Emergency care for stroke. If a stroke occurs at home, what should you do? First aid rules Providing first aid for a stroke

Help provided in the first seconds after an attack and medical care within the first three hours is tantamount to saving a life.

A stroke is a sudden disruption or cessation of blood supply to the brain. If a blood vessel in the brain is blocked by a blood clot, an ischemic stroke develops. Rupture of a blood vessel leads to hemorrhagic stroke. Both types of circulatory problems during a stroke can lead to brain cell death or death. Therefore, it is so important to be able to provide first aid to people for strokes before the ambulance arrives.

Stroke ranks fifth in the list of all types of deaths from the disease. But the worst of all are the consequences that this pathology brings with it: paralysis, loss of vision, speech impairment, changes in thinking and consciousness.

The first signs of a stroke may occur among women aged from 18 to 40 years old. Ignoring these “bells” increases the risk of having a stroke. In men, the disease often occurs by the age of 40; they suffer strokes more easily than women and recover faster.

The development of a stroke can be prevented if its warning signs are recognized in time, consult a doctor and do not forget about prevention.

Precursors of stroke:

• sudden weakness, rapid fatigue;
• severe headache;
• change, double vision (even short-term);
• feeling of numbness in the hand;
• severe dizziness;
• sudden, momentary disturbances in spatial orientation;
• speech difficulties, the simplest, most familiar words are forgotten;
• impaired ability to concentrate thoughts.

The listed symptoms may be signs not only of a stroke, but also of other pathologies. But in any case, you should consult a doctor, because often such symptoms are associated with insufficient blood supply, which can lead to a stroke and cause irreversible destruction of the nervous tissue of the brain.

Ischemic stroke

Ischemic Stroke Clinic:

• occurs in the morning or during night rest;
• the patient's consciousness is not impaired;
• weakness of the limbs appears on one side of the body;
• There are signs of speech impairment and facial distortion.

Hemorrhagic stroke

If a blood vessel in the brain ruptures, a person may temporarily lose hearing and may lose consciousness.

Symptoms:

• severe headache, hearing loss;
• occur during high psycho-emotional or physical stress;
• the patient has no consciousness;
• there is strong tension in the neck muscles;
• blood pressure is very high;
• convulsions and paralysis of the limbs develop.

Calling an ambulance is mandatory. Stroke cannot be treated at home. It is necessary to transport the person to a medical facility as soon as possible within the first 3 hours to reduce brain damage after a circulatory disorder.

At-risk groups

Stress and prolonged emotional stress can lead to stroke at a fairly young age.

People of working age are most often at risk for developing a stroke. The main reasons leading to the development of stroke:

• arterial hypertension;
• cerebrovascular accident;
• cardiovascular pathologies;
• stress and prolonged emotional stress;
• atherosclerosis, high cholesterol in the blood;
• diabetes mellitus, obesity, genetic predisposition;
• smoking, use of contraceptive pills by women;
• elderly age.

How to recognize a stroke

Face – hand – speech – test. These are not just words, but criteria that need to be assessed if a stroke is suspected. In Russian-language literature, the test is called “UPZ”, which means “smile, raise both hands, speak”:

Signs	What to pay attention to.
	Ask the patient to smile and show his teeth. Alarm: The appearance of facial asymmetry, weakness of facial muscles on the affected side.
	Ask to raise both arms up, palms parallel to the floor, hold them for 5 seconds, then lower them. If a person is lying down, the arms can be raised 45 degrees. Alarm: Lowering of one of the arms due to emerging muscle weakness.
	Ask to say any simple phrase, for example FIRST NAME Alarm: Unintelligible speech, failure to understand words in simple commands or phrases indicate speech impairment.

Important: If there are no symptoms, but the patient’s condition is alarming, you should immediately call an ambulance or take the person to the doctor.

Emergency first aid for stroke

The provision of the first, pre-hospital stage of first aid is reserved just 5-10 seconds, so there is no room for panic. You need to immediately call an ambulance - the faster the victim is provided with qualified assistance, the greater the chance of saving life and restoring health.

General instructions

How to provide first aid if you suspect a stroke

Action	Description
	Call an ambulance
	Check for consciousness: gently shake the person, ask a question.
	Determine whether the victim is breathing: bend your ear low to your face, listen to the sounds, notice whether the chest is moving.
	Check the carotid artery to see if a pulse is palpable. If possible, measure your blood pressure - emergency doctors will need this data.
	If spontaneous breathing is not possible, start. If there is a pulse, take 12 breaths per minute.
	Lay the patient down carefully. To prevent cerebral edema, raise your head slightly by 20-30 cm, placing a pillow, rolled up towel or other object under it.
	Tilt your head back a little, grab your lower jaw with your fingers and push it forward a little. If necessary, clean your mouth of dentures.
	During vomiting, carefully turn the patient onto the right side.
	Unbutton your clothes so that nothing restricts your neck or chest. Provide fresh air.
	During convulsions, you need to hold your head so that the person does not hit himself or choke on the foam coming out of the mouth.
	It is impossible to move or transfer a person to another place during a stroke - rupture of blood vessels may occur.
	From the moment the first signs appear, assistance should be provided within 3 hours.

Help with hemorrhagic stroke

In case of hemorrhagic stroke, two rules are added to the standard care at the prehospital stage:

1. To ensure the outflow of blood, be sure to place a pillow, a cushion from a jacket, or a bag under the patient’s head.
2. Place an ice pack (cold water bottle) on your head (presumably on the side where the hemorrhagic stroke occurred).

For ischemic stroke, pre-medical care is standard, according to the algorithm.

Providing assistance on the street

If you see a person on the street who has had a stroke:

Providing assistance in closed spaces

When providing assistance in closed spaces (in offices, stores, at home), in addition to the standard algorithm for providing assistance to the victim:

• you need to create an influx of fresh air - open the door, window, balcony;
• measure blood pressure (you can ask for the machine at your nearest pharmacy).

Caution: Never give any medicine to a patient yourself unless you are a doctor. Do not revive a person with ammonia - it can cause respiratory arrest.

If you are confused and don’t know what specific help you need to provide to a person:

• ask someone again call back by phone 103 or 112;
• describe the patient’s condition and receive recommendations for your further actions.

Watch the video at the link in this article: the author briefly talks about first aid for a stroke.

Chinese technique: needle for stroke

To help a person with a stroke, Chinese doctors suggest bleeding all 10 fingers and earlobes with a sterile needle. The punctures need to be small so that only blood flows.

But not all doctors agree with the effectiveness of this method:

• earlobe piercings can only be performed by an acupuncturist;
• Bloodletting can only help as an emergency treatment for high blood pressure.

Chinese medicine suggests using a sterile needle to puncture all 10 fingertips and both earlobes, and squeeze out a drop of blood.

After the ambulance has delivered the patient to the hospital, treatment of stroke symptoms takes place in several stages:

• intensive care in the intensive care unit to reduce, reduce brain damage, the risk of death,
• conservative therapy in a neurological or cardiological department;
• rehabilitation treatment in a rehabilitation center;
• physical therapy, speech exercises, massage, water treatments at home.

According to statistics, competent first aid in the first three hours after a stroke saves the lives of at least 50-60% of patients, even with severe forms of stroke. The disease has become very young, affecting both elderly and young, twenty-five-year-old people. Therefore, you need to be prepared to, if necessary, be able to recognize a stroke and provide quick and competent assistance to the victim.

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The possibility of restoring damaged areas of the brain and the normal functioning of the nervous system depend on correctly performed first aid for a stroke.

How to determine a stroke

A stroke is an acute form of disruption of blood flow in the brain, which causes damage and death of nerve cells.

Strokes occur in people 20 years of age and older. There are 2 varieties:

• with an ischemic stroke, the blood vessels of the brain narrow or become blocked;
• with hemorrhagic, bleeding begins in this area.

Vascular problems can be suggested by the following signs:

• numbness of the face, arms or legs;
• headache, dizziness;
• loss of control over the situation;
• nausea, vomiting;
• double vision, other visual problems;
• problems with motor activity, sensory disorders.

How often do you get your blood tested?

Poll Options are limited because JavaScript is disabled in your browser.

