Hemorrhagic stroke emergency care. Providing first aid for a stroke. What not to do if you have a stroke

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

1. Normalization of vital functions (see the topic GENERAL ISSUES IN RESUSCITATION).

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

3. For hemorrhagic stroke products with hemostatic and angioprotective properties are indicated. The drug of choice for this purpose is dicinone (synonyms: etamsylate, cyclonamide). The hemostatic effect of dicinone when administered intravenously begins within 5-15 minutes. the maximum effect occurs after 1-2 hours, the effect lasts 4-6 hours or more. 2-4 ml of 12.5% solution is administered intravenously, then 2 ml every 4-6 hours. Can be administered intravenously by drip, adding to conventional solutions for infusion (M. D. Mashkovsky, 1997).

4. For normalization of blood pressure at the emergency stage, you can use intravenous injections of dibazole (2-4 ml of 1% solution), clonidine (1 ml of 0.01% solution), droperidol (2-4 ml of 0.25% solution) . If there is no effect, ganglion blockers are indicated - pentamine (1 ml of 5% solution) or benzohexonium (1 ml of 2.5% solution), but the administration of these drugs must be done with caution and constant monitoring of blood pressure.

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

6. Relief of cerebral edema and intracranial hypertension - see the topic CEREBRAL EDEMA.

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

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

9. Care aimed at preventing trophic complications (bedsores).

10. Control of intestinal function.

11. Symptomatic therapy.

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

First aid for stroke

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

Types of strokes:

Ischemic stroke is a cerebral infarction. Accounts for more than 75% of all cases.
Hemorrhagic stroke is bleeding in the brain.

Stroke - symptoms and first aid

Signs of hemorrhagic stroke:

Sharp severe headache.
Hearing loss.
Vomit.
Paralysis of limbs.
Distorted facial expressions.
Increased salivation.

Symptoms of ischemic stroke:

Gradual numbness of the limbs.
Weakness in an arm or leg on one side of the body.
Speech disorders.
Numbness of the face.
Headache.
Dizziness.
Loss of coordination.
Deterioration of vision.
Cramps.

First of all, an emergency must be called health care in case of a stroke or when its obvious symptoms appear. Please note that when calling, it is necessary to describe in detail the signs of the disease and the patient’s condition.

Emergency care for stroke

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

Hemorrhagic stroke - first aid:

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

First aid for ischemic stroke:

Emergency care for strokes

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

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

Transient cerebrovascular accidents (TCI) are the most common variant of cerebral stroke or hypertension, atherosclerosis of cerebral vessels and the impact on these vessels of pathologically altered cervical vertebrae (spondylogenic circulatory disorders in the vertebrobasilar region). This option includes only those observations in which general cerebral and focal neurological symptoms disappear after 24 hours.

Symptoms. Characterized by general cerebral and focal disorders. General cerebral symptoms include headache, non-systemic dizziness, nausea, vomiting, noise in the head, possible disturbances of consciousness, psychomotor agitation, and epileptiform seizures. General cerebral symptoms are especially characteristic of hypertensive cerebral crises. Hypotonic crises are characterized by less pronounced cerebral symptoms and are observed against the background of low blood pressure and weakened pulse.

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

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

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

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

Hemorrhagic stroke.

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

Symptoms. Hemorrhagic stroke of any location is characterized by general cerebral symptoms: severe headache, nausea and vomiting, bradycardia, rapid depression of consciousness. Focal symptoms depend on the location of the hemorrhage. More often, hemorrhagic stroke develops in middle-aged and elderly people and occurs suddenly, at any time of the day. The patient falls, loses consciousness, and vomits. On examination, the face is purple, the breathing is snoring (stertorous), urinary incontinence. Blood pressure is often elevated. Considering the predominance of the lesion in the internal capsule of the brain, hemiplegia and hemihypesthesia can also be detected when the patient is unconscious. In case of blood breakthrough into the subarachnoseal space, meningeal symptoms are added. When blood breaks into the ventricles of the brain, hormetonic convulsions develop, disturbances of consciousness deepen to the point of atonic coma, pupils dilate, body temperature rises, breathing problems increase, tachycardia increases, and after a few hours death can occur. Subarachnoid hemorrhage usually develops suddenly (rupture of an aneurysm), with physical stress: a severe headache occurs, sometimes radiating along the spine, followed by nausea, vomiting, psychomotor agitation, sweating, ophthalmic symptoms, and depressed consciousness.

