A stroke is a medical emergency occurring when blood flow to a part of the brain is disrupted, leading to brain cell death. This disruption can be due to a blocked blood vessel (ischemic stroke) or bleeding in the brain (hemorrhagic stroke). Both types cause the affected brain area to stop functioning. Brain cells die within minutes without oxygen and nutrients. Calling emergency services is the first step for anyone suspected of having a stroke.
Recognizing a Stroke: Your Role in Early Detection
The F.A.S.T. acronym helps identify stroke symptoms for timely medical attention. “F” stands for Face drooping, where one side of the face might appear uneven; asking the person to smile can reveal this. “A” represents Arm weakness, identified if one arm drifts downward when the person tries to raise both arms. “S” signifies Speech difficulty, such as slurred speech or trouble understanding words, and “T” means Time to call 911 if any of these symptoms are observed. Even if symptoms seem mild or resolve quickly, call for emergency medical assistance, as these could indicate a transient ischemic attack (TIA), a warning sign for a larger stroke.
Initial Response: What EMTs Do First on Scene
Upon arrival at a suspected stroke scene, Emergency Medical Technicians (EMTs) initiate a rapid assessment. Their first priority involves ensuring scene safety for themselves, the patient, and any bystanders. EMTs then quickly gather patient information, focusing on the “last known well” time—the exact or approximate time symptoms began. This information determines eligibility for specific hospital treatments. A rapid primary assessment follows, checking the patient’s airway, breathing, and circulation (ABCs) to address immediate life threats.
Specialized Stroke Assessment: EMTs Rapid Evaluation
Following initial stabilization, EMTs conduct specialized assessments to confirm a suspected stroke and gather critical information for the hospital. They use prehospital stroke scales, such as the Cincinnati Prehospital Stroke Scale (CPSS) or the Los Angeles Motor Scale (LAMS), to quickly evaluate neurological deficits. The CPSS assesses facial droop, arm drift, and abnormal speech; any single abnormal finding suggests a high probability of stroke. EMTs also check the patient’s blood glucose levels to rule out hypoglycemia, a condition that can mimic stroke symptoms. This rapid assessment aligns with the “time is brain” concept, emphasizing that for every minute a stroke goes untreated, approximately 1.9 million brain cells can be lost.
Expedited Transport: Getting to Specialized Care
Once the on-scene assessment is complete, rapid transport to a specialized stroke center is the objective. EMTs prioritize quick transport directly to a hospital equipped to handle strokes, understanding that every moment counts in stroke care. During transport, EMTs communicate with the receiving hospital through pre-notification, alerting the stroke team and providing details about the patient’s condition and estimated time of symptom onset. This allows the hospital to prepare personnel and resources, ensuring immediate evaluation and intervention upon arrival. EMTs do not administer clot-busting medications (thrombolytics) in the field; these treatments require precise diagnosis, monitoring, and specialized imaging only available in a hospital setting.