Only as prescribed by the attending physician 31%, 1593 vote

Once a year and I think that’s enough 17%, 889 votes

At least twice a year 15%, 781 voice

More than twice a year but less than six times 11%, 582 vote

I take care of my health and donate once a month 6%, 307 votes

I'm afraid of this procedure and try not to pass 4%, 215 votes

21.10.2019

A stroke appears suddenly, but there are warning signs:

• headaches, and their exact localization cannot be felt; they can appear due to fatigue or due to weather dependence;
• noise in ears;
• dizziness, both at rest and during movement;
• memory problems;
• sleep problems;
• malfunction.

It is necessary to conduct a test with the victim:

1. Ask the person to smile. The face will look unusual. If one corner of the mouth does not rise, then it is a stroke.
2. Ask to raise both hands. If one has weakened and cannot be held, then this also indicates pathology.
3. Ask the person to pronounce his own name. If speech is slurred, or the victim cannot say anything, then this is also a sign of a stroke. The person will speak unusually, with difficulty, strangely.

When symptoms of pathology are identified, assistance for a stroke is provided immediately. It is important to call a medical team as quickly as possible. Doctors have only 3 hours (maximum 4.5 hours) to save a person having a stroke.

During the therapeutic window (which is only 3-6 hours after a stroke), severe complications of ischemia and tissue death can be prevented with special therapeutic manipulations.

Correct position

In case of a stroke, first aid involves giving the victim the correct body position. The patient must be given rest; he is prohibited from moving. It is best to place the patient on his back and raise his head a little (if he has not lost consciousness).

When the patient faints or has convulsions, it is necessary to lay him horizontally on his side.

Use of medications

When the medical team is called, first aid does not involve the use of special drugs.

But if the process of transporting the victim to the hospital is very prolonged, then the following medications are administered intravenously to help the brain: Actovegin, L-lysine, Furosemide, Cortexin, Nootropil, Thiocetam, Piracetam. This is one of the emergency measures for stroke.

First aid

Before the ambulance arrives, it is necessary to begin the first steps at home to improve the patient’s condition. It is necessary to provide first aid for a stroke as correctly as possible:

1. Calm down and assess the general condition of the patient. Help begins with determining breathing rate, pulse and the presence of consciousness.
2. Call an ambulance so that it can arrive as quickly as possible. Over the phone, indicate all the information about the location of the victim, quickly and clearly describe the situation.
3. If the patient is conscious, then it is necessary to calm him down and assure him that they will help him. You should not allow yourself to be very worried, as stress will aggravate the condition.
4. Resuscitation care (artificial respiration, cardiac massage) for stroke is carried out only if necessary.
5. Place the patient horizontally on his back or side and raise his head.
6. Open windows to allow oxygen in to make breathing easier.
7. Constantly monitor the standing of the victim. If the patient is on the street, then he needs to be covered with warm clothes and rub his arms and legs.

A stroke victim, the people around him and doctors have no more than 4 hours to restore blood flow to the brain. Therefore, promptly provided first aid for a stroke is extremely important; during this period it is necessary to recognize the attack by its characteristic symptoms, reduce the impact of the attack by providing primary care before the arrival of doctors, take the victim to the hospital and prescribe treatment.

The first signs of a stroke

A stroke and the nature of its development mechanism can be recognized by a set of general neurological and specific symptoms in order to provide first aid in a timely manner. Common primary symptoms that occur spontaneously without any precursors include:

• numbness of the limbs - in most cases on one side of the body;
• darkening and double vision;
• impaired coordination and orientation;
• short-term attacks of amnesia;
• speech disorder.

Manifestations of ischemic stroke have their own characteristic features:

• paralysis of the body or limbs develops on one side, almost always the opposite side of the damage to the brain cells;
• the gait becomes uncertain and shaky, often the victim cannot stand on his own;
• speech becomes difficult, articulation and perception of what is said decreases;
• dizziness occurs, accompanied by bouts of vomiting.

An attack of hemorrhagic stroke is often preceded by a sharp increase in blood pressure - a hypertensive crisis. As a result, the artery ruptures and hemorrhages into the brain tissue. During an attack, a person experiences:

• sharp and unbearable pain that feels like it’s tearing your head apart;
• increased heart rate;
• facial distortion due to increased muscle tone;
• paralysis;
• high sensitivity to light, dots and blurry circles before the eyes.

Signs that allow a definitive diagnosis of a stroke before doctors arrive include:

• asymmetrical smile and inability to lift one of the corners of the lips;
• impaired articulation and inhibited speech;
• asymmetrical movement of the limbs when trying to simultaneously lift them up.

If, in the event of a sudden deterioration in a person’s health, at least a few of the described signs are detected, an emergency ambulance should be immediately called and taken to the hospital.

First aid for stroke at home

At the first signs of a stroke, despite the victim’s consciousness and his assurance that everything is in order, people nearby should promptly call an ambulance and describe in detail to the dispatcher the symptoms of brain failure that have appeared. Before the arrival of doctors, the patient must be provided with primary care to alleviate the condition:

1. In case of special instructions from the dispatcher, follow them unquestioningly.
2. Carefully place the victim in a position in which the head is elevated to 30° and slightly turned to one side. This is necessary so that in case of sudden vomiting, food debris does not enter the respiratory organs, and also in case of loss of consciousness, the tongue does not become stuck.
3. Open a window or vent to allow fresh air into the room where the victim is located.
4. Calm the patient if he is overexcited or begins to get nervous due to limited mobility. It should be explained in a calm tone that he will soon receive medical assistance to alleviate his condition.
5. Measure your blood pressure and, if possible, your sugar level and record the results of the measurements so that you can inform your doctors later.
6. Remove or unfasten clothing items that are squeezing your throat, chest, or belt.
7. In the absence of consciousness, breathing and heartbeat, immediately perform indirect cardiac massage and artificial respiration.

There are also methods of primary care for stroke, which are not always recognized by traditional medicine specialists, but are quite effective in practice. The main one is acupuncture. For an unconscious victim, the fingertips are pierced with an alcohol-treated needle until 2 or 3 drops of blood appear.

Also, if there is severe facial asymmetry, the patient’s earlobes are intensively rubbed, and then they are pierced with a needle until blood appears. This technique quite often brings the patient to consciousness and allows you to relieve tension in the structures of the brain.

Actions that are prohibited from performing if a stroke is suspected include:

• strong shaking of the victim, sudden movements, screams and hysterics of others;
• feeding and drinking plenty of fluids;
• bringing to life with ammonia and other acid-containing agents;
• attempts to eliminate the symptoms of brain failure independently with pharmaceuticals;

First aid for stroke

Before the ambulance team arrives, it is not recommended that the victim be given any medications on his own, except in cases where the ambulance dispatcher can make a one-time prescription based on the described symptoms.

Medication assistance is provided by ambulance paramedics. Directly in the resuscitation vehicle, doctors perform surgical actions aimed at maintaining the vital signs of the body. These include:

• indirect cardiac massage;
• artificial respiration;
• tracheal intubation;
• administering blood thinners for symptoms of ischemic stroke;
• administration of anticonvulsants for severe convulsive syndrome;
• reducing blood pressure with medications if its levels are critically elevated;
• administration of osmodiuretics if the victim shows signs of cerebral edema;
• administration of thrombus-forming agents if a hemorrhagic stroke is diagnosed;
• administration of drugs that improve blood flow through blood vessels and arteries.

After delivering the patient to the hospital, it is extremely important to promptly confirm the preliminary diagnosis using instrumental methods and prescribe adequate treatment aimed at restoring blood flow and damaged nerve tissue.

First aid for stroke

An infarction of the brain substance that occurs as a result of sudden circulatory failure is called a stroke. This is a fatal pathological condition for humans. First aid (first aid) for a stroke helps a person save a life, as well as avoid its severe consequences.

It is especially important to know what to do in case of a stroke for each person to provide first aid - sometimes the count can literally be “minutes”.

Causes of stroke

During a stroke, blood flow to certain areas of the brain decreases or stops. It is customary to distinguish two variants of the disease - ischemic, when full blood flow is prevented by a plaque, and hemorrhagic - when the vessel wall is ruptured.

Causes of plaque:

• The formation of an atherosclerotic or thrombotic obstruction - thrombosis.
• The entry of a foreign particle into the choroid duct is an embolism.