Diagnostics. Based on characteristic clinical symptoms and cerebrospinal fluid examination data.

Urgent Care. For hemorrhagic stroke, the following are necessary: strict bed rest, stopping bleeding, reducing blood pressure to normal, reducing intracranial pressure, combating edema and swelling of the brain, eliminating acute respiratory disorders, combating cardiovascular disorders and psychomotor agitation.

Transportation of the patient to a neurological hospital is carried out in the most early dates from the moment of the occurrence of a cerebral stroke, observing all precautions: carefully placing the patient on a stretcher and bed, maintaining a horizontal position when carrying, avoiding shaking, etc. Before transportation, the patient is administered hemostatic agents (vicasol, dicinone, calcium gluconate), a venous tourniquet is applied on the thighs to reduce the volume of circulating blood. In case of threatening respiratory failure, transportation with IVP and oxygen inhalation are advisable. In the early stages, administration of epsilon-aminocaproic acid (100 ml of 5% solution intravenously) with 2000 units of heparin is indicated. To reduce intracranial pressure, active dehydration therapy is carried out: Lasix 4-6 ml of 1% solution (40-60 mg) intramuscularly, mannitol or mannitol (200-400 ml of 15% solution intravenous drip). the earliest possible use of means of “metabolic protection” of brain tissue and antioxidants is justified (sodium hydroxybutyrate 10 ml of a 20% solution intravenously slowly - 1-2 ml per minute; piracetam 5 ml of a 20% solution intravenously; tocopherol acetate 1 ml 10-30 % solution intramuscularly; ascorbic acid 2 ml of 5% solution IV or IM. Fibrinolysis inhibitors and proteolytic enzymes are also administered in the early stages: Trasylol (contrical) 10,000-20,000 IU IV drip.

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

Hospitalization. urgent to the neurosurgical hospital.

Ischemic strokes.

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

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

Urgent Care. Basic principles: inhibition of thrombus formation and lysis of fresh thrombi, limitation of areas of ischemia and perifocal cerebral edema, improvement of function of cardio-vascular system, elimination of acute respiratory disorders In case of thrombosis or thromboembolism of the vessels of the brain or spinal cord, it is necessary to immediately begin treatment with heparin or fibrolysin (iv up to 20,000 units of heparin at normal blood pressure). Along with anticoagulants, antiplatelet agents and vasodilators (5 ml of 2% solution of pentoxifylline, trental IV) should be administered, and hemodilution should be performed with rheopolyglucin (400 ml IV at a rate of 20-40 drops/min). During a crisis rise in blood pressure, it should be reduced to a “working” level due to a violation of the autoregulation of cerebral circulation during this period and the dependence of cerebral blood flow on the level of blood pressure. Improve microcirculation using dipyridamole (chimes, persantine - 2 ml of 05% solution IV or IM), trental (0.1 g - 5 ml of 2% solution IV dropwise in 250 ml of saline or 5% solution glucose), Cavinton (2-4 ml of 05% solution in 300 ml of physiological solution intravenously).

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

Disturbances in the rhythm and strength of heart contractions can be both the background against which a stroke develops (often embolic type) and a consequence of impaired central regulation of the heart. In the first case, emergency measures are carried out according to the same principles as for cardiac arrhythmias without cerebral circulation impairment. In this case, it is advisable to avoid large doses of beta blockers, especially anaprilin, and sudden arterial hypotension. For myocardial ischemia, the full scope of appropriate care is provided, which, as a rule, is also useful for cerebral ischemia. If possible, drugs that cause severe dilatation of cerebral vessels, in particular nitroglycerin, should be avoided. Against the background of high blood pressure, this can lead to increased cerebral edema and the emergence of a persistent focus of ischemia.

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

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

It is especially important to know what to do in case of a stroke for each person to provide first aid - sometimes the count can literally be “minutes”.

Causes of stroke

During a stroke, blood flow to certain areas of the brain decreases or stops. It is customary to distinguish two variants of the disease - ischemic, when full blood flow is prevented by a plaque, and hemorrhagic - when the vessel wall is ruptured.

Causes of plaque:

The formation of an atherosclerotic or thrombotic obstruction—thrombosis.
The entry of a foreign particle into the choroid duct is an embolism.

