Stroke: It's always an emergency

Stroke is a medical emergency. If a spouse, partner, friend, work associate — or you — experience sudden numbness or weakness in the face, arm or leg, especially on one side of the body, call 911 immediately.

Other sudden symptoms including confusion, trouble speaking, difficulty seeing out of one or both eyes, difficulty walking, dizziness or the onset of a sudden severe headache also warrant calling 911.

These are warning signs of a stroke and should not be ignored, even if they go away.

At Sarver Heart Center’s second lecture of the season on Thursday, Leslie Ritter, the coordinator of University Medical Center’s Primary Stroke Center, stressed the importance of getting immediate attention.

It’s natural for the person with symptoms not to want to call 911, but that could cost precious time.

“Time is brain,” said Ritter, who also is an associate professor in the College of Nursing and the Department of Neurology at the University of Arizona. Symptoms and warning signs of a stroke must be diagnosed and treated within three hours of onset.

While a spouse or neighbor may ask to be driven to the hospital, that’s not good enough, Ritter said. Paramedics call ahead and a stroke team is waiting as the ambulance pulls up.

Since UMC became Southern Arizona’s first Joint Commission Primary Stroke Center in March, Ritter said, “We have a formalized plan. Everyone is on the same page from when a patient is admitted to when they’re discharged. We must use national standards for stroke care.”

Strokes are the third-leading cause of death in the United States, with 150,000 deaths annually. About 700,000 people have a stroke annually. Of those 500,000 are first-time strokes and 200,000 are recurrent. The yearly cost is $41 billion.

Ritter explained UMC’s oversight by the accredited body of the Joint Commission.

“The emergency room doctor sees the patient immediately... we must track this ... and a neurologist sees the patient within 20 minutes. There’s extensive evaluation and UMC offers 24/7 coverage.

“Blood work and results are done within 45 minutes. A CT or MRI with results is also done within 45 minutes. Blood pressure and vitals are closely monitored. A patient is admitted to a special stroke unit with a diagnosis.”

Risk factors

There are two types of risk factors, those that cannot be changed, such as age, heredity, sex and having had a prior stroke or heart attack.

Risk factors that are treatable and controllable include high blood pressure, smoking cigarettes, diabetes, carotid or other artery disease, atrial fibrillation (this heart rhythm disorder raises the risk for stroke), sickle cell disease, high blood cholesterol, poor diet, physical inactivity and obesity.

“Taking care of these risk factors causes a remarkable reduction in strokes,” Ritter said.

Though two-thirds of people over 65 have high blood pressure, treating it results in almost four times the reduction of strokes, she said.

Diabetics are 2 to 6 times more likely to have a stroke. High blood pressure and diabetes is a bad combination, Ritter said.

Take action

Ritter stressed the following:

Not all warning signs occur in every stroke. Don’t ignore signs of a stroke, even if they go away.

Note that the common feature of the signs is their sudden onset.

Check the time. When did the first warning sign or symptom start? This will be asked at the hospital.

“If you’re with someone who may be having stroke symptoms, call 911 or the EMS immediately. Expect the person to protest; denial is common. Don’t take ‘no’ for an answer. An ambulance calls ahead and they get in faster.

Insist on taking prompt action.”

Contact Green Valley freelance reporter Ellen Sussman at ellen2414@cox.net.