women often have their own characteristics when it comes to stroke.

Features in men

If a man has a stroke on the street, passersby often assume that he is intoxicated. This is due to the similarity of some features:

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

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

Features in women

In addition to general symptoms, women experience 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;
exposure to stress and strong emotionality.

It is much more common in women early signs onset of 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 based on symptoms at home. It makes a huge difference though. After all, both PMP and subsequent treatment vary significantly depending on the type.

Extensive stroke is divided into:

1. Ischemic.
2. Hemorrhagic.

But there is also a micro-stroke.

Microstroke

This disease contributes to the development of a major stroke. A microstroke is a circulatory disorder in the brain tissue that leads to cell death. Most often this occurs due to the formation of clots in the blood.

Microstroke

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

dizziness;
headache;
sensitivity to loud sounds and bright lights;
sudden jumps in blood pressure;
feeling of numbness of the face and/or limbs;
general poor health, weakness;
loss of consciousness;
confusion of thoughts;
impaired coordination and balance.

If you detect only a few symptoms, you should immediately consult a doctor. Correct and timely treatment will prevent the occurrence of more serious disorders.

Ischemic stroke

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

thrombosis;
arterial blockage;
vascular insufficiency.

At risk are people who suffer from atherosclerosis and diabetes mellitus, mainly elderly (after 60 years).

Hemorrhagic stroke

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

This type of stroke mainly affects people 40–60 years old. The risk group consists of obese patients who lead a sedentary or unhealthy lifestyle (smoking, alcohol abuse).

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 disease you go to a medical facility. At the first signs, it is necessary to call an emergency room and provide first aid.

Before medical workers arrive, you should:

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

Further medical care

Upon arrival, doctors will try to determine which type of stroke affected the patient and take the necessary treatment measures even before hospitalization, if possible. Most often, emergency doctors lower blood pressure and transport the patient to the neurological department. There, the patient is prescribed and urgently undergoes the necessary laboratory tests. Treatment methods directly depend on test results. During this period, self-administration of not prescribed medicines like death. The doctor’s prescriptions will necessarily include the following medications:

reducing blood pressure;
antiplatelet agents or anticoagulants;
normalizing blood cholesterol levels;
B vitamins.

Even if the crisis situation was 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 senses.

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

Prevention

In short, then preventive measures can be called leading the right image life. It is necessary to monitor blood pressure, cholesterol and blood sugar levels. Morning work-out And proper nutrition will help maintain the body in good shape for many years.

From this article you will learn: what first aid should be for a stroke. Features of emergency measures at home and on the street, depending on the type of stroke.

Article publication date: November 25, 2016

Article updated date: 05/25/2019

First aid measures for stroke are a set of actions and measures aimed not only at saving the patient’s life. The possibility of restoring damaged brain cells and functional abilities depends on the time and correctness of its provision. nervous system. According to foreign and domestic experts, the optimal time for delivering a patient to medical institution– 3 hours from the moment of illness (the sooner the better).

What should be done first when a person has a stroke?

Wherever the stroke occurs and no matter what the stroke is, both the patient himself (if his condition allows) and those around him must act according to a clear algorithm:

Do not panic!!!
Assess the patient’s general condition: consciousness, breathing, heartbeat, blood pressure.
Define obvious signs stroke: unilateral paralysis of the arms and legs, distorted face, speech impairment, lack of consciousness, convulsions.
Call an ambulance by calling 103!
Find out the circumstances of the illness (briefly if possible).
Provide resuscitation measures (artificial respiration, cardiac massage), but only if they are necessary (lack of breathing, heartbeat and dilated pupils).
Position the patient correctly - on his back or side, either with his head and torso slightly elevated, or strictly horizontally.
Provide conditions for good oxygen access to the lungs and blood circulation throughout the body.
Monitor the patient's condition.
Arrange transportation to the nearest hospital.

The emergency care described above is general and does not include some situations that are possible during a stroke. The sequence of events does not always have to be strictly the same as in the given algorithm. In case of critical impairment of the patient's condition, one has to act very quickly, performing several actions simultaneously. Therefore, if possible, 2-3 people should be involved in providing assistance. In any case, following the algorithm, you can save the patient’s life and improve the prognosis for recovery.

