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BRAIN ATTACK - STROKE

By: Karen Peper RN MSN CFNP©Providence Hospital 9/07

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Objectives

Define Stroke

List types of Strokes

List risk factors for Stroke

Identify the signs and symptoms of Stroke

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Stroke Statistics

Stroke is the No. 3 cause of death in the U.S.

(#1 – Heart Disease, #2 – Cancer)

Stroke kills more than 160,000 American each year

On average, every 53 seconds, someone in the US experiences a stroke.

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Stroke Statistics

Every 3.1 minutes someone dies of a stroke

Stroke risk increases with age. For each decade after age 55, the risk of stroke doubles.

72% of all strokes occur in people over the age of 65

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What is a Stroke?

Brain tissue is damaged from a sudden loss of blood flow, resulting in a loss of neurological function

Causes:– Blockage (blood clot) occurring

inside a blood vessel– Blood vessel leaks blood due to

rupture

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Types of Strokes

Ischemic Stroke (85%)

Hemorrhagic Stroke (15%)

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Ischemic Stroke

Types of Ischemic Stroke

– Embolic Stroke• Blood clot travels to the

brain

– Thrombotic Stroke• Blood flow is blocked to

the brain

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Hemorrhagic Stroke

Bleeding occurs from vessels within the brain. High blood pressure or a rupture of a blood vessel or an aneurysm may be the cause.

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Transient Ischemic Attacks (TIAs)

A stroke-like event lasting minutes, or hours, that occurs when the brain is deprived of oxygen-rich blood temporarily, but in which the effects wear off completely after the blood-flow returns

TIA’s do not result in permanent brain damage

TIA is serious and too often ignored

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PLEASE…Pay Attention to these symptoms

TIA’s should not be ignored– More that 1/3 of people will go on to

have an actual stroke– 5% of strokes will occur within 1

month of the TIA or first stroke– 12% will occur within 1 year– 20% will occur within 2 years– 25% will occur within 3 years

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Stroke affects people of

• All Ages

• All Ethnic Groups

• All Backgrounds

Most strokes are preventable, take steps NOW to reduce having a stroke!

Stroke does not Discriminate

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Signs & Symptoms of Stroke

Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body

Sudden confusion, trouble speaking or understanding

Sudden trouble seeing in one or both eyes

Sudden trouble walking, dizziness, loss of balance or coordination

Sudden, severe headache with no known cause

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Strokes occur in the brain and affect the opposite side of the body

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Everyone…

Please stand up

If you answer yes to any of the following questions, please sit down

Thank you

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Risk Factors for Stroke

Blood Pressure over 120/80?Smoker – exposed to tobacco?Overweight?Diabetes?High Cholesterol?Heart Disease?

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Risk Factors for Stroke

Family History of Stroke?Physical activity…less than a total

of 30 minutes on most days?Man over age of 45, OR a woman

over 55 years of age?

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Are you sitting down?

Yes, you are at risk for a stroke, but it doesn’t mean you will have one

There are risk factors that can be controlled and risk factors that cannot be controlled

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Risk Factors

Risk factors you can control:– DIET - How we eat, do we follow our

diet?– EXERCISE - Do we exercise or get

some physical activity?– MEDICATIONS - Taking medications

correctly– SMOKING - Stop smoking

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Strokes can affect different parts of the brain, this results in patients experiencing different symptoms

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Strokes are an EMERGENCYIf you are having a Stroke come to

the hospital right away – CALL 9-1-1

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Once You are at the HospitalDiagnostic Testing

– CT or MRI of the brain

– EKG

– Carotid Ultrasound

– Echocardiogram

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EKG – may show atrial fibrillation

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Carotid Ultrasound – will show if there is stenosis (narrowing of the blood vessel)

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Echocardiogram – detects if any thrombus (blood clot) within the heart chambers

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Chest X-ray

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Blood work - Labs

Any labs may be ordered, Lipid Profile (checking your cholesterol level) is done on all patients.

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Recognize the Symptoms of a Stroke

3 Simple Questions

– Ask the person to smile

– Ask the person to raise both arms

– Ask the person to say a simple sentence “The sky is blue in Boston”

The sky is blue in Boston

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ACT IN TIME

Stroke is a medical emergency. Every minute counts when someone is having a stroke. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save people's lives and enhance their chances for successful recovery

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tPA (Tissue Plasminogen Activator)

– is a clot-busting drug

– Ischemic strokes, the most common type of strokes, can be treated with a drug called t-PA, that dissolves blood clots obstructing blood flow to the brain.

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TIME IS BRAIN

Time is very important in order to receive this medication

Window of opportunity to start treating stroke patients is three hours, but to be evaluated and receive treatment, patients need to get to the hospital within 60 minutes.

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Medications

AspirinAggrenoxPlavixBlood pressure

medication if appropriate

Cholesterol lowering medicines if needed

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Hospital Treatment for Stroke

Medical Management – Dietary– Physical & Occupational

Therapy– Speech Therapy if indicated– Nursing

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Hospital Treatment for Stroke

Rehabilitation– Physical Medicine

Consult– Determine what type of

therapy best for patient• Rehab Unit • Subacute Rehab• Extended Care Facility• Home Care with PT/OT

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Discharge Planning

Starts upon admission to the hospital– Consult social worker or care

coordinator to help identify discharge needs

– Provide patient/family with Stroke education

– Stroke Support Group meetings

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Can you SPOT a Stroke?

This is the end of the program

– Do you have any questions??

THANK YOU….