Causes of vascular wall rupture:

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

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

A sudden, painful, severe headache, accompanied by severe nausea and repeated vomiting, flashing of foreign spots before the eyes are the first symptoms of increased intracranial pressure.
Significant fluctuations in individual blood pressure parameters.
Possible loss of coordination of movements, up to loss of consciousness.
Significant impairment of facial expressions and speech – “verbal porridge”.
The appearance of double vision, a decrease in visual acuity, usually in one eye.
A person suddenly stops recognizing familiar objects, surrounding people, does not remember dates and what day of the week it is on the street.
Unilateral paresis and paralysis of the limbs, half of the face.
Tremor of the tongue, its pathological deviation to the side.

Any of the listed signs, or their combination, should be alarming - only a specialist will be able to determine the root cause of the condition and prescribe adequate treatment tactics.

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

Increased frequency of headaches.
Accompanying habitual headaches with numbness of the face and limbs.
Increased forgetfulness, which was not typical for women before.
Impaired coordination of movements.

Signs of stroke in men that you should pay close attention to so that first aid is provided in time:

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

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

Introduce yourself to the person and ask him to respond with his details - last name, first name, address, phone number.
Smile and watch how the person smiles back - if certain muscle groups no longer participate in the smile, a stroke is quite possible.
Asking a person to raise his hand up and hold it there for a while on his own - if the muscles are weak, this simple action is impossible.
When you open your mouth, your tongue may reflexively move to the side - one of the signs of a stroke.

First aid

As early medical care as possible for a stroke helps to avoid the development of irreversible processes in the human brain, and also saves lives. It is a well-known fact 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 in 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 to the resuscitation medical team. If the request was transmitted on time, the person’s life will be saved. While emergency personnel are rushing to the call site, it is recommended to perform a number of important actions:

Reassure the patient as much as possible - fear and anxiety only aggravate his condition.
Loosen the compressive elements of clothing - the waistband of trousers, the collar of a shirt or blouse.
The person's head should be higher than the body.
Ensure as much air flow as possible (if the action takes place indoors).
If a person knows about the presence of hypertension, and has a tonometer at hand, be sure to check the numbers; if they are significantly exceeded, antihypertensive drugs will be required (hypertensive patients should always have them 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 placed on his side in order to prevent aspiration of possible vomit. If the gastric contents come out, the oral cavity needs to be cleaned. Trace the location of the tongue - it should not go deep inside, otherwise the person may suffocate.
It is strictly forbidden to give a person vasodilators, give him water or feed him before the arrival of emergency medical personnel. You can only wipe your face with a damp cloth and lightly massage your scalp.

First aid for suspected hemorrhagic stroke

Place 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 significant distance.
Unfasten tight clothing.
Remove dentures, if present.
Provide a massive influx of air masses.
Tilt the person's head to the side. After vomiting, clean the mouth with a piece of gauze or a clean handkerchief.
A container with ice liquid should be applied to the head - to the numb limbs on the opposite side.
Maintain optimal blood circulation in all extremities - cover with a warm blanket, apply a heating pad or mustard plasters.
Prevent aspiration by monitoring salivation and removing everything from the oral cavity.
In case of paresis, lightly rub the limbs with an oil-alcohol solution.

First aid for suspected ischemic stroke

Place the person on a hard surface, in a lateral position.
Ensure maximum peace, do not move anywhere.
Keep the victim in a clear consciousness using cotton wool and ammonia.
Monitor breathing function - the tongue should not sink.
Do not allow the victim to take any medications, food or liquids.
Wipe the head and neck area with a damp cloth every thirty minutes.
Rub the torso and limbs with a soft cloth or with your hands.
If individual pressure levels are high and in the absence of antihypertensive drugs, immerse the person’s legs in 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 issues to date is bloodletting. It consists of piercing the fingertips with a needle disinfected over a flame until the first drops of blood appear. If there is asymmetry of facial features, you can intensively rub the ears, and then pierce each earlobe until a drop of blood appears.

It is not recommended to perform it without the advice of a specialist. Using this measure, you can get a double effect - a person’s condition will stabilize, or it will significantly worsen. In the opinion of medical specialists, this method does not have sufficient grounds.

Prevention

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

Pay attention to individual blood pressure parameters.
Regular passage medical examinations and not only in old age, but in the most able-bodied age - stroke significantly - “rejuvenated”.
Complete, fortified nutrition.
Regular walks in the fresh air.
Sufficient exercise stress visiting swimming pools and fitness centers.
Attention to the slightest deviations in well-being is not typical: forgetfulness, imbalance of movements, numbness in the limbs.
Compliance with the instructions issued by the attending family doctor.

