Where stroke is concerned, every second counts. The sooner stroke treatment begins, the better the chances of saving the brain before permanent damage occurs.
Knowing the signs of stroke and when to call for help can literally make the difference between life and death or serious disability — and even with COVID-19, you can feel safe getting emergency stroke care at Scripps.
In this video, San Diego Health host Susan Taylor talks with Mary Kalafut, MD, a neurologist with Scripps Clinic and medical director of the Stroke Program at Scripps, about why immediate treatment is so important.
When someone has a stroke, a blood vessel that supplies oxygen and nutrients to the brain is blocked, often by a blood clot that travels from elsewhere in the body. Without oxygen, the brain tissue begins to die, and the functions controlled by the dying areas — such as speech, movement or cognitive abilities — can be severely damaged. The longer the vessel is blocked, the worse the damage may be. Severe strokes may be fatal.
“Because time is so critical in recognizing the signs of a stroke and getting emergency medical help, the acronym BE FAST can help,” says Dr. Kalafut. “It can be a good way to remember what to look for and do if it seems someone is having a stroke.”
The letters in BE FAST stand for:
- BALANCE: Is the person unsteady on their feet?
- EYE: How is the person’s vision? Can they see clearly, or is vision distorted or double?
- FACE: Can the person smile symmetrically? Does one side of the face droop?
- ARMS: Ask the person to raise both arms. Does one arm drift downward?
- SPEECH: Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?
- TIME: Time is crucial with stroke treatment. If you observe any of these signs, immediately call 911 to get the person to the nearest stroke center or hospital.
In addition to BE FAST symptoms, other stroke signs can include sudden confusion, problems understanding speech, numbness, dizziness or problems with movement or coordination, and severe headache.
With stroke, “time is brain.” This phrase summarizes the crucial need to get medical treatment as soon as possible when you suspect someone is having a stroke. The more time passes, the longer the brain is without oxygen, and the greater the damage can be.
“We need to open up the blood vessel and restore the blood flow, so that the nerve cells can continue to work,” says Dr. Kalafut. “There’s a medication called tissue plasminogen activator or TPA, which is a clot-busting medication that can open the blood vessel, but it has to be given within the first few hours after a stroke to be effective.”
Make a note of the time when the first symptoms appeared, as this can be important to treatment. Even if the symptoms only last for a few moments and the person says they feel better, get emergency help. There may still be damage to the brain, or another stroke may be on the way.
Though you may be tempted to drive to the hospital yourself rather than wait for an ambulance, always call 911. Patients can deteriorate as the stroke progresses, and emergency medical technicians can begin treatment on the way to the hospital.
The COVID-19 pandemic has raised concerns about going to the hospital because people worry they will contract the virus. In fact, the Centers for Disease Control and Prevention (CDC) reported a 20 percent decrease in the number of people coming to the emergency department with signs of a stroke. Others wait a day or two before coming in. Delaying stroke treatment, however, can increase the risk of severe disability or death, notes Dr. Kalafut.
“We have lifesaving treatments that can reverse the stroke, but you need to call 911 and come in immediately as soon as you notice possible signs of stroke,” she says. “It’s very safe to come into our hospitals. Patients are being tested immediately for COVID-19 and we’re taking every precaution for prevention.”