Detailed description of all emergency steps

Each activity that includes first aid for a stroke requires proper execution. It is very important to adhere to subtleties, since any “little detail” can be fatal.

No fuss

No matter how serious the patient’s condition, do not panic or fuss. You must act quickly, harmoniously and consistently. Fear, fuss, haste, and unnecessary movements lengthen the time it takes to provide assistance.

Reassure the patient

Every conscious person with a stroke is definitely worried. After all, this disease is sudden, so the body’s stress reaction cannot be avoided. Anxiety will aggravate the condition of the brain. Try to reassure the patient, convince him that everything is not so scary, this happens and doctors will definitely help solve the problem.

Call an ambulance

Calling an ambulance is the first priority. Even the slightest suspicion of a stroke is an indication to call. Specialists will better understand the situation.

Call 103, tell the dispatcher what happened and where. It will take no more than a minute. While the ambulance is on the way, you will provide emergency care.

Assess your general condition

First of all, pay attention to:

Consciousness: its complete absence or any degree of confusion (lethargy, drowsiness) is a sign of a severe stroke. Mild forms are not accompanied by impaired consciousness.
Breathing: it may not be impaired, or it may be absent, intermittent, noisy, frequent or rare. Artificial respiration can be performed only in the complete absence of respiratory movements.
Pulse and heartbeat: they can be clearly audible, rapid, arrhythmic or weakened. But only if they are not defined at all, you can do .

Assess the patient's condition and determine the need for cardiopulmonary resuscitation

Identify the signs of a stroke

Stroke patients may have:

severe headache, dizziness (ask what is bothering the person);
short-term or persistent loss of consciousness;
distorted face (ask him to smile, bare his teeth, stick out his tongue);
impaired or lack of speech (ask to say something);
weakness, numbness of the arms and legs on one side, or their complete immobility (ask them to raise their arms in front of you);
visual impairment;
impaired coordination of movements.

Lack of consciousness or any combination of these signs is a high probability of a stroke.

Correct position of the patient

Regardless of whether the consciousness and general condition of a stroke patient is impaired or not, he needs rest. Any movements, especially independent movement, are strictly prohibited. The position could be:

It is forbidden to turn a person on his stomach or lower his head below his body position!

If there are cramps

Convulsive syndrome in the form of severe tension of the whole body or periodic twitching of the limbs is a sign of a severe stroke. What to do with the patient in this case:

Lay on your side with your head turned to prevent saliva and vomit from entering your respiratory tract.
If you can, place any object wrapped in cloth between the jaws. It is rarely possible to do this, so do not make much effort - it will do more harm than good.
Do not try to push the jaws apart with your fingers - this is impossible. Better grab the corners of the lower jaw, try to bring it forward.
Do not insert your fingers into the patient's mouth (risk of injury and loss of a finger).
Keep the patient in this position until the convulsions end. Be prepared for the possibility that they may happen again.

On the importance of the circumstances of the disease

If possible, find out exactly how the person got sick. This is very important, since some symptoms of stroke can also be observed in other diseases:

traumatic brain injury;
diabetes mellitus;
brain tumors;
poisoning with alcohol or other toxic substances.

Resuscitation: conditions and rules

An extremely severe stroke, affecting vital centers, or accompanied by severe cerebral edema, occurs with signs of clinical death:

complete lack of breathing;
dilation of the pupils of both eyes (if only one pupil is dilated - a sign of a stroke or hemorrhage in the hemisphere on the affected side);
complete absence of cardiac activity.

Follow these steps:

Place the person on their back on a hard surface.
Turn your head to the side, use your fingers to free the oral cavity from mucus and foreign objects (dentures, blood clots).
Throw your head back well.
Grab the corners of the lower jaw with 2–5 fingers of both hands, pushing it forward, at the same time thumbs open the patient's mouth slightly.
Artificial respiration: cover the patient’s lips with any cloth, and, pressing your lips tightly, take two deep breaths (mouth-to-mouth method).
Heart massage: Place your right hand on top of your left (or vice versa), interlocking your fingers. Applying your lower palm to the junction of the lower and middle parts of the patient's sternum, apply pressure to the chest (about 100 per minute). Every 30 movements should alternate with 2 breaths of artificial respiration.

