Monday, August 21, 2017

Strokes at Sea

May 1, 2017 by · Leave a Comment 

stroke at sea title

Every responsible boater has a first aid kit, but it’s not possible to be prepared for all emergencies. Everything seems well as you head away from shore, but then someone aboard begins to look or act quite strangely. You suspect something serious is happening — what should you do?

Let’s put our engine into neutral for a moment and decide that your fellow boater is having a stroke. Now let’s put it into reverse to learn about this medical condition that prevents the proper circulation of blood to and through the blood vessels of the brain. The American Stroke Association says stroke is the fifth leading cause of death and a principal cause of disability in the United States.

Dr. Paul WrightAccording to Dr. Paul Wright, chair of neurology at North Shore University Hospital in Manhasset and LIJ Medical Center in New Hyde Park (both members of Northwell Health), “A stroke occurs when a blood vessel becomes narrow or closes. This results in lack of blood flow to the brain tissue, causing death of the tissue. This is called an ischemic stroke.  A hemorrhagic stroke is a stroke that is caused by a blood vessel rupture.”

Although a physician makes a diagnosis of stroke, anyone can recognize one or more of the symptoms that would indicate a stroke. Per Dr. Wright, “We like to educate people with the acronym FAST” to determine whether a stroke is suspected.

Face: Ask the person to smile and then look for asymmetry or drooping of the face.

Arms: Ask the person to raise their arms to see if there is weakness.

Speech: Ask the person to talk. Look for an inability of the person to understand, or to reply with garbled or nonsensical speech.

Time: Not all the symptoms need be present for someone to be having a stroke, so if any are present, contact emergency services immediately — time is of the essence.

“Recently,” says Dr. Wright, “we have added BE to FAST (BEFAST). This takes into consideration additional areas of the brain that can be affected by a stroke.”

Balance: Look for a sudden loss of balance or difficulty with coordination.

Eyes: Is there a sudden loss of vision, blurred vision, or abnormal eye movements?

spot a stroke

Don’t discount the occurrence of a stroke because the person is young, cautions Dr. Wright. “Strokes can happen at any age — in fact, strokes in the younger population are actually on the rise.”

There is also no difference in gender when it comes to stroke symptoms. Men and women are equally susceptible, but “strokes in females tend to be under-recognized and under-diagnosed when compared to males,” per Dr. Wright.

Once you’ve checked off at least one symptom corresponding to the first five letters of BE FAST, don’t waste time. “The faster a stroke patient is treated, the higher the likelihood of improving back to normal,” Dr. Wright emphasizes.

Even if the person seemingly recovers and says all is fine, call 911 or radio the U.S. Coast Guard. “The benefits of getting checked are significantly greater than the risk of not taking things seriously and suffering irreversible consequences,” warns Dr. Wright.

Once emergency services have been alerted, ensure the person is “placed in a safe location, lying down, in order to avoid any falls and to possibly improve blood flow to the brain,” instructs Dr. Wright. “The head should be slightly elevated; any food or drink should be avoided.”

Have as much information available as possible to share with the emergency responders. Dr. Wright says this may include “the onset of the symptoms, prior medical history, medications, allergies, and the name of the primary care physician and the contact information of the next of kin.” He adds, “An important point is any medication that person may have taken before going on the boat or if there was any alcohol imbibed.”

It’s vital for medical personnel to be told if the person took a medication for seasickness, as effects of Benadryl, Bonine, Dramamine or Scopolamine may mimic some signs of stroke —confusion, sleepiness, double vision, and incoordination. Along with other consequences, Dr. Wright advises that alcohol can sometimes mask the signs of stroke, so “it should be consumed judiciously.”

For more information: https://www.northwell.edu/find-care/services-we-offer/neuroscience-institute/stroke-center and http://www.strokeassociation.org/.

By Lita Smith-Mines

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