Causes of vascular wall rupture:

• Arterial hypertension.
• Aneurysms are congenital thinning of a section of the vascular wall.

• Tobacco smoking.
• Abuse of excessively fatty foods.
• Obesity.
• Alcoholism.

Signs of an acute condition

Every person needs to know how to recognize a stroke. It could one day save another person's life. The main symptoms of the pathology include:

1. A sudden, painful, severe headache, accompanied by severe nausea and repeated vomiting, flashing of foreign spots before the eyes are the first symptoms of increased intracranial pressure.
2. Significant fluctuations in individual blood pressure parameters.
3. Possible loss of coordination of movements, up to loss of consciousness.
4. Significant impairment of facial expressions and speech – “verbal porridge”.
5. The appearance of double vision, a decrease in visual acuity, usually in one eye.
6. A person suddenly stops recognizing familiar objects, surrounding people, does not remember dates and what day of the week it is on the street.
7. Unilateral paresis and paralysis of the limbs, half of the face.
8. Tremor of the tongue, its pathological deviation to the side.

Any of the listed signs, or their combination, should be alarming - only a specialist will be able to determine the root cause of the condition and prescribe adequate treatment tactics.

Signs of stroke in women, often ignored, and in the meantime they already need first aid:

• Increased headaches.
• Accompanying habitual headaches with numbness of the face and limbs.
• Increased forgetfulness, which was not typical for women before.
• Impaired coordination of movements.

Signs of stroke in men that you should pay close attention to so that first aid is provided in time:

• Misunderstanding of speech addressed to him.
• Sudden onset of sweating and weakness.
• Numbness in the limbs.
• A sharp decrease in hearing or vision on one or both sides.
• Bradycardia.
• Disorientation in time, personality, space.

Many people do not understand how to determine a stroke in a person. To this end, you can carefully ask him to repeat a few simple steps:

1. Introduce yourself to the person and ask him to respond with his details - last name, first name, address, phone number.
2. Smile and watch how the person smiles back - if certain muscle groups no longer participate in the smile, a stroke is quite possible.
3. Asking a person to raise his hand up and hold it there for a while on his own - if the muscles are weak, this simple action is impossible.
4. When you open your mouth, your tongue may reflexively move to the side - one of the signs of a stroke.

First aid

As early medical care as possible for a stroke helps to avoid the development of irreversible processes in the human brain, and also saves lives. It is a well-known fact that the therapeutic window, when it is possible to stop the pathological process as much as possible, lasts only three hours.

If emergency care for a stroke was provided correctly and in this limited period of time, there is a high probability of a favorable outcome of the disease and optimal restoration of all body functions.

First aid for a stroke is an emergency call to the resuscitation medical team. If the request was transmitted on time, the person’s life will be saved. While emergency personnel are rushing to the call site, it is recommended to perform a number of important actions:

• Reassure the patient as much as possible - fear and anxiety only aggravate his condition.
• Loosen the compressive elements of clothing - the waistband of trousers, the collar of a shirt or blouse.
• The person's head should be higher than the body.
• Ensure as much air flow as possible (if the action takes place indoors).
• If a person knows about the presence of hypertension, and has a tonometer at hand, be sure to check the numbers; if they are significantly exceeded, antihypertensive drugs will be required (hypertensive patients should always have them with them).
• First aid for a stroke at home will consist of distracting procedures - foot baths with boiling water, applying mustard plasters to the calf muscles, etc.
• In case of loss of consciousness, the person should be carefully placed on his side in order to prevent aspiration of possible vomit. If the gastric contents come out, the oral cavity needs to be cleaned. Trace the location of the tongue - it should not go deep inside, otherwise the person may suffocate.
• It is strictly forbidden to give a person vasodilators, give him water or feed him before the arrival of emergency medical personnel. You can only wipe your face with a damp cloth and lightly massage your scalp.

First aid for suspected hemorrhagic stroke

1. Place the patient on a hard surface - table, floor, etc., so that the shoulders and head are in an elevated position. It is not recommended to move the victim over a significant distance.
2. Unfasten tight clothing.
3. Remove dentures, if present.
4. Provide a massive influx of air masses.
5. Tilt the person's head to the side. After vomiting, clean the mouth with a piece of gauze or a clean handkerchief.
6. A container of ice liquid should be applied to the head - to the numb limbs on the opposite side.
7. Maintain optimal blood circulation in all extremities - cover with a warm blanket, apply a heating pad or mustard plasters.
8. Prevent aspiration by monitoring salivation and removing everything from the oral cavity.
9. In case of paresis, lightly rub the limbs with an oil-alcohol solution.

First aid for suspected ischemic stroke

1. Place the person on a hard surface, in a lateral position.
2. Ensure maximum peace, do not move anywhere.
3. Keep the victim in a clear consciousness using cotton wool and ammonia.
4. Monitor breathing function - the tongue should not sink.
5. Do not allow the victim to take any medications, food or liquids.
6. Wipe the head and neck area with a damp cloth every thirty minutes.
7. Rub the torso and limbs with a soft cloth or with your hands.
8. If individual pressure levels are high and in the absence of antihypertensive drugs, immerse the person’s legs in hot liquid (at home).

First aid for stroke and bloodletting

When providing first aid to a person with a suspected stroke, one of the most controversial issues to date is bloodletting. It involves piercing the fingertips with a needle disinfected over a flame until the first drops of blood appear. If there is asymmetry of facial features, you can intensively rub the ears, and then pierce each earlobe until a drop of blood appears.

It is not recommended to perform it without the advice of a specialist. Using this measure, you can get a double effect - a person’s condition will stabilize, or it will significantly worsen. In the opinion of medical specialists, this method does not have sufficient grounds.

Preventive measures designed to prevent the development of this severe pathology include:

• Pay attention to individual blood pressure parameters.
• Regular medical examinations and not only in old age, but in the most able-bodied people - stroke significantly - “rejuvenated”.
• Complete, fortified nutrition.
• Regular walks in the fresh air.
• Sufficient physical activity, visiting swimming pools and fitness centers.
• Attention to the slightest deviations in well-being is not typical: forgetfulness, imbalance of movements, numbness in the limbs.
• Compliance with the instructions issued by the attending family doctor.

Deviations noticed in time require consultation with a specialist, and then a stroke can be avoided.

First aid for stroke: symptoms, algorithm of actions at home

When a stroke occurs, there is little time to save the person. Seconds literally count. The main factor that has a beneficial effect on treatment is the timely provision of qualified medical care to the patient. Therefore, the first action of any person near the victim will be to call an ambulance. But this requires basic knowledge about the symptoms and signs of a stroke and the correct algorithm of actions while waiting for doctors.

The development of a stroke is accompanied by the following general symptoms:

• sudden acute headache;
• fainting;
• weakness;
• speech, vision, hearing impairments;
• convulsions;
• nausea;
• vomit;
• asymmetry on the face;
• paralysis (if the right hemisphere of the brain is damaged, the left side of the body is taken away and vice versa).

But it should be noted that men and women often have their own characteristics when it comes to stroke.

If a man has a stroke on the street, passersby often assume that he is intoxicated. This is due to the similarity of some features:

• uncontrolled bowel movements or urination;
• increased salivation;
• impaired coordination of movements;
• problems with orientation in space;
• coma.

According to statistics, stroke affects men mainly after 40 years of age.

In addition to general symptoms, women experience a strange emotional background and severe dizziness. They are much more susceptible to the disease than men. Doctors believe that this is due to the following factors:

• pathologies during pregnancy;
• taking hormonal contraceptives;
• predisposition to diseases of the circulatory system;
• exposure to stress and strong emotionality.

Women are much more likely to experience early signs of a stroke. Most often this disease affects the weaker sex after 60 years.

Unfortunately, it is not possible to determine which type of disease has developed based on symptoms at home. It makes a huge difference though. After all, both PMP and subsequent treatment vary significantly depending on the type.

Extensive stroke is divided into:

But there is also a micro-stroke.

This disease contributes to the development of a major stroke. A microstroke is a circulatory disorder in the brain tissue that leads to cell death. Most often this occurs due to the formation of clots in the blood.

