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Introduction: For this assignment, I have chosen the topic: Stroke and its prevention for preparing the health information patient hand out. Stroke is a serious health condition and the third leading cause of disability and death worldwide. The handout will help create awareness about the condition in the population at risk. The handout will serve as an excellent source of information on this topic and the user can always refer back to check on this information. Creating awareness and preventing stroke are important as the condition is lethal and causes irreversible brain damage. Most cases of stroke are preventable (Revill, 2014). The handout can be used to educate people who are at risk will enable early recognition of stroke, prompt transport to the hospital and enable prompt treatment to the patient. Stroke risk is high in among the older population and increases every year after 65 years of age (Jacin, 2011). So the target population for my topic of interest would be elderly and geriatric patients.
The search for relevant information using google and google scholar. Only information from credible sources like peer reviewed journal and the website of American stroke association were used in this paper. The definition of stroke was adapted from a textbook. The different search terms used were: “stroke, risk factors for stroke, management of stroke, prevention of stroke and stroke statistics”. The information was compiled to develop a handout that could provide information to a group of people at risk for stroke, namely the elderly population 60 years and above. The credibility of the sources can be verified using the list of references provided at the end of the text.
Key terms used: stroke, hemorrhagic stroke, ischemic stroke and transient ischemic attack (TAI) The definition of each term is provided in the handout.
Handout for Stroke Information:
Stroke is defined as a clinical syndrome that occurs from loss of brain function or neurological deficits, following inadequate blood supply to regions of the brain (Gillard, 2013). It is difficult to predict stroke attract, as it occurs suddenly. However, the factors leading to stroke can be identified and prevented, before they cause this life-threatening condition.
Two major forms of stroke are Ischemic stroke and Hemorrhagic stroke (Gillard, 2013). More than 75 % of the stroke that occur in the population are an ischemic stroke that results from the block in the blood vessels supplying the brain (Gillard, 2013). Hemorrhagic strokes occur following a rupture of the arteries supplying the brain. Both these strokes are life threatening.
Figure 1: Types of stroke: Ischemic and hemorrhagic stroke. Picture taken from www.memmorialhermann.org
Cause: Clot and thrombosis can block blood supply to the brain and cause ischemic stroke. Hypertension is the most common cause of hemorrhagic stroke. Other causes of hemorrhagic stroke include an aneurysm and other arterio-venous malformations.
Risk factor: Some strong risk factors for stroke include hypertension, smoking, diabetes, asymptomatic carotid stenosis, atrial fibrillation, hyperlipidemia, sickle cell disease and other cardiac disease. They are modifiable risk factors and their association with the diseases has been established through research and is well documented. (Spence, 2013)
Other less documented risk factors include: Obesity, physical inactivity, poor diet, poor nutrition, alcohol/drug abuse, hyper coagulation syndrome, hormone replacement therapy, use of contraceptives and inflammatory process. (Spence, 2013)
While the above risk factors can be controlled, certain non-modifiable risk factors like old (65 years and above), ethnicity, gender and family history of stroke increases the person’s susceptibility to stroke Though stroke can occur in anybody, studies report very high incidence of stroke in African-American when compared to the rest of the U.S population. Likewise, incidence of stroke in first degree relative can increase the person’s chances of getting stroke. Among gender, the incidence of stroke is higher in female than in male.
Signs and symptoms: As stroke is a life-threatening condition, the patient, family and emergency care providers must recognize the signs and symptoms associated with the disease. The patient may experience numbness in the face and extremities. Very often, the numbness is felt unilaterally. Temporary loss of vision in one or both eyes is present. The patient experiences sudden confusion, dizziness, and trouble speaking. Loss of balance and coordination is also reported in stroke. Severe headache, loss or altered consciousness are also observed. The patient may exhibit any of the above symptoms. It is important to recognize and quickly seek medical help on observing these symptoms. Some patient exhibit signs like nausea, vomiting and headache. These symptoms are often associated with hemorrhagic stroke. (AMA, 2016)
Figure 2: Typical signs of stroke: droop face, unable to lift arm & keep it in place, and slurred speech. On recognizing these symptoms, it is time to act immediately.
Picture taken from : http://www.wales.nhs.uk/
Transient ischemic attack (TIA) also called mini stroke has symptoms similar to a stroke, but usually, resolve within minutes or hours. TIA acts as a foreteller of future stroke occurrence (AMA, 2016).
Management of stroke:
Step 1: The first step in stroke management is to stroke detection. Early detection will enhance the success rate of treatment and patient survival. Patient and bystanders may ignore mild symptoms of stroke, thus hampering early detection. (Jauch, 2016)
Step 2: On recognizing the symptoms, the patient or the family should activate the EMS (Emergency medical service) by calling 9-1-1. The dispatchers of EMS are to prioritize such calls. (Jauch, 2016)
Step 3: The third step is the transport of the patient to the treatment facility. Vital support is provided to the patient during transportation. The hospital is notified about the probably time of arrival of the patient. This will help them to get ready and prevent delays at the receiving end. The patient’s signs like facial droop, arm shift and speech are assessed during transportation. Once the stroke is confirmed, the breathing and circulation of the patient are closely monitored. Evaluation data is communicated to the hospital. (Nam, Park, & Heo, 2013; Jauch, 2016)
Step 4 is the delivery of patient to the hospital, where neurological examination and diagnostic studies are performed. (Jauch, 2016)
Step 5: Emergency diagnostic studies and differential diagnosis are made. (Jauch, 2016)
Step 6: Decision on specific therapy is made and treatment initiated. Fibrinolytic treatment in provided to treat ischemic stroke and neurosurgical procedures may be required to treat hemorrhagic stroke. (Jauch, 2016)
Conclusion: Stroke is an emergency life threatening condition. It causes irreversible brain damage and disability. Early recognition of symptoms and treatment, increases complete revival of patient and enhances success rate of treatment. Most incidences of stroke can be prevented by correcting the modifiable risk factors. A healthy lifestyle (physically active, healthy low-sodium, low-fat diet, and reduced stress) can help to prevent stroke.
References
AMA,. (2016). Stroke Warning Signs and Symptoms. Strokeassociation.org. Retrieved 11 August 2016, from http://www.strokeassociation.org/STROKEORG/WarningSigns/Stroke-Warning-Signs-and-Symptoms_UCM_308528_SubHomePage.jsp
Gillard, A. (2013). Stroke. Detroit: Greenhaven Press.
JANCIN, B. (2011). Maximize Stroke Risk Reduction in Elderly. Cardiology News, 9(6), 35. http://dx.doi.org/10.1016/s1544-8800(11)70193-2
Jauch, E. (2016). Acute Management of Stroke: Initial Treatment, Thrombolytic Therapy, Stabilization of Airway and Breathing. Emedicine.medscape.com. Retrieved 11 August 2016, from http://emedicine.medscape.com/article/1159752-overview
Nam, H., Park, E., & Heo, J. (2013). Facilitating Stroke Management using Modern Information Technology. J Stroke, 15(3), 135. http://dx.doi.org/10.5853/jos.2013.15.3.135
Revill, J. (2014). Is the mortality from ischemic heart desease (IHD) & ST (atherogenic stroke} almost completely preventable? Atherosclerosis, 236(2), e308. http://dx.doi.org/10.1016/j.atherosclerosis.2014.08.018