Deviations noticed in time require consultation with a specialist, and then a stroke can be avoided.

Navigation

First aid for a stroke should be provided to a person in as soon as possible. Correctly taken actions, as well as measures aimed at saving lives, will alleviate the condition of the victim before the arrival of qualified medical personnel.

The ease of subsequent restoration of damaged cells directly depends on how correctly these actions are performed, as well as nervous system. It is necessary to take the person to the hospital within 3 hours after the disease is detected.

Priority measures

First aid for a stroke at home should be provided as correctly as possible. Regardless of where the stroke occurred and what caused the stroke, those providing assistance should act according to the following algorithm:

Do not panic;
Assess the general condition of the victim. First aid for a stroke begins with identifying the presence of consciousness, breathing, and heartbeat;
Call an ambulance;
When the first signs of a stroke are detected, it is necessary to provide resuscitation assistance, but only if clearly necessary;
Correct positioning of the patient's body is also very important. Before providing first aid for a stroke, you need to lay the person correctly, on his back or on his side;
Emergency care for a stroke involves providing access to oxygen to facilitate breathing;
You need to constantly pay attention to the person’s condition.

The above describes general measures that should be taken if you have a stroke. First aid must be competent and timely so that a person has not only a chance to survive, but also to fully recover from an illness. If there are significant disturbances in the patient’s well-being, all measures must be taken very quickly. It is better if first aid for heart attack and stroke is performed by several people.

Detailed description of the required steps

It is important to follow all the subtleties, because any mistake can worsen the situation.

But even if the signs of a stroke and micro-stroke in a woman are very obvious, there is no need to panic. First responders should act quickly. Fear and unnecessary movements can lengthen the time of assistance and lead to negative consequences.

The patient should be reassured if he is conscious. The first thing to do in case of a stroke before the ambulance arrives is to reassure the conscious person that they will definitely get help. An illness of this kind always begins suddenly, so a strong stress reaction will certainly be present.

The presence of anxiety can aggravate the already deteriorated state of the brain.

Calling an ambulance is very important; you should make the call as quickly as possible. A minimal suspicion of a micro-stroke should be the basis for contacting specialists who are able to understand the situation much better and more correctly. When you get through, you should give the dispatcher information about what happened and clearly name the location. All this will help save precious minutes, while medical workers are on the way, pre-hospital medical care should be provided.

The following factors will help assess the condition:

Presence of consciousness. Absence, as well as gloominess, are a sign of a serious condition. This does not happen with mild forms.
Breath. Algorithm of actions involves assessing breathing and the presence of breathing disorders, for example, intermittency. A person should be given artificial respiration only if there is no movement of the chest.
Pulse. You should listen to the heartbeat to understand its frequency and rhythm. It is allowed to massage the heart only if there is no pulse at all.

It is equally important to understand the characteristics of a stroke and symptoms in order to provide first aid in accordance with them. You need to ask if there is severe pain in the head or if there is dizziness. in men and women - a distorted face, the inability to smile or perform other simple facial actions, the presence of speech impairment, less often - its complete absence.

Weakness, numbness on one or both sides, and immobility may also be observed. You need to understand whether there is visual impairment and problems with coordination of movements. The combination of the symptoms described above also indicates the need for emergency assistance.

Correct position

Regardless of the presence of problems with consciousness, it is necessary to provide the person with peace. Movements, and especially attempts to move independently, should be excluded.

First aid initially boils down to the need to place the victim on his back, lifting his head and chest if he is conscious. A horizontal position, which involves turning the head to one side, will be necessary in case of fainting or convulsions.

Use of medications

When paramedics have already been called, first aid does not involve the use of medications. But if the process of delivery to the hospital is delayed, the following can help the brain, which should preferably be administered intravenously:

Paracetam;
Thiocetam;
Nootropil;
Cortexin;
Furosimide;
L-lysine;
Actovegin.

Measures for mini-stroke

The main features of diet selection are as follows:

After an attack, you need to restore the physiological minimum. To do this, a person is given two liters of liquid per day, which can be in the form of various broths, weak tea, or milk.
The acute period is the time when you should eat low-calorie food, but the nutritional value must be sufficient to fully support the patient’s vital functions.
The first day after a stroke is the hardest, during this time the food is ground to a pulp, the person needs to be fed. You need to drink from a small teapot or a special bottle.
If there is no swallowing reflex, food is delivered using a probe, in which case it is prepared as liquid as possible, with vitamins. In case of serious neurological disorders, if motor functions are lost, it is quite possible to make a decision on the intravenous administration of special solutions.
After the ability to swallow is restored and the general condition improves, you can eat solid foods: vegetables, steamed cutlets, mashed potatoes, eggs.