What medications can be given for a stroke?

If an ambulance is called immediately after a stroke occurs, it is not recommended to give the patient any medications on your own. If delivery to the hospital is delayed, the following drugs (preferably in the form of intravenous injections) help support brain cells at home:

Piracetam, Thiocetam, Nootropil;
Actovegin, Ceraxon, Cortexin;
Furosemide, Lasix;
L-lysine escinate.

Self-help for stroke

The ability to help yourself with a stroke is limited. In 80–85% of cases, a stroke occurs suddenly, manifested by a sharp deterioration in condition or loss of consciousness. Therefore, patients cannot help themselves. If you experience stroke-like symptoms:

take a horizontal position with the head end raised;
tell someone you feel bad;
call an ambulance (103);
adhere to strict bed rest, do not worry and do not move excessively;
release the chest and neck from constricting objects.

Helping yourself if you have a stroke

If the stroke is ischemic

Ideally, even first aid for a stroke should take into account the type of disease. An ischemic stroke is most likely if:

arose in the morning or at night at rest;
the patient's condition is moderately impaired, consciousness is preserved;
signs of speech impairment, weakness of the right or left limbs, facial distortion are expressed;
no cramps.

For such patients, first aid is provided according to the classical algorithm described above.

If the stroke is hemorrhagic

Symptoms that speak in favor:

arose abruptly at the height of physical or psycho-emotional stress;
there is no consciousness;
have convulsions;
the neck muscles are tense, it is impossible to bend the head;
high blood pressure.

In addition to standard care, such patients need:

The position is strictly with the head end elevated (except for convulsions or resuscitation).
Applying an ice pack to the head (preferably to the half in which hemorrhage is suspected - opposite to the immobilized tense limbs).

Features of providing assistance on the street

If a stroke occurs on the street, first aid has the following features:

Involve several people to help. Organize the actions of each of them, clearly distributing responsibilities (someone calls an ambulance, and someone assesses the general condition, etc.).
Having placed the patient in the desired position, free the neck and chest to make it easier for him to breathe (remove the tie, unfasten the buttons, loosen the belt).
Wrap up the limbs, cover the person with warm clothes (in cold weather), massage and rub them.
If you have a mobile phone or contacts with relatives, inform them about what happened.

Features of providing assistance at home or in any enclosed space

If a stroke occurs indoors (at home, in an office, in a store, etc.), then in addition to standard first aid, pay attention to:

Free access of fresh air to the patient: open the window, door.
Release your chest and neck.
If possible, measure your blood pressure. If it is elevated (more than 150/90 - 160/100 mmHg), you can give antihypertensive drugs under the tongue (Captopress, Farmadipin, Metoprolol), lightly press on the solar plexus or on closed eyes. If it is low, raise your legs, but do not lower your head, massage the area of the carotid arteries on the sides of the neck.

How to provide first aid for a stroke indoors

First aid effectiveness and prognosis

According to statistics, correctly provided emergency care for stroke patients with delivery to a medical facility within the first three hours:

saves the lives of 50–60% of patients with severe massive strokes;
in 75–90% it allows people with minor strokes to fully recover;
improves the recovery abilities of brain cells by 60–70% in case of any stroke (better in case of ischemic stroke).

Remember that a stroke can happen to anyone at any time. Get ready to take the first step to help fight this disease!

Contents of the article: classList.toggle()">toggle

A stroke, or acute circulatory disorder, is an emergency condition in which blood flow to a specific area of the brain is cut off. The consequences of an acute condition are very serious, so it is necessary to provide first aid for a stroke as quickly as possible.

First aid for the first symptoms of a stroke should be provided in as soon as possible. This will help save the patient’s life and minimize possible complications and consequences.

What to do in case of a stroke before the ambulance arrives

First aid is provided without the use of any medications, as this can only worsen the condition. You should also not disturb or revive the patient using ammonia.

The first action when the first signs of a stroke appear is to call an ambulance. And begin to help the victim.

