If you suspect a stroke, question on the HLTH 57A final exam


QUESTION

2) When you think someone is having a stroke, you need to act FAST.
Give the word to go with each letter
and something to ask the victim to do, or something you need to do.

F____________

A_____________

S_____________

T_____________ Big hint, this one has two things you need to do.

 

These next photos are here to help keep you from scrolling down to the answer so you can you pause for a moment and think about what the answers are.

 

A photo from the De Anza College Outdoor Club between summer quarter and fall quarter Grand Teton National Park trip:

sunlight streaming through clouds teton range Sept 2011: photo mostly of clouds with a mountain range in the distance and little light on a lake in the mid distance

 

At different times of the day and night on The De Anza Outdoor Club winter Yosemite trip people have seen raccoons, coyotes, deer and ravens and more in the campsites. We also found tracks in the snow, below raven, raccoon and steel belted radials:

raven footprints in snow: raven footprints in snow with a human hand for size comparison raccoon footprints in snow: raccoon footprints in snow with human hand for size comparison tire tracks in snow: tire tracks in snow

On the Outdoor Club Yosemite Winter trip you can do the hike shown below to the top of one of the highest waterfalls in the world:

Yosemite falls trail display at visitor center with route.: photo of Yosemite cliffs with Yosemite falls trail outlined

waterfall in three sections

 

A stroke (also commonly known as a brain attack) happens when a blood clot or bleeding in the brain interrupts blood flow to part(s) of the brain.
drawing of arteries

Worth noting is that high blood pressure is a leading cause of stroke.
High cholesterol diets, diabetes and tobacco use increases the risk for stroke.
IV drug use is sometimes listed as a major cause of strokes in young people because the drugs are cut with cornstarch, artificial sweeteners, bleach crystals and/or animal tranquilizers.

 

When you ask the victim these questions,
you are trying to see if they have some of the signs and symptoms of a stroke,

such as
drooping of features on one side of their face,
weakness in their arm,
or trouble with speech and language.

ANSWERS:

(Your answer on the final does not need to include everything in the parentheses to get full credit, but reading all of this could help you comprehend the material.)

Face     Ask the person to smile.

(Watch their face to see if both sides of their face move the same when they smile
or if there is drooping or weakness on one side of their face.)

Arm     Have them hold up both arms, extended out straight from their body.

(Someone who had a stroke might be able to lift both arms up, but not be able to keep both arms at the same height
or might not be able to lift both arms up to the same height
or might have numbness in one arm and can not lift that arm up, or will lift it up slowly)

Speech     Have the person try to repeat something simple you say, example: “The sky is blue.”

(Someone who had a stroke might have slurred, incoherent or distorted speech or trouble speaking or can’t speak at all.
OR they might speak clearly, but say the wrong words.)

If the person has difficulty with any of these three above:

Time    

note the time the signs and symptoms began

and it is time to call 911 and tell the dispatcher about the symptoms and what time the symptoms started.

(Or tell the dispatcher if the stroke was not witnessed and you do not know when the symptoms started,
OR tell the dispatcher someone told you the time the victim was last known to be well and free of signs and symptoms of a stroke.)

– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –

Examples of wrong answers students wrote on the final exam and did not get credit for:

Face:     “ask the victim to stick their tongue out and move it from side to side” is something a doctor might ask a patient to do during a more complete neurological exam, but could be embarrassing for a person to do, and is not what you should be asking a stroke victim to do. Keep it simple and just ask them to smile.

Arm     “ask the victim to lift up one arm” or “ask the victim to lift up their hand”
These are wrong because you need to see them try to lift BOTH ARMS so you can compare.

“check arm grip weakness” is wrong. (It is something you might check under different circumstances, but is not what you do for a possible stroke victim.)

“Ask them to lift arms to the sky,” and “ask them to lift arms overhead” are also incorrect answers.

Speech

The correct answer, asking them to repeat a simple sentence
(as in “say this, the sky is blue” or “repeat after me, the sky is blue”)
is all you should be asking them to try to say.
You do this to be able to hear if they are slurring words or are unable to form words or are having trouble speaking.

These next three are wrong because they are probably not able to answer questions,

“ask the victim “Is the sky blue?”

“ask the victim what state they live in”

“ask the victim “What color is the sky?”

not only because they might not be able to think well enough to answer questions, but also because you might only get a one word answer, and you need to hear more words than that to tell if they are slurring or are unable to form words / having trouble speaking.

“Try to make them speak,” is not a correct answer. You should ask them specifically  (“say this, the sky is blue” or “repeat after me, the sky is blue”)

 

Time     “ask the victim what time they had the stroke” or “ask the victim how long they have been having the stroke”
or “ask when did this happen to you,”
or “what time did you have the issue”
or ask “How long have you been feeling this way?”

These are wrong because they usually do not know they are having a stroke and would have no idea when their symptoms started.

“Ask victim – Do you know what time it is,” is also wrong because they are having a stroke and do not know.

 

“it is time for you to take them to the hospital”
“call 911 or take to the hospital”

These are wrong because they need a specific drug to potentially reverse the symptoms of the stroke, and need it quickly. You need to call 911 so they can get the care they need. If you take them to the hospital you will delay the start of required care.

“Call 911 as soon as possible.” This is wrong because you need to call 911 right away.

 

“recognize they are having a stroke and perform CPR” is also wrong, because you would not perform CPR on a stroke victim,.

bar of alternating solid colors

The American Heart Association (AHA)
studied eight different pre-hospital screening tools (methods of recognizing) stroke including FAST
and concluded “First aid providers can use the signs of weakness in the face (eg, droop), arm, or grip on one side of the body, or speech disturbance to identify individuals with a possible stroke and should activate emergency services when this occurs.”