Diet features

Proper food is as important as timely medical care. A person should completely give up fatty and sweet foods and should not drink coffee or tea. If a person recovering from a stroke is hypertensive, his diet must contain a lot of buckwheat, figs, and oatmeal, which contain very useful magnesium and potassium salts.

To normalize the functioning of the digestive system, it is advisable not to resort to the use of medications, but to choose the right diet. It is better for a person to eat only black bread made from coarse flour. You need to drink a lot of water and eat fresh fruits.

First aid effectiveness level

If you believe the statistics, then the correct provision of medical care to the victim and the coordinated actions of people who help the person before the doctors arrive provide enormous benefits in terms of recovery.

If all actions for a stroke are done correctly, the chances are as follows:

50-60% of massive strokes end in saving the patient’s life;
75-90 percent chance of full recovery for mild stroke;
The chance of recovery and restoration of the abilities of brain cells improves by 60-70%, regardless of the type of stroke.

You need to understand that an attack can occur in any person, regardless of age and location. To prevent a stroke, you should carefully monitor your diet, physical and mental condition. It is advisable to forget about. It will be beneficial to monitor your own and timely contact a doctor if it is exceeded.

Minimizing stress will also help you feel healthy longer. It is important to treat any diseases of the blood vessels and especially the heart, even if they are not so dangerous. In case of illness diabetes mellitus it is necessary to be constantly monitored by a doctor.

“Stroke” is a scary word familiar to everyone to modern man. It often seems to come on quite suddenly, causing serious consequences ranging 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 left to begin 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 stroke varies depending on the type it belongs to. It is usually customary to distinguish two main groups:

. This is what 80% of all patients suffer from. With timely initiation of treatment and the absence of aggravating circumstances, the prognosis is favorable. It develops due to blood stagnation: one of the vessels is blocked, the tissue around it is deprived of vital oxygen and begins 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. Occurs when a blood vessel in the brain ruptures, causing blood to splash out uncontrollably and form a clot, blocking intact vessels, compressing tissue and causing widespread necrosis.

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

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

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

Symptoms and first signs of stroke

Symptoms of stroke are divided into two large groups:

Common symptoms of brain damage occur with any disease affecting the brain. This:
- dizziness, fainting;
- loss of balance;
- emotional instability;
- lightheadedness, weakness, nausea;
- excited or, on the contrary, stunned state;
- Strong headache;
- epileptic seizure.
Focal symptoms occur mainly with strokes and depend on which part of the brain is affected. This:
- sensitivity disturbance - decreased, goosebumps, tingling;
- impaired motor activity - stiffness or complete paralysis, tics;
- violation of the position of the head - the head moves to one shoulder, the tongue may move;
- disturbances in the functioning of the nerves that regulate the functioning of the face - squint, bulging of one eye, complete paralysis of the facial muscles on one side, lagging corner of the mouth on one side;
- violations of basic functions - swallowing, breathing, heartbeat.

Not all symptoms can develop simultaneously, and not all of them can be seen in the same person. People often look like they are drunk when they have a stroke.

To determine whether a person is sick, you can perform a rapid test:

Ask a person to smile - if he has a stroke, one corner of his mouth will be delayed in reacting, his cheek may sag, and his eyelid will not obey.
Ask him to extend his arms straight and hold them straight. At the same time count to ten. If a person has a stroke, one arm will lag or not move at all.
Ask him to repeat a few words, for example: “It will rain tomorrow morning.” 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 the person will not realize the severity of his own condition;
The disease is characterized by the absence of severe pain at the time of the attack - a person may deny that there is anything 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 stroke in men

Men and women experience many diseases differently, and strokes can manifest themselves differently in them. Moreover:

men enter the risk group for strokes after 40 years, while women only after 60;
strokes occur less frequently in young men than in young women;
for men, the disease is less likely to be fatal;
men recover more easily afterwards.

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

weakness and headaches;
difficulty swallowing;
coordination and speech disorder;
hearing and vision impairment;
fainting.