Algorithm of actions for providing first aid for a stroke before the ambulance arrives:

The person providing assistance should calm down. All actions must be clear, coordinated and fast. Panic and fuss will lead to patient anxiety and interfere with the provision of effective care;
Place the patient in a forced position. Or rather, lay him on his back with the head end raised or on his side (if there is no consciousness, then this position will help to avoid aspiration of vomit);
Assess the patient’s condition, namely: is the person conscious, does he have a pulse and breathing;

Provide fresh air flow. To do this, open a window or door, unfasten restrictive clothing (collar, tie, belt);
If the patient is conscious, then reassure him and always be nearby and note the changes that occur (for example, deterioration of his condition);
If the patient is unconscious, then it is necessary to monitor the condition. As soon as cardiac and respiratory arrest is detected, begin performing cardiopulmonary resuscitation ();

If the patient has convulsions, it is necessary to hold him firmly so that he does not hit his head. You need to insert a stick or spoon wrapped in cloth between your teeth;
Stay close to the victim until the ambulance arrives.

Emergency assistance to the victim

First aid for a stroke is provided by ambulance doctors. Upon arrival to the call, the specialist, when providing emergency medical care, assesses the patient’s condition, measures his blood pressure and determines his pulse.

The procedure for providing emergency medical care for a stroke is as follows:

How to help yourself

Most often, a stroke develops suddenly, the patient suddenly becomes ill and loses consciousness. Therefore, in this case, it is impossible to help yourself.

This
healthy
know!

If a person feels unwell, but is conscious and the symptoms resemble a stroke, then you need to give yourself first aid:

Tell any person who happens to be nearby that you feel unwell. There is no need to be embarrassed to ask strangers on the street for help. This could save your life;
Take a forced position. Namely, lie down in bed or on another horizontal plane. Place something under your head so that the head end is higher than the body (at an angle of about 30 degrees, no more);
Call an ambulance yourself or ask someone to do it. Describe your condition to the dispatcher in detail and tell where you are;
Open the windows and unbutton your clothes;
Try to calm down and not panic. Wait for the ambulance to arrive in a lying position, do not make sudden movements.

Drug therapy

Drug assistance for stroke is provided only medical workers. First aid at home does not involve the use of drugs.

When providing assistance for stroke, several groups of drugs are used.

Group of drugs	Drug name	Effect of the drug
Antiplatelet agents	Aspirin	Thinning the blood and preventing blood clots. Used for ischemic stroke
Antiplatelet agents	Pentoxifylline	Improves blood microcirculation in the affected area of the brain, prevents the formation of blood clots
Anticoagulants	Heparin	Prevents the growth of already formed blood clots and prevents new ones from appearing. For ischemic stroke
Vasoactive drugs	Eufillin	Dilation of blood vessels by relieving spasm from them
	Vinpocetine	Improving cerebral circulation and metabolism in brain cells and tissues
Muscle relaxants	Mydocalm	Helps relieve muscle hypertonicity, used for convulsive status
Enzymes	MASP 2	This is a modern drug that is injected into the abdominal wall. The administration must be carried out by a doctor in a hospital setting. The drug helps: improve brain microcirculation, restore damaged tissue, minimize the likelihood of developing severe complications. It should be noted that it is advisable to use the drug only in the first 3 hours of the development of pathology. There is no point in introducing it later, it will not work

What to do if a person becomes ill on the street

A stroke can develop at any time, so a person can feel ill even on the street. Therefore, it is necessary to clarify what first aid should be on the street and what its features are.

First aid for ischemic or hemorrhagic stroke:

If you see a person lying on the street, then you need to approach and ask if he needs help;
Invite other passers-by to help. This will help you act faster. Someone calls an ambulance, and someone at this time examines the victim and checks the pulse and breathing;
Lay the person directly on the asphalt on his side if he is unconscious. Or on his back, and put something under his head, maybe a bag (if he is conscious);
If it is cold outside, the patient must be covered (any outerwear, for example, a jacket). Hands and feet should be gently rubbed to keep them warm;
If possible (for example, the victim’s cell phone or a notebook with contacts), then inform close people about what happened;
Do not leave the person until paramedics arrive.