The clot clogs the blood vessels and the blood stops feeding the brain cells, which causes them to die. If blood flow is not normalized within 6 hours, a stroke occurs. Symptoms:

• dizziness;
• headache;
• sensitivity to loud sounds and bright lights;
• sudden jumps in blood pressure;
• feeling of numbness of the face and/or limbs;
• general poor health, weakness;
• loss of consciousness;
• confusion of thoughts;
• impaired coordination and balance.

If you detect only a few symptoms, you should immediately consult a doctor. Correct and timely treatment will prevent the occurrence of more serious disorders.

90% of patients encounter this type. In medical circles it has another name - cerebral infarction. The reasons for the development of this pathology are:

The risk group includes people who suffer from atherosclerosis and diabetes mellitus, mainly the elderly (after 60 years).

The main cause of this disease is hypertension. Unable to withstand high blood pressure, blood vessels burst. Through the rupture, blood enters the brain tissue, causing hemorrhage.

This type of stroke mainly affects people 40–60 years old. The risk group consists of obese patients who lead a sedentary or unhealthy lifestyle (smoking, alcohol abuse).

It is important to provide first aid for a stroke in a timely and correct manner. Death due to this pathology does not occur instantly! The patient's condition worsens over several days. But a lot depends on at what stage of the disease you go to a medical facility. At the first signs, it is necessary to call an emergency room and provide first aid.

Before medical workers arrive, you should:

1. 1. Help the patient take a horizontal position. The upper part of the body (head and shoulders) should be slightly raised (approximately 30 cm).
2. 2. Prepare a container in case of vomiting.
3. 3. Examine the patient for any things compressing his body. If there are any (tie, scarf, belt), release their pressure (unbutton the top buttons on the shirt too).
4. 4. Ensure complete rest.
5. 5. Ventilate the room in which it is located or turn on the air conditioner.
6. 6. Measure the pressure, if possible. If the values ​​are elevated, give medicine.
7. 7. If the patient has a disturbance in the rhythm of breathing and/or pulse, resuscitation should begin: chest compressions and artificial respiration, even when he is still conscious.

Upon arrival, doctors will try to determine which type of stroke affected the patient and take the necessary treatment measures even before hospitalization, if possible. Most often, emergency doctors lower blood pressure and transport the patient to the neurological department. There, the patient is prescribed and urgently undergoes the necessary laboratory tests. Treatment methods directly depend on test results. During this period, self-administration of non-prescribed medications is similar to death. The doctor’s prescriptions will necessarily include the following medications:

• reducing blood pressure;
• antiplatelet agents or anticoagulants;
• normalizing blood cholesterol levels;
• B vitamins.

Even if the crisis situation was overcome, the consequences of a stroke require long-term rehabilitation. They can be different: loss of the ability to move, impaired speech function, deviations in the functioning of the vestibular apparatus. You should be very attentive to the patient, note everything that he feels and perceives.

During the recovery process, it is important to strictly follow the doctor's recommendations. After all, 30–40% of patients are diagnosed with a recurrent stroke over the next two years. Its consequences are many times worse than the first.

In short, preventive measures can be called maintaining a correct lifestyle. It is necessary to monitor blood pressure, cholesterol and blood sugar levels. Morning exercises and proper nutrition will help keep the body in good shape for many years.

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First medical aid for stroke

D Oct. med., prof., Research Institute of Neurology, Russian Academy of Medical Sciences

K and. honey. Sciences, Center for Stroke Research, Ministry of Health of Russia

Cerebral circulatory disorders, causing disruption of nutrition and oxygen supply to certain parts of the brain, lead to the development of focal neurological symptoms: disturbances of movements, speech, vision, memory, etc. Based on the duration of the existence of focal neurological symptoms, cerebral circulatory disorders are conventionally divided into strokes (acute disorders cerebral circulation) and for transient disorders of cerebral circulation (abroad, the term “transient ischemic attacks” is more often used). If disturbances in movement, speech or vision are restored within 24 hours, then such disturbances of cerebral circulation are classified as transient; if the disturbances last more than 24 hours (and can fully recover) - to a stroke.

Rice. 1 Types of stroke

Rice. 2 Stroke treatment plan

Every year in highly developed countries, 25-30 cases of stroke occur among each population. Out of 100 stroke patients, 35-40 people die in the first 3-4 weeks. Economic losses from stroke in the United States amount to approximately $30 billion per year.

More than 400 thousand strokes occur in Russia, which is equal in number to the population of an average regional city. Among the survivors, the majority experience various functional disorders: by the end of the acute period, almost 80% of patients have motor disorders (most often these are paresis of varying severity), more than a third of patients have speech disorders.

According to the mechanism of development, there are three types of stroke:

• ischemic (synonyms: cerebral infarction, softening of the brain), when, as a result of blockage of a cerebral vessel or for another reason, an acute deficiency of blood supply (ischemia) of a certain area of ​​the brain develops;
• hemorrhagic (synonyms: cerebral hemorrhage, intracerebral hematoma), when, due to a rupture of a cerebral vessel, blood flows into the brain, disrupting the normal blood circulation of the brain tissue;
• subarachnoid hemorrhage - hemorrhage in the subarachnoid space of the brain.

On average, ischemic strokes account for 80% of all strokes, intracerebral hemorrhages account for 17%, and subarachnoid hemorrhages account for 3% (Fig. 1).

In those countries where there is a mandatory national program to combat arterial hypertension, along with a general decrease in the number of strokes in the population, the proportion of intracerebral hemorrhages also decreases, since their main cause is high blood pressure. In contrast, in developing countries, where health care is unaffordable for large portions of the population and there is high levels of chronic stress in society due to poverty, unemployment, and crime, higher rates of hemorrhagic strokes are observed.

There are four main post-stroke periods: acute (first 3-4 weeks), early recovery (first 6 months), late recovery (from 6 to 12 months), residual (after 1 year).

The most common causes of ischemic stroke (cerebral infarction) are: atherosclerosis of the main arteries of the head (internal carotid and vertebral arteries), arterial hypertension, and heart disease. Rarer causes include coagulopathies, vasculitis, blood diseases (erythremia). In addition to such leading factors as atherosclerosis, arterial hypertension and heart disease, risk factors for the development of ischemic stroke include smoking, which affects the antithrombotic properties of the vascular wall, lipid metabolism disorders, obesity, and diabetes mellitus.

According to the development mechanism, there are five main subtypes of ischemic stroke: atherothrombotic, which is based on the formation of a blood clot at the site of an atherosclerotic plaque; hemodynamic, which occurs when two factors are combined: a sharp decrease in pressure due to a temporary deterioration in cardiac activity and stenosis (narrowing) of one of the main vessels of the head; embolic, in which emboli from the heart or atherosclerotic plaque of a large vessel are transferred with the bloodstream to smaller cerebral vessels and clog them; hypertensive lacunar infarction develops against the background of arterial hypertension, which is characterized by stenosing damage to the walls of small arteries (arteriosclerosis); hemorheological occlusion (blockage) of cerebral vessels with increased blood clotting and/or with hyperaggregation (increased ability to stick together) of platelets.

Atherothrombotic and hemodynamic strokes often occur at night due to decreased blood pressure and slower blood flow.

Lacunar infarction and cardioembolic stroke, on the contrary, develop during the day against the background of physical and emotional stress.

Main symptoms of ischemic stroke. During a stroke, not only focal neurological symptoms (disturbances in movement, speech, vision, etc.) may occur, but also general cerebral symptoms in the form of disturbances of consciousness, headache, and vomiting. If the nature and severity of focal symptoms depend on the location of the lesion in relation to functionally significant areas of the brain (motor center, speech or visual center), then general cerebral symptoms largely depend on the size of the lesion and the accompanying cerebral edema. In most cases of ischemic stroke, cerebral symptoms are not pronounced.

Treatment of ischemic stroke. A patient with any type of stroke must be immediately hospitalized. It is desirable that this be a hospital that has modern examination methods: computed tomography (and/or magnetic resonance imaging), angiography, a neurosurgical department (or a group of neurosurgeons) and an intensive care unit.

Patients with impaired consciousness and vital functions (primarily respiratory function) are hospitalized in the intensive care unit. The remaining patients are hospitalized in a neurological department, or even better - in a specialized angioneurological department with an intensive care unit.

