L.A.F. Lets Act Fast A community Stroke education by the professional nursing members of NAINA www.nainausa.com Presentation prepared by Varsha Singh MSN,APN-C

NAINA Stroke Community Education L.A.F. A NATIONAL Community Education Project Prevention is better than cure.

Lets Act Fast (L.A.F.) Objectives Conduct the stroke education for community members. Create awareness about Stroke Discuss warning signs of stroke Discuss action plan when signs and symptoms noted. Mention Stroke Risk factors Discuss resources available for stroke awareness.

Heart and Brain Brain is like a master controller, which controls every function of the body. But brain needs oxygen and sugar which is supplied through blood vessels. Heart is a pump that sends blood to all the different parts of body. It brings blood to brain. Its function is just like a pump similar to the water supply pump in our house. When heart works under pressure the tiny little pipes (arteries) in brain can break and lead to what is known as bleed in the brain or hemorrhagic stroke. The high cholesterol or diseases that can cause clots can block an artery in brain and cause what is known as Ischemic stroke.

Why Your Brain is So Important???? THE CENTER OF THE HUMAN UNIVERSE…..IS “YOUR BRAIN” MEMORY INTELLIGENCE BEHAVIOR PERSONALITY THOUGHT SPEECH ALL MOVEMENTS HEARING VISION COORDINATION BODY FUNCTIONS COMPREHENSION

Stroke - A Major Medical Concern #5th Leading cause of death in the United States Every 40 seconds, someone in the US has a stroke #1 Cause of disability in the US Approximately, 1 in 4 people die within one year after having an initial stroke Every 4 minutes, someone in the US dies from stroke Good news! Up to 80% of all strokes are Preventable through risk factor management

What is a Stroke? A stroke or a “Brain Attack” occurs when there is no blood circulation to the brain. The brain needs oxygen and nutrients transported by the blood travelling to the brain. A block in the arteries of brain or bleeding in brain can stop the blood supply to brain No blood flow to the brain = No function of brain

Types of Stroke Ischemic= Clot/Block Hemorrhagic= Bleed Blockage of arteries 87% of all strokes Hemorrhagic= Bleed Bleeding around brain Bleeding into brain

Types of Stroke Blocked Vessel Broken Vessel

Time is BRAIN Think about this!! 1.9 million neurons die every minute after Stroke Someone can loose all the functions controlled by those neurons every minute

Some myths about stroke Myth: Stroke happens to the heart Reality: Stroke is a "Brain Attack" Myth: Stroke cannot be treated. Nothing can be done once someone has stroke. Reality: Stroke requires emergency treatment Myth: Stroke only strikes the elderly Reality: Stroke can happen to anyone Myth: You can’t prevent if someone is going to have a stroke. Reality: Stroke is largely preventable

What the community members need to know? 1. Learn about the warning signs of stroke 2. Learn what to do if someone is exhibiting these signs and symptoms. 3.Understand the risk factors for stroke and practice prevention.

Why it is important to educate the community?? Stroke can occur ANYWHERE. Community members must know how to recognize the signs and symptoms of stroke. To provide critical treatment there is only 3 hour window. Early arrival to hospital is main goal. If no one is aware in community then we miss the chance to bring someone quickly to emergency room.

F-A-S-T F = Face: ask the person to smile See if the smile is even or not. A = Arm: ask the person to raise both arms. See if the arms stay at the same level. S = Speech: ask the person to speak a simple sentence. Note is there is any change in speech or the person cannot talk properly. If you suspect that the person is showing any of the FAST sign then it is T = Time: to CALL 911 Every minute matters! Rose is red

Warning Signs indicating stroke Uneven face, droop on one side of face or drooling Sudden numbness or weakness of the face, arm, or leg Sudden trouble seeing in one or both eyes Sudden confusion, trouble speaking or Sudden trouble walking, dizziness, loss of balance, or coordination Sudden severe headache with no known cause Sudden trouble with understanding the speech ,blank look on face Suddenly dropping things due to weakness of hands.

TIA/Mini Stroke A possible sign that a stroke is about to occur, is called a transient ischemic attack (TIA) “warning sign” – A temporary interruption in blood flow to a part of the brain Symptoms of TIA are similar to a stroke but resolve within 24 hours or less Do Not Ignore any symptoms! Call 911 immediately! You may be able to Prevent a Major Stroke from occurring! TIME IS BRAIN!

When Stroke Strikes (L.A.F.)Lets Act F.A.S.T. Call 9-1-1

What happens in the hospital The patient is treated immediately in emergency department as an emergency. Across the nation the hospital professionals are trained to treat Stroke First of all the patient will get the CT Scan of the head to find out what is the type of stroke .Clot or bleed in brain. Next treatment is decided based on the CT Scan results. They will try to administer a clot buster medication that opens up the blood flow to brain If there is hemorrhagic stroke then there are surgical procedures that can save the life.