First aid for stroke at home

If a person experiences signs of a stroke at home, he needs help. What to do if you have a stroke at home?

Providing 1 assistance for stroke at home:

Call an ambulance;
Lay the victim on his back with his head raised or on his side (if there is no consciousness, this position will help avoid aspiration of vomit);
Open windows and doors to provide fresh air. IN winter time set the ventilation mode and cover the patient so that he does not freeze;

Even if the patient has minor manifestations of pathology and the condition is stable, hospitalization is still necessary.

Symptoms of the pathological process

There are 2 types of acute circulatory disorders:

Hemorrhagic. Characterized by damage to the blood vessels of the brain and hemorrhage in its tissue;
Ischemic. It is characterized by a sudden cessation of nutrition to a certain area of the brain due to spasm of blood vessels, blockage of the lumen of the vessel by a thrombus, and so on.

Characteristic pathological symptoms of hemorrhagic stroke:

Occurs after excessive physical activity or severe psycho-emotional stress;
A significant increase in blood pressure is detected;
Consciousness is often absent or confused;
Overstrain of the muscles of the neck and occipital region, which makes it impossible to bring the head to the chest;
Convulsions occur.

Characteristic signs of ischemic stroke:

State saved;
Occurs at rest;
No cramps or muscle tension are observed;
Facial asymmetry;
Paralysis of one side of the body;
Speech impairment.

Causes of acute circulatory disorders

The absolute causes of stroke are:

Rupture of the artery of the arachnoid membrane of the brain;
Blockage of a blood vessel by a thrombus or atherosclerotic plaque;
Sharp and persistent spasm of cerebral vessels.

It should be noted that ischemic stroke is more often diagnosed, with a more favorable prognosis.

Predisposing factors for ischemic stroke:

Hypertension, especially with a malignant course;
Elderly age;
Hereditary predisposition (there are close relatives who had a stroke);
Heart disease (ischemia, arrhythmias);
Bad habits (smoking, alcohol abuse);
Osteochondrosis of the cervical spine;
Diabetes;
Obesity;
Sedentary lifestyle;
Frequent stress;
Drug use.

Etiological factors of hemorrhagic stroke:

Hypertonic disease;
Increased fragility of blood vessels;
Malignant neoplasms;
Drug use;
Hemorrhagic diathesis;
Long-term use of anticoagulants (blood thinning drugs).

Hospital treatment

A patient with a stroke is admitted to the hospital. In the first few days he will be in the intensive care unit (resuscitation) under the supervision of a resuscitator, neurologist and, if necessary, a neurosurgeon.

In which department do they go with a stroke? This depends on the type of treatment, which is prescribed after a thorough examination and laboratory and instrumental diagnostics.

If surgery is required, the patient is placed in the neurosurgical department.

When treatment is conservative, it is carried out in the neurological department.

The attending physician prescribes treatment aimed at:

Normalization of intracranial and blood pressure;
Elimination of cerebral edema;
Restoration of damaged tissues;
Increasing the strength of vascular walls and blood clotting abilities;
Restoration of impaired functions.

How long do people stay in hospital with a stroke? The duration of treatment is strictly individual and depends on the severity of the patient’s condition, the extent of brain damage and lost functions of the nervous system.

Psychological rehabilitation

Recovery after a stroke is quite long (several months), and in some cases the patient may remain disabled.

A person who has suffered from this disease may experience long-term and severe depression, loss of meaning in life, and suicidal tendencies.

That is why after a stroke, during the rehabilitation period, a psychologist should work with the patient. Psychological help after a stroke is as important as physiological.

A psychologist will help:

Learn to control the patient’s behavior and reactions;
Accept a new self as a person;
Minimize manifestations and survive a period of depression;
Improve cognitive (mental) abilities.

Work with a psychologist begins in the hospital, but after discharge it should continue at home. Recovery of the psyche and emotional sphere is long and labor-intensive. Therefore, the support of loved ones and relatives is required.