To the number urgent measures both for patients with ischemic stroke and for patients with cerebral hemorrhage, include: restoration of breathing (installation of an air duct, and, if necessary, artificial ventilation); for epileptic seizures, which often occur in patients with severe stroke, intravenous administration of diazepam (Relanium, Seduxen), for repeated convulsions and the development of epistatus - sodium thiopental.

Arterial pressure for ischemic stroke, it is reduced only when it exceeds 180-190 mm Hg. Art. (systolic) and 110 mm Hg. Art. (diastolic). The pressure should be reduced very carefully - by 15-20% of the initial value, since a sharp decrease in it can aggravate cerebral ischemia.

General events for all types of stroke include: maintaining normal levels of breathing and cardiac activity, controlling blood pressure, inserting a nasogastric tube if swallowing is impaired, combating dehydration, monitoring the condition of the intestines and bladder, skin care to prevent bedsores.

But special measures may be necessary in cases of ischemic and hemorrhagic strokes. These measures can be carried out only when the nature of the stroke is beyond doubt, that is, when the patient has undergone a computed tomography study of the brain, and if an ischemic stroke is suspected, an angiographic study of the vessels that led to cerebral ischemia.

The main objectives of specific treatment of ischemic stroke in the acute period are: restoration of blood flow (in case of complete blockage of the blood supply artery) and neuroprotection (protection of neurons from structural damage). These tasks can be fully completed provided that the patient is taken to the hospital within the first three hours after the first signs of a stroke, during the so-called therapeutic window.

Thrombolytics are used to restore blood flow- urokinase, streptokinase and tissue plasminogen activator. These drugs are prescribed only after a computed tomography study and angiography have confirmed the assumption of the presence of thrombosis and no later than 3 hours from the onset of the stroke. The dose of tissue plasminogen activator is 0.9 mg/kg body weight, the drug is administered intravenously. Hemorrhagic complications occur on average in 5% of patients (according to various researchers, this figure ranges from 0.7 to 56%).

Neuroprotective therapy is aimed at protecting nerve cells from damage caused by various metabolic disorders that occur in the first minutes and hours of a stroke. The following have neuroprotective properties:

• postsynaptic antagonists of glutamate receptors (not available in the pharmacy chain; they are being clinically tested in major neurological centers around the world);
• presynaptic glutamate inhibitors (lubeluzole);
• antioxidants (emoxipine, alpha-tocopherol, carnosine, mexidol);
• calcium channel blockers (nimodipine);
• drugs that have a nootropic effect: nootropil (piracetam) (in the first days, up to 12.0 g intravenously), Cerebrolysin (in the first days, 10.0-20.0 g intravenously), Semax.

The “cytoprotective therapeutic window” for the use of many neuroprotective drugs (for example, for glutamate receptor antagonists) is quite narrow: the first 5-6 hours after the first signs of stroke. Nootropics and antioxidants are used throughout the acute period of stroke; the effectiveness of nootropic drugs (nootropil, piracetam, Semax, Cerebrolysin) and in the recovery period has been shown to improve cognitive and speech functions.

Regardless of the timing of delivery of a patient with ischemic stroke (primarily with atherothrombotic and cardioembolic), he is prescribed hemocorrection: antiplatelet agents (aspirin 100 mg per day or ticlide, or dipyridamole (chimes) and/or anticoagulants. Hemocorrection, in contrast to thrombolytic therapy, is not designed to lyse a blood clot - its task is to prevent recurrent strokes, blood clot enlargement, thrombosis of the veins of the lower extremities and pulmonary embolism.

Of the direct-acting anticoagulants in the acute period of ischemic stroke (with the exception of lacunar infarction), low-molecular-weight heparin (fraxiparin 7.5 thousand units 2 times a day for the first few days under the control of blood clotting) is recommended. Subsequently, patients who have suffered a cardioembolic and atherothrombotic stroke are prescribed indirect anticoagulants: phenylin or syncumar, or warfarin under the control of blood prothrombin.

Patients with severe and moderate stroke undergo hemodilution to increase cerebral perfusion and improve the rheological properties of the blood. Low molecular weight dextrans are used: rheopolyglucin, rheomacrodex. Reopoliglucin is administered intravenously by drip during the first few (no more than seven) days.

From vasoactive drugs in the most acute period of stroke, trental (intravenous drip), aminophylline (2.4% - 10.0 intravenously), and Cavinton are used. The effectiveness of the use of such popular vasoactive drugs as cinnarizine, papaverine, nicotinic acid, xanthinol/nicotinate in the acute period of stroke is denied by many researchers.

One of the serious complications of both cerebral hemorrhage and extensive cerebral infarction is cerebral edema and increasing intracranial hypertension. Among the medications used to combat cerebral edema, osmodiuretics are used: mannitol, which is administered intravenously over 20 minutes. at a dose of 0.5-1.0 g/kg body weight, then at a halved dose every 4-5 days depending on the level of osmolarity and the state of kidney function; glycerin in the same dose as mannitol, orally (with juice) every 4-5 hours for the first 3-4 days. Hyperventilation is effective in combating cerebral edema. In case of cerebellar infarction, accompanied by an increase in edema, which threatens to compress the brain stem (where the vital centers of respiration and circulation are located), decompressive trepanation of the posterior cranial fossa is indicated. It should be noted that corticosteroids, once popular for reducing cerebral edema in strokes, are not currently used.

The main cause of intracerebral hemorrhage is arterial hypertension. Other causes include rupture of an arterial saccular aneurysm or arteriovenous malformation. In developed countries, due to the active fight against arterial hypertension on a national scale, there is a trend towards a decrease in the incidence of hemorrhagic stroke.

The main factor determining the severity of hemorrhagic stroke and the development of cerebral symptoms up to coma is the size of the hematoma. However, even with a relatively small hematoma located close to the pituitary-hypothalamic region, which is the center of all vegetative functions of the body, serious consequences can be observed.

Cerebral hemorrhage, to a greater extent than ischemic stroke, is characterized by: severe general cerebral symptoms, including impaired consciousness and level of wakefulness (from stupor, lethargy to coma), meningeal symptoms (similar to those observed with inflammation of the meninges - meningitis), and blood is found in the cerebrospinal fluid. However, almost 30% of patients with intracerebral hemorrhage have no cerebral symptoms, no meningeal symptoms and no blood in the cerebrospinal fluid. These are so-called limited hematomas without breakthrough of blood into the ventricles of the brain and subarachnoid space. Therefore, if a doctor does not have the opportunity to conduct a CT scan of the patient’s brain, he sometimes cannot prescribe treatment specific to this type of stroke. A correct lifetime diagnosis can only be made by analyzing data from a computed tomography scan of the brain.

The main method of treating intracerebral hemorrhages with a volume exceeding ml(this can be determined using a CT scan of the brain) is a surgical intervention. In case of hemorrhagic stroke, the measures already described above to combat cerebral edema, neuroprotective therapy, and, if necessary, resuscitation measures, including artificial ventilation, are also carried out.

Many drugs previously used for hemorrhagic stroke (such as aminocaproic acid) to stop bleeding are currently not recommended due to the threat of developing disseminated intravascular coagulation syndrome.

Subarachnoid hemorrhages are hemorrhages in the subarachnoid space of the brain. Subarachnoid hemorrhages are less common than cerebral infarctions and intracerebral hemorrhages: their frequency ranges from 12 to 16 cases per 100 thousand population annually. They occur at any age, but most often between the ages of 45 and 60 years. Mortality during their development is no more than 20%.

The most common cause of subarachnoid hemorrhage is rupture of an arterial saccular aneurysm. Subarachnoid hemorrhage is characterized by a sudden, very strong (“dagger”, “scalded with boiling water”) headache, often accompanied by neck pain, nausea, vomiting, and occasionally impaired consciousness, disorientation, and epileptic seizures. Focal neurological symptoms (motor, speech disorders) are usually absent in the first days. Examination reveals severe meningeal syndrome and bloody cerebrospinal fluid. The most common complication of subarachnoid hemorrhage is vascular spasm, accompanied by the development of cerebral infarction. The peak of spasm development occurs on the 7-12th day.

If an aneurysm is accessible, the best treatment for subarachnoid hemorrhage is to surgically remove it or remove it from the bloodstream. In case of severe cerebral edema and increased intracranial pressure, the decongestant therapy described above is carried out. To reduce the severity of vasospasm and prevent the development of cerebral infarction, nimodipine (Nimotop) is administered intravenously for the first few days, then taken orally for 7-10 days.