Why it is important to ACT FAST Once stroke warning signs are detected there is a 3 hour window to administer clot buster medication. So faster the patient is taken to hopsital,faster the medication can be given. For bleeding, faster the patient gets a specialist evaluation or surgery, faster is recovery and chances of saving the dying neurons. Every minute counts.

What is the main goal? The person affected with the Stroke symptoms must be taken to nearest Stroke Center AS SOON AS possible. The best way to accomplish this is by calling 911. All EMS and Ambulance squads are trained to transfer the stroke patients immediately to Stroke Center.

What Can I do to Prevent Stroke? Know the risk factors and keep them in control

Stroke Risk Factors That Cannot Be Controlled Age: Stroke can occur in all age groups Heredity (family history): Stroke seems to run in some families Race: In African Americans the risk is twice as high as Hispanics compared to white population. South Asians have higher mortality when they have stroke. Sex (gender): Men have a higher risk for stroke, but more women die from it Previous stroke or heart attack

Stroke Risk Factors that Can be Controlled Ten Prevention Guidelines Hypertension/High Blood Pressure High blood pressure is also known as “Silent Killer” because there are no obvious symptoms High blood pressure slowly makes changes to heart and blood vessels and increases your risk of stroke by 4 to 6 times! Cigarette Smoking- Stop! It increases the risk of ischemic stroke by 2 times and up to 4 times in hemorrhagic strokes

Stroke Risk Factors that Can be Controlled (contd.) Heart disease Common heart disorders such as Coronary Artery disease, valve defects, irregular heart beats (Atrial-Fibrillation) and enlargement of the heart are risk factors for stroke (Coronary arteries bring blood to the heart ) All these condition can lead to small blood clots that may break loose and travel to cause a block in arteries Such a block can stop blood supply to brain causing stroke Diabetes Having it, is equal to aging 15 years. It causes destructive changes in the blood vessels Control your diabetes by monitoring your blood sugar

Stroke Risk Factors that Can be Controlled (contd.) High Cholesterol Know your LDL levels & Triglycerides Change your Diet & get more exercise Medication regimen: Talk to your Doctor Alcohol Intake In moderation: Heavy alcohol use may elevate stroke risk through increasing risks of hypertension, atrial fibrillation, cardiomyopathy, and diabetes Physical Inactivity Try to exercise for at least 40 minutes 3-4 times a week. Start slow and progress at your comfort level Diet Control Low Fat, Low sodium (salt) Fruits, Vegetables and Whole Grains

Stroke Risk Factors that Can be Controlled (contd.) Obesity Obesity and inactivity are associated with hypertension, diabetes and heart disease Waist circumference to hip circumference ratio is the best way to assess risk of stroke Warning signs or history of TIA or Stroke You are at a higher risk of having a stroke than someone who has never had a stroke Dial 911 immediately should you see or have any of the warning signs!

Stroke is an emergency L.A.F. Lets Act Fast STROKE CENTER! If you notice one or more of the stroke warning signs, GET HELP IMMEDIATELY! Stroke is an emergency L.A.F. Lets Act Fast CALL 9-1-1 (Not a transport service) Don’t delay! Have the Patient transported to the nearest STROKE CENTER!

Stroke Recovery But remember that 80% stroke are preventable 10% of stroke survivors recover almost completely 25% recover with minor impairments 40% experience moderate to severe impairments requiring special care. 10% require care within either a skilled-care or other long-term care facility. 15% die shortly after the stroke But remember that 80% stroke are preventable

Where can I get more information about my own risk for stroke Your own primary provider (MD or APN) Your cardiologist Your local hospital community education dept. Your city health department Your local library where you can read variety of health journals Website www.strokeassociation.org/targetstroke

Community member as a peer educator Take the FAST card or poster with you. Talk to your friends and family members about Stroke Warning Signs Organize an event for your community organization Invite the Stroke educators to your monthly meetings Educate about stroke and L.A.F. –Lets Act Fast

Stroke can be treated……. L.A.F. –Lets Act Fast

What is the first action if someone is experiencing stroke? Call 911

Before clot removal and after clot removal

Acknowledgements American Heart Association: 1-800-242-8721; www.americanheart.org American Stroke Association: 1-888-4-STROKE (1-888-478-7653); www.strokeassociation.org Brain Attack Coalition: 301-496-5751; www.stroke-site.org Internet Stroke Center: www.strokecenter.org Joint Commission on Accreditation of Healthcare Organizations: 630-792-5000; www.jcaho.org National Stroke Association: 1-800-STROKES (1-800-787-6537); www.stroke.org

Thank you for listening Questions?