Criteria for the need for medical care if a stroke is suspected may include the signs given in the table:

First aid for stroke

Prehospital care for hemorrhagic stroke:

Place the patient in a horizontal position with the head end raised, regardless of the degree of impairment of consciousness and the severity of the condition;

Remove all removable dentures from the mouth;

Provide free access to fresh air to the patient;

If the patient is unconscious, it is necessary to turn the head slightly 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 of vomit if there was vomiting;

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

Cover the patient with a blanket;

Monitor breathing parameters, heart rate and blood pressure;

If there are signs of clinical death (cardiac arrest, respiratory arrest and dilated pupils), begin resuscitation measures (indirect cardiac massage and artificial ventilation of the lungs)

Prehospital care for ischemic stroke

Free your neck and provide access to fresh air;

Monitor basic vital parameters;

Rub paralyzed limbs with a semi-alcohol solution, or simply massage them;

Do not allow drinking water or taking any tablet medications.

The most important assistance measure for any type of stroke, which must be performed at the prehospital stage, is calling a specialized ambulance team. The patient should be hospitalized in a medical facility as soon as possible.

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Medical care for stroke

All patients with suspected stroke, or people with an obvious diagnosis of this, should be treated in the intensive care unit or in the intensive care wards of a neurological hospital under the supervision of a neurologist. In a medical institution, all the activities that were provided at the prehospital stage are continued.

In addition, they are complemented by:

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

Monitoring the vital parameters of the body using modern equipment;

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

Administration of cerebroprotectors - drugs that restore the structure of damaged brain cells (ceraxone, piracetam, thiocetam, actovegin);

Hemostatic drugs (hemostatics): aminocaproic acid, etamsylate. Indicated only for clearly defined hemorrhagic stroke;

Blood thinners (heparin, pentoxifylline, Cerebrolysin, Cavinton). Strictly contraindicated for cerebral hemorrhages and hemorrhagic stroke;

Proper nutrition. It is selected taking into account the patient’s consciousness and the ability to swallow independently. It can be represented by intravenous administration of amino acids, glucose and vitamins, tube administration of liquid mixtures into the stomach, and normal nutrition within the framework of dietary table No. 10;

Prevention of bedsores;

Control of bowel movements and urination. If necessary, a catheter is installed in the bladder;

Hygienic care of skin, eyes and mucous membranes.

The story of a sudden stroke

A middle-aged woman, relaxing in nature, fell and tripped over a stone. She assured everyone that she was fine and had simply tripped because she was not used to her new shoes. Despite the desire of those present to call an ambulance, she refused to do so. They helped her get up, clean herself up 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 a call from her husband, it became known that this woman was taken to the hospital and at 18:00 she died. As determined by doctors, she suffered a stroke at the picnic, which did not immediately manifest itself in full force, but made itself felt with some symptoms. If this woman's friends had known about them, they would have insisted on calling an ambulance, and perhaps she would have survived.

Neurologists argued that if the patient had been delivered to them within a 3-hour period of time, they would have had the opportunity to completely restore the lost functions and damaged brain tissue. They also drew attention to how difficult it is to help such patients independently at home, and how important this particular 3-hour period is, as the “golden time” for saving the functioning of all brain structures.

New materials

Scientific centers

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

One of the biggest medical centers in Russia and the CIS. This leading institution at 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 the few clinics in our country that provide the most modern and high-tech methods of treating cerebrovascular disorders (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, you should immediately call an ambulance.

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

urgently place the patient on the bed and place a pillow under his head, shoulders and shoulder blades so that the angle of inclination of the patient in relation to the bed is no more than 30 degrees;
remove the removable dentures, unbutton the shirt collar, remove the belt;
provide access to fresh air by opening a window or vent;
do not give the patient any medications except for glycine (if the patient is conscious), which should be given either 10 tablets under the tongue at once or given 3 times five tablets at intervals 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 the side;

After the ambulance arrives, doctors will immediately carry out a set of treatment measures aimed at maintaining of cardio-vascular system and respiratory organs. Afterwards, the issue of the possibility of urgent transportation to the hospital will be decided.

Clinical medical care.

Diagnostics.

After diagnosis using computed tomography of the brain and taking cerebrospinal fluid for analysis, it is once again clarified 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 performed to check whether the patient still has aneurysms, which would be best removed to avoid another stroke.