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

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

Signs of stroke in women

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

pregnancy, during which the body experiences constant stress and blood pressure rises;
uncontrolled use of hormonal contraceptives, which may result in unwanted and unexpected side effects;
genetic predisposition to vascular complications, which is statistically 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, chest, or one side of the body;
rapid heartbeat and shortness of breath.

Special studies have been conducted that have shown that half of women develop at least one atypical symptom.

Nervous, sensitive people who constantly experience stress are more susceptible to strokes - the risk especially increases if emotions do not find expression.

First aid for stroke

First aid is the most important stage in the treatment of stroke. 3 hours after the onset of an attack, the patient’s brain cells begin to change and die - this 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 first to save a life

When a rapid test has been carried out and there is some confidence that the person is having a stroke, resuscitation can begin.

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

Calm. A person who is trying to provide help should not panic himself, should not fuss and rush, this will only increase the likelihood of an error. 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 calling specialists. 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 is having a stroke - the team will need specialized equipment to immediately start working.

When the first steps have been 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 nervous the patient is, the slower his pulse and the less tension in the brain. A calming tone and rhetorical questions work well. It is worth reporting that help is already on the way.
Lay him on his back, on something hard. Elevate 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 his tie, and take off his shoes. If the action takes place on the street, ask passers-by to disperse and give space.
Do not give the patient anything to eat or drink. Do not give him any medications - even those that under normal circumstances are taken “from the heart.”
If you have a tonometer at hand, measure your blood pressure. If it is elevated, give him a pill to take. If there is no tablet, apply cold under the lower jaw on the side and heat on 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 beneficial and can provoke a blood clot.
Monitor the patient. Don't let him move. If vomiting starts, help, hold the head, clear the airways, if something goes wrong.

The main thing in this situation is to prevent it from getting worse.

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

check for breathing - you can see if the chest is rising, assess whether the nostrils flutter, whether the lips are turning 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 or pulse, resuscitation measures should be started immediately:

If the patient's lips turn pink, he is breathing again, his heart is beating - or has not stopped beating - you can proceed to simple first aid:

If an epileptic seizure begins, it is definitely not worth it:

trying to unclench the patient’s teeth to prevent tongue injuries is much more likely to cause injury yourself;
trying to hold the patient in one position has a very high chance of injuring him.

It is worth moving away all solid objects that the patient might hit and noting 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 care

Before the ambulance gets there, the first aid provider’s task is to hold out and prevent the condition from worsening. During this time, you should remain closely 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 documents - if the first aid provider has them;
if necessary, help carry 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 may be needed - documents, hygiene items, a change of linen.

When the patient is admitted to the hospital, nothing more is required from the assistant; the doctors will do the rest:

They will examine you, take tests and take an ECG;
will conduct a computed tomography scan;
evaluate the results of tests and tomography;
will begin basic therapy.

Basic therapy includes:

for ischemic stroke - improving blood circulation, accelerating metabolism, increasing tissue resistance to oxygen starvation;
for hemorrhagic stroke - relieving swelling, correcting 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 will spend there depends solely on the severity of the stroke.

After discharge, the patient will need:

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

If the stroke was not too severe and first aid was provided correctly, he has every chance of recovery.

If a relative has suffered a stroke, the task of his relatives is to make sure that he reduces the likelihood of a second stroke as much as possible.

Traditional 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 if we're talking about about stroke.

Really working ways traditional 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 ambulance.

Traditional methods can be useful for prevention purposes strokes. But we will talk about this in other articles.

Brief reminder “algorithm of actions - first aid for a stroke before the ambulance arrives”

Long descriptions are good, but in a critical situation they can slip out of memory. It’s easier to rely on a short reminder:

Call an ambulance.
Determine whether a person is conscious:
1. Is he breathing?
2. Is there a pulse?
If conscious:
1. Calm down.
2. Lay it down so that your legs are higher than your head.
3. Don't let him move, don't let him eat or drink.
4. Measure your blood pressure and give a pill if it is high.
If unconscious and not breathing:
1. Clear the airways.
2. Deliver a precordial blow.
3. Start chest compressions and artificial respiration.
If unconscious but breathing:
1. Lay it on its side.
2. Tilt your head back and down a little.
Wait for the ambulance.

Stroke cannot be treated at home. A stroke cannot be treated if too much time has passed. A stroke cannot be treated if first aid was provided incorrectly.

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

Perhaps one day this will save a person's life.

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

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 the functional abilities of the nervous system depends on the time and correctness of its provision. 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, while using your thumbs to slightly open the patient’s mouth.
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!