Considering the severe consequences of stroke, the duration and high cost of treatment, the high level of disability resulting from this serious illness and the enormous economic damage caused by this disease, much more attention should be paid to the prevention of strokes.

First aid algorithm for stroke: for a stranger, for yourself, on the street and at home

From this article you will learn: what first aid should be for a stroke. Features of emergency measures at home and on the street, depending on the type of stroke.

First aid measures for stroke are a set of actions and measures aimed not only at saving the patient’s life. The possibility of restoring damaged brain cells and the functional abilities of the nervous system depends on the time and correctness of its provision. According to foreign and domestic experts, the optimal time for delivering a patient to a medical facility is 3 hours from the moment of illness (the sooner the better).

What should be done first when a person has a stroke?

Wherever the stroke occurs and no matter what the stroke is, both the patient himself (if his condition allows) and those around him must act according to a clear algorithm:

1. Do not panic.
2. Assess the patient’s general condition: consciousness, breathing, heartbeat, blood pressure.
3. Identify the obvious signs of a stroke: unilateral paralysis of an arm and leg, a distorted face, speech impairment, lack of consciousness, convulsions.
4. Call an ambulance by calling 103!
5. Find out the circumstances of the illness (briefly if possible).
6. Provide resuscitation measures (artificial respiration, cardiac massage), but only if they are necessary (lack of breathing, heartbeat and dilated pupils).
7. Position the patient correctly - on his back or side, either with his head and torso slightly elevated, or strictly horizontally.
8. Provide conditions for good oxygen access to the lungs and blood circulation throughout the body.
9. Monitor the patient's condition.
10. Arrange transportation to the nearest hospital.

The emergency care described above is general and does not include some situations that are possible during a stroke. The sequence of events does not always have to be strictly the same as in the given algorithm. In case of critical impairment of the patient's condition, one has to act very quickly, performing several actions simultaneously. Therefore, if possible, 2-3 people should be involved in providing assistance. In any case, following the algorithm, you can save the patient’s life and improve the prognosis for recovery.

Detailed description of all emergency steps

Each activity that includes first aid for a stroke requires proper execution. It is very important to adhere to subtleties, since any “little detail” can be fatal.

No fuss

No matter how serious the patient’s condition, do not panic or fuss. You must act quickly, harmoniously and consistently. Fear, fuss, haste, and unnecessary movements lengthen the time it takes to provide assistance.

Reassure the patient

Every conscious person with a stroke is definitely worried. After all, this disease is sudden, so the body’s stress reaction cannot be avoided. Anxiety will aggravate the condition of the brain. Try to reassure the patient, convince him that everything is not so scary, this happens and doctors will definitely help solve the problem.

Call an ambulance

Calling an ambulance is the first priority. Even the slightest suspicion of a stroke is an indication to call. Specialists will better understand the situation.

Call 103, tell the dispatcher what happened and where. It will take no more than a minute. While the ambulance is on the way, you will provide emergency care.

Assess your general condition

First of all, pay attention to:

• Consciousness: its complete absence or any degree of confusion (lethargy, drowsiness) is a sign of a severe stroke. Mild forms are not accompanied by impaired consciousness.
• Breathing: it may not be impaired, or it may be absent, intermittent, noisy, frequent or rare. Artificial respiration can be performed only in the complete absence of respiratory movements.
• Pulse and heartbeat: they can be clearly audible, rapid, arrhythmic or weakened. But only if they are not detected at all, you can do indirect cardiac massage.

Identify the signs of a stroke

Stroke patients may have:

• severe headache, dizziness (ask what is bothering the person);
• short-term or persistent loss of consciousness;
• distorted face (ask him to smile, bare his teeth, stick out his tongue);
• impaired or lack of speech (ask to say something);
• weakness, numbness of the arms and legs on one side, or their complete immobility (ask them to raise their arms in front of you);
• visual impairment;
• impaired coordination of movements.

Lack of consciousness or any combination of these signs is a high probability of a stroke.

Correct position of the patient

Regardless of whether the consciousness and general condition of a stroke patient is impaired or not, he needs rest. Any movements, especially independent movement, are strictly prohibited. The situation could be:

• On the back with the head and chest raised - with preserved consciousness.
• Horizontally on the side with the head turned to one side - in the absence of consciousness, vomiting, convulsions. Correct position of the patient in the absence of consciousness
• Horizontally on the back with the head slightly thrown back or turned to the side - during transportation and resuscitation measures.

It is forbidden to turn a person on his stomach or lower his head below his body position!

If there are cramps

Convulsive syndrome in the form of severe tension of the whole body or periodic twitching of the limbs is a sign of a severe stroke. What to do with the patient in this case:

• Lay on your side with your head turned to prevent saliva and vomit from entering your respiratory tract.
• If you can, place any object wrapped in cloth between the jaws. This can rarely be done, so don’t make much effort - it will do more harm than good.

Do not try to push the jaws apart with your fingers - this is impossible. Better grab the corners of the lower jaw, try to bring it forward.

Do not insert your fingers into the patient's mouth (risk of injury and loss of a finger).

On the importance of the circumstances of the disease

If possible, find out exactly how the person got sick. This is very important, since some symptoms of stroke can also be observed in other diseases:

• traumatic brain injury;
• diabetes mellitus;
• brain tumors;
• poisoning with alcohol or other toxic substances.

Resuscitation: conditions and rules

An extremely severe stroke, affecting vital centers, or accompanied by severe cerebral edema, occurs with signs of clinical death:

• complete lack of breathing;
• dilation of the pupils of both eyes (if only one pupil is dilated - a sign of a stroke or hemorrhage in the hemisphere on the affected side);
• complete absence of cardiac activity.

Follow these steps:

1. Place the person on their back on a hard surface.
2. Turn your head to the side, use your fingers to free the oral cavity from mucus and foreign objects (dentures, blood clots).
3. Throw your head back well.
4. Grab the corners of the lower jaw with 2–5 fingers of both hands, pushing it forward, while using your thumbs to slightly open the patient’s mouth.
5. Artificial respiration: cover the patient’s lips with any cloth, and, pressing your lips tightly, take two deep breaths (mouth-to-mouth method).
6. Heart massage: Place your right hand on top of your left (or vice versa), interlocking your fingers. Applying your lower palm to the junction of the lower and middle parts of the patient's sternum, apply pressure to the chest (about 100 per minute). Every 30 movements should alternate with 2 breaths of artificial respiration.

What medications can be given for a stroke?

If an ambulance is called immediately after a stroke occurs, it is not recommended to give the patient any medications on your own. If delivery to the hospital is delayed, the following drugs (preferably in the form of intravenous injections) help support brain cells at home:

• Piracetam, Thiocetam, Nootropil;
• Actovegin, Ceraxon, Cortexin;
• Furosemide, Lasix;
• L-lysine escinate.

Self-help for stroke

The ability to help yourself with a stroke is limited. In 80–85% of cases, a stroke occurs suddenly, manifested by a sharp deterioration in condition or loss of consciousness. Therefore, patients cannot help themselves. If you experience stroke-like symptoms:

1. take a horizontal position with the head end raised;
2. tell someone you feel bad;
3. call an ambulance (103);
4. adhere to strict bed rest, do not worry and do not move excessively;
5. release the chest and neck from constricting objects.

If the stroke is ischemic

Ideally, even first aid for a stroke should take into account the type of disease. An ischemic stroke is most likely if:

• arose in the morning or at night at rest;
• the patient's condition is moderately impaired, consciousness is preserved;
• signs of speech impairment, weakness of the right or left limbs, facial distortion are expressed;
• no cramps.

For such patients, first aid is provided according to the classical algorithm described above.

If the stroke is hemorrhagic

• arose abruptly at the height of physical or psycho-emotional stress;
• there is no consciousness;
• have convulsions;
• the neck muscles are tense, it is impossible to bend the head;
• high blood pressure.

In addition to standard care, such patients need:

1. The position is strictly with the head end elevated (except for convulsions or resuscitation).
2. Applying an ice pack to the head (preferably to the half in which hemorrhage is suspected - opposite to the immobilized tense limbs).