An ultrasound is done. Echocardiography 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 an ischemic stroke, a decision will be made for surgical intervention.

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

Hospital

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

monitoring the state of the cardiovascular and respiratory systems.

At the beginning, strict bed rest will be prescribed. To avoid the formation of bedsores, it is necessary to ensure that the mattress is flat and no folds form on the sheets. You should wipe the body of an immobile patient with camphor alcohol and powder the folds of the skin with talcum powder. It is advisable to place the patient on a rubber circle, and put cotton bandages on the heels and sacrum.

It is important to provide normal nutrition to the patient. If swallowing is impaired, he is fed through a tube. If the patient can swallow, in the first days he is given fruit and berry juices and 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 doctor.

We need to let the blood out. This helps a lot. ethnoscience advises immediately after a cerebral hemorrhage to put leeches on the ears.

This is how we have always helped people. But unfortunately, not everyone has a jar of leeches and the necessary skills to perform bloodletting correctly.

In this regard, if you find yourself next to a person at the moment of the “impact”, you should immediately do cold washings of the back, chest and abdomen. After allowing the heat and blood to 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, for the next two days, you should not give anything else and give the patient only fruit juices.

When the blow is weak enough and the patient can sit, he can be given 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, lower or full wraps. You can wash a numb limb with cold water, even if it seems hopeless to change anything. On the second day, you should take two warm baths with washing your feet and four washings of your upper body. On the fourth day you can do the bottom wrap. The “lost” limb can also be immersed in a warm bath with salt.

After these procedures, you need to do full washes daily, and steam baths for your feet and head once a week. You need to take a warm bath once a week and a cold one 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, each lasting one minute. Course 2-3 weeks.

Only after this can you begin full douches and other water procedures.

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

You need to try and try all the restorative procedures:

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

Inhaling valerian tincture is very helpful in cases of cerebrovascular accident. You need to inhale through your nose 3-4 times, inhaling alternately through the right and left nostrils.

A foot bath is a good way to draw blood away from the head. You just need to simply immerse your feet in water up to your ankles or calves, and to achieve a greater effect it is better to alternate hot, warm and cold baths. Based on the general condition of the patient’s body, you can add mustard, oat straw, hay blossom or something else to the water.

First, in order to protect yourself from a recurrent stroke, you must definitely measure your blood pressure in the morning and evening (it should not exceed 140/90 mm Hg). Then, after two months, it is advisable to monitor your blood pressure 2-3 times a week and also measure it immediately if it appears. nausea, headache, sudden unexplained weakness and pain in the heart.

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

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

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

First aid for stroke

Brain damage due to a stroke is a deadly disease, leading to 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, call an ambulance

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

Next, if the person is conscious, lay him down so that his head is on an elevation, unfasten the top buttons of restrictive clothing, and, if possible, give him at least ten Glycine tablets.

Glycine helps to save a significant number of brain cells in the first hours, and has no side effects that are dangerous for the patient, and is also fully compatible with drug therapy, which will be carried out by emergency personnel.

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 blood to flow out of the head, but you should never give any medications for heart spasms and the like, since in this case they can only aggravate the situation;
It is possible, after measuring the pressure, if the numbers are very high, 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 use 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 the person does not choke on the vomit, for which his head is turned to the side;
if breathing stops, you can try to resuscitate it artificially; such pre-medical care for a stroke will save a person’s life;
Doctors arriving at the scene will definitely ask what medications the patient took and how quickly the symptoms of stroke develop - this will help them determine the degree of danger and the speed of development of the disease.

Punctures

Providing first aid for a stroke includes a somewhat unexpected and controversial but nevertheless effective technique based on the acupuncture technique.

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

If a person loses consciousness, the fingertips on his hands are pierced with a needle disinfected over fire or in alcohol until a few drops of blood appear. This is a must.

After this, the patient can come to his senses, and his condition can stabilize. If there is asymmetry of the face, then you need 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 intended to relieve tension in the area of the brain that has been attacked. These actions in case of 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 according to statistics, they are the first patients in intensive care units.

Therefore, it is imperative to insist on calling an emergency medical team when symptoms of a stroke occur in a person nearby, even despite his protests.

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