Act F.A.S.T.

I came across an interesting fact recently, a fact worth sharing:

In an ischaemic stroke, cell death occurs at a rate of 1.9 million neurons an hour. This is the equivalent of the patient ageing 3.1 weeks every minute (1)

Makes you reconsider what is actually going on in the brain. For successful treatment and a (near) full recovery, time is of the essence…as the best anti-ageing potion.

There is a definitive time bracket for the treatment of ischaemic strokes with tPA (Tissue Plasminogen Activator) – where I live the cut of time is 4.5 hours from symptom onset (2)

Many stroke symptoms are recognise too late – remember, time is brain, and the public need to be aware of common stroke symptoms. The F.A.S.T. mnemonic has been an initiative by the stroke foundation here in Australia:

http://www.strokefoundation.com.au/signs-of-stroke-FAST

But we as Paramedics can also have a positive impact on suspected stroke victims – by recognising the signs, transporting the patient to an appropriate facility and pre-notifying the staff of our arrival (3).

 

What are your stroke guidelines and procedures?