Features of providing assistance on the street

If a stroke occurs on the street, first aid has the following features:

• Involve several people to help. Organize the actions of each of them, clearly assigning responsibilities (someone calls an ambulance, and someone else assesses the general condition, etc.).
• Having placed the patient in the desired position, free the neck and chest to make it easier for him to breathe (remove the tie, unfasten the buttons, loosen the belt).
• Wrap up the limbs, cover the person with warm clothes (in cold weather), massage and rub them.
• If you have a mobile phone or contacts with relatives, inform them about what happened.

Features of providing assistance at home or in any enclosed space

If a stroke occurs indoors (at home, in an office, in a store, etc.), then in addition to standard first aid, pay attention to:

• Free access of fresh air to the patient: open the window, door.
• Release your chest and neck.
• If possible, measure your blood pressure. If it is elevated (more than 150/90 - 160/100 mm Hg), you can give antihypertensive drugs under the tongue (Captopress, Farmadipin, Metoprolol), lightly press on the solar plexus or on closed eyes. If it is low, raise your legs, but do not lower your head, massage the area of ​​the carotid arteries on the sides of the neck.

How to provide first aid for a stroke indoors

First aid effectiveness and prognosis

According to statistics, correctly provided emergency care for stroke patients with delivery to a medical facility within the first three hours:

• saves the lives of 50–60% of patients with severe massive strokes;
• in 75–90% it allows people with minor strokes to fully recover;
• improves the recovery abilities of brain cells by 60–70% in case of any stroke (better in case of ischemic stroke).

Remember that a stroke can happen to anyone at any time. Get ready to take the first step to help fight this disease!

Cerebral stroke is an acute disorder of cerebral circulation. In most cases, the cause of stroke is hypertension and atherosclerosis, less often - heart valve disease, myocardial infarction, congenital anomalies of cerebral vessels and arteritis.

At the prehospital stage it is necessary:

Clear the airways of vomit; introduce an air duct, and, if necessary, mechanical ventilation;

Elevate your head to reduce intracranial pressure and apply ice to your head. If urination is delayed, it is necessary to drain the urine with a catheter; cleanse the intestines with a cleansing enema;

First aid for stroke

Stroke is one of the most dangerous diseases of the cardiovascular system. According to statistics, every minute in Russia someone experiences a cerebrovascular accident - stroke. including micro-stroke. Stroke occurs even more often than myocardial infarction.

The mortality rate from stroke in the first month is 20-25%; in the first year, more than 1/3 of patients die from complications caused by cerebrovascular accidents, and 30-40% become disabled. Such depressing statistics are caused not only by the severity of the disease, but also by untimely (unqualified) assistance provided. Patients who received qualified medical care in the first three hours (maximum 6) have a chance to fully (as far as possible) restore all functions lost as a result of a stroke. This period (3 hours) even got its name “therapeutic window”; then irreversible pathological changes begin.

All patients with this diagnosis should be hospitalized - especially if cerebrovascular accidents occurred at work, on the street, or in transport. The doctor, having done a Computerized or Magnetic Resonance Imaging, must determine what is causing the cerebrovascular accident: blockage of blood vessels or hemorrhage. If this is a hemorrhage (Hemorrhagic stroke), then in what place it occurred, it is also necessary to restore the functioning of the vessels as quickly as possible and remove the blood. If there is a blockage in the blood vessels, the doctor will administer a drug that dissolves the blood clot.

The first symptoms of a stroke

The disease progresses individually for everyone. Symptoms of a stroke depend on what type of stroke the person has and what area of ​​the brain is damaged. The most common symptoms:

• headache;
• dizziness, sometimes accompanied by nausea. vomiting;
• possible loss of consciousness;
• weakness, numbness in half of the face, paralysis in the arm, leg;
• impairment of speech, memory, and ability to reason logically;
• increased pain in half of the body.

If at least two of the above symptoms appear in you, a family member, or a colleague, this is a reason to immediately call an ambulance. Describe the symptoms to the dispatcher so that the ambulance team arrives well prepared, with a planned action plan. Do not self-medicate, remember that you have three hours to return to normal life.

Actions before the doctor arrives

The patient must be laid down with a pillow under his head, shoulders and shoulder blades, so that the head makes an angle of approximately 30° to the bed, floor, bench. Provide access to fresh air, to do this, remove tight clothing, unbutton your shirt collar, open the window, if there is air conditioning, turn it on. Remove removable dentures.

If there is vomiting, turn your head to the side, wrap your hand in a clean tissue or gauze and clear the vomit from your mouth. Throwing them into the respiratory tract threatens with a severe form of pneumonia, which will then be difficult to fight.

Be sure to measure your blood pressure. Previously, it was believed that if it is elevated, it should be reduced to 120/80 mmHg. Art. A sharp decrease in pressure is no less dangerous than its high values! What to do? Usually a person knows his “working” numbers. For example, he feels good at 150/80 mmHg. Art. We need to focus on numbers that exceed the “working” ones by 5-10 mmHg. Art. and give an antihypertensive drug (preferably the one to which the victim is accustomed and uses in everyday life). A sharp drop in blood pressure can increase the focus of ischemia, which in turn will cause new disorders, in particular, paresis can turn into paralysis.

Is there anything to reduce the pressure? Are you afraid of overdosing on your medicine? Don't be alarmed and keep in mind if your blood pressure rises to 180 mmHg. Art. in a person who did not suffer from arterial hypertension, and up to 200 mm Hg. Art. – in a hypertensive patient, this is not very scary. It's better not to adjust it at all. You can resort to non-medicinal methods: ask the patient to take a deep breath and hold his breath for as long as possible. It is very important to measure your pulse. After all, some types of stroke are caused by atrial fibrillation. If the pulse “breaks”, give the patient the drug that he usually takes in such cases. Do not self-medicate, do not administer any drugs that affect blood vessels and brain structures! The drug glycine (aminoacetic acid) can be recommended. In a critical situation, it is recommended to give it one gram (10 tablets under the tongue) per dose or 5 tablets 3 times with an interval of 30 minutes. It will not do any harm and will ease the course of the disease.

If a stroke attack occurs on the street, your steps to help are similar. Ask someone to call an ambulance. Lay the victim down. Make sure that he does not choke on vomit; provide air access by unfastening the buttons, belt, belt. The decision is always clear - you need to take him to the hospital. If it is not possible to call an ambulance, deliver the patient by any means of transport, remembering the “therapeutic window”.

If you are using personal transport, then unfold the car seat, lay the patient down (at an angle of 30°), be sure to remove dentures, turn your head to the side and make sure that he does not choke on his own saliva or vomit. Don't forget the tonometer, measure your blood pressure and pulse. Even if you have nothing to correct them, information about the changes will help doctors make a correct diagnosis and quickly begin adequate treatment.

First aid for stroke

A stroke is a disorder of cerebral circulation. The arteries supplying blood to the brain may become blocked, and then an ischemic stroke occurs, or the artery may rupture and this is a hemorrhagic stroke. Thus, as a result of this vascular catastrophe, part of the brain is left without normal blood supply and experiences oxygen starvation. As a result of hypoxia - lack of oxygen in tissues, nerve cells die. This leads to a variety of neurological symptoms, this can be complete or partial loss of speech, memory loss, paralysis of body parts (hemiparesis).

Among all strokes, the ischemic variant occurs in 80% of cases. Blockage of the arteries that supply oxygenated blood to the brain is most often caused by cholesterol deposits. Ischemic strokes most often occur against the background of low blood pressure and occur mainly in the morning. If the artery is not very large in diameter, then the clinical picture of such a stroke develops gradually, begins with weakness, dizziness, a feeling of numbness of the face, arms and (or) legs on one side, visual and speech disturbances may appear, the corners of the mouth become asymmetrical, headaches may appear , loss of balance. When a large diameter artery is blocked, it is extremely difficult to differentiate between ischemic and hemorrhagic stroke at the prehospital stage.

A cerebral hemorrhage (hemorrhagic stroke) occurs when a blood vessel ruptures and fills the surrounding tissue with blood. This disrupts the normal flow of blood to the brain, and the released blood puts pressure on the brain tissue, leading to further damage. Most often, hemorrhagic strokes occur against the background of increased blood pressure.

When the lumen of the vessels supplying the brain with blood decreases and, accordingly, its nutrition deteriorates, it is necessary to prescribe drugs that reduce blood clotting (blood thinning) - this can be aspirin, which is used for quite a long time, ¼ tablet per day, or newer drugs - warfarin, in a dose prescribed by the attending doctor. The drug clopidogrel or zylt, which is also recommended as a disaggregant by neurologists, including at the prehospital stage, is now being used.

What to do

Emergency care for severe stroke at the prehospital stage does not require an accurate determination of its nature (hemorrhage or ischemia). The basic principles of such emergency care are to create conditions for the normalization of vital functions of the body - breathing and blood circulation, combating cerebral edema. Respiratory disorders during loss of consciousness may be caused by obstruction of the airway, which means it is necessary to exclude the retraction of the tongue, the entry of vomit into the trachea and bronchial tree, and for this the patient’s head must be turned to the side. According to modern recommendations of neurologists, blood pressure correction is carried out only if it significantly exceeds normal values, since low blood pressure in patients with stroke usually leads to a worsening of its condition and further prognosis.

The patient must be provided with oxygen, and drugs with an antihypoxic effect are prescribed. Today, preference is given to the drug Mexidol, which must be administered intravenously, in a dose of 5 milliliters, diluted in saline solution. Of the drugs that improve cerebral circulation, neurologists today recommend the use of magnesium sulfate solution at the prehospital stage. The use of aminophylline for strokes has now been abandoned and is no longer recommended. If there is a threat of cerebral edema, oxygen therapy is continued and diuretics (Lasix) are prescribed. In case of seizures, anticonvulsant therapy (Relanium). The patient should be hospitalized in the vascular center, in the primary vascular department, or in the nearest medical institution with an intensive care unit, since quite often such patients require intensive care, including resuscitation measures.

Prevention measures consist of protecting blood vessels, and this is, first of all, quitting smoking, since nothing destroys the vascular wall more than the components of tobacco smoke (and there are more than three hundred components!), control and treatment of arterial hypertension, diet, and regular physical activity. It is worth recalling that 80% of our health, according to WHO, depends on our lifestyle.

Stroke is a dangerous disease that results in impaired cerebral circulation and a number of negative symptoms. Every year, half a million people are diagnosed with this disease in Russia alone, and up to a third of all patients die. Qualified and correct first aid provided at an early stage, as well as prompt delivery of the patient to the hospital, doubles the likelihood of survival.

The first signs of a cerebral stroke

In most cases (with or), a stroke has its own precursors and first signs, which can be used to accurately diagnose a cerebrovascular accident.

1. Loss of consciousness and stupor.
2. Severe drowsiness or, on the contrary, agitation.
3. Palpitation with dizziness.
4. Sweating, nausea and vomiting.
5. Partial or complete loss of orientation in time and/or space.
6. Partial or complete loss of control over individual parts of the body, paralysis of the lower and upper limbs.
7. Hemiparesis in the acute stage.
8. Violations of visual perception and speech apparatus, loss of sensitivity.

If you suspect, you must urgently call an ambulance, preferably an ambulance. After this, begin to proceed with the following activities:

1. Lay the person horizontally and place a pillow under the head, raising it above the body at an angle of 25-30 degrees.
2. Open the shutters and windows indoors or place the person in the shade if he is outdoors.
3. If the patient begins to vomit, immediately turn him on his side to prevent him from choking.
4. Maintain contact with the patient if he is conscious, but under no circumstances give him anything to eat or drink.
5. Immediately after placing in a horizontal position, loosen the person’s knots, belt, tie and other tight clothing items.
6. Measure your blood pressure - if it is elevated, give a beta blocker such as Atenolol immediately.
7. If breathing disappears or the heart stops, perform resuscitation measures. Perform a precordial blow (with the edge of a clenched fist, in the area of ​​the lower middle third of the sternum, two centimeters above the xiphoid process) - this will start the heart pumping. After this, begin chest compressions and artificial respiration.

Actions of a patient during a stroke

1. At the first suspicion of a stroke, you must immediately inform others about the problem and take a horizontal position with a pillow under your head.
2. Do not take medications, drink water or consume liquids on your own.
3. In most cases, during a stroke, a person cannot independently and adequately control his own actions, so he cannot take any additional actions. The patient should inform relatives, friends or an ambulance about his condition as quickly as possible before loss of speech function or paralysis.

To prevent ischemic stroke (primary or recurrent), you should:

1. Radically change your own lifestyle.
2. Quit smoking and alcohol addiction.
3. Monitor your blood pressure periodically - if it regularly exceeds 140 to 90, you should consult a doctor.
4. Minimize the number of stressful situations.
5. Treat any, even not very dangerous, cardiovascular diseases; be constantly monitored by a doctor if you have diabetes.
6. Normalize your weight by going on a diet and doing regular physical activity on your body.

The patient successfully survived the stroke - now he requires a comprehensive recovery, including a number of medical, physiological and socio-psychological procedures.

The most important stage is the first three months; it is during this period that motor and other functions begin to be restored. In the absence of progress, the chances of a full recovery are practically non-existent.

The list of classic techniques includes conservative medicinal therapy, classes with a massage therapist, speech therapist, physiotherapeutic procedures, kinesio- and neurophysiotherapy, as well as ergo-adaptability.

Useful exercises

Any physical and other types of exercises can be carried out only after prior agreement with the attending physician, who will develop an individual training regimen with the exact number of approaches and repetition cycles.

If the patient is on bed rest and cannot move independently, then simple extension/flexion/rotation of the elbows, knees, feet, fingers and other parts of the body is usually recommended. It is rational to use splints and other medical systems.

In addition, clasping the hands over the ankles, raising the arms above the head with a smooth amplitude, as well as rotating the eyeballs, visual fixation on distant/near objects, etc., help restore control over movements.

In a sitting or standing position, the range of exercises is much larger:

1. From a sitting position, raise your knees to your chest, arching your back and holding your breath at the peak of the exercise.
2. Sitting on a chair, squeeze your shoulder blades and throw your head back.
3. Raise the kugi above your head and lower them to your knees.
4. Extend your arms to the sides using an expander.
5. From a standing position (feet shoulder-width apart), tilt your torso to the sides, then slowly squat (feet together).
6. Throw a small object on the floor, then pick it up without assistance and place it on the table.
7. Other exercises.

In addition, do not forget about restoring memory and speech. If it’s easier to deal with the second one by performing simple exercises on pushing the tongue forward, folding the lips into a tube and other facially active actions, then restoring memory is more difficult - complex exercises are required, including arithmetic and logical training, as well as taking nootropic medications.

During this difficult period of time for the patient, proper nutrition will become one of the cornerstones of the patient’s quick and effective rehabilitation. Main points:

1. After an attack and restoration of the patient’s physiological minimum, he needs at least two liters of liquid per day in the form of broths, weak tea, low-fat milk, etc.
2. In the acute and subacute period of the disease, the caloric content of food should be low, but at the same time, the nutritional value should be sufficient to maintain normal life functions.
3. In the first days after a stroke, food is thoroughly ground into a paste and the person is fed from a teaspoon. Drink from a miniature teapot or a special bottle.
4. In the absence of a swallowing reflex, food is delivered to the body through a tube; naturally, it should be liquid with the addition of vitamins. In case of severe neurological disorder and loss of basic motor functions, intravenous administration of nutrient solutions is resorted to.
5. After the final restoration of the swallowing reflex and a general improvement in the body's condition, it is allowed to introduce more solid foods - vegetables, steamed cutlets, mashed potatoes, soft-boiled eggs, etc.

Basic characteristics of the post-stroke diet include avoiding sweet and fatty foods, salt, spicy snacks, alcohol, strong tea/coffee and any kind of marinades/smoked meats. It is advisable for hypertensive patients to introduce more buckwheat, dried apricots, cabbage and figs into their daily diet - they contain magnesium and potassium salts that are beneficial after a stroke.

Nutritionists note that people who have suffered a stroke quite often experience regular constipation. It is advisable to fight them not with medications and enemas, but with the correct selection of a nutritional plan, which includes, in addition to all of the above, eating exclusively black bread made from wholemeal flour, prunes, honey, fresh fruits (excluding those that increase blood pressure), as well as minerals. waters with a laxative effect.

Useful video

Elena Malysheva in the program “Live Healthy”. First aid for stroke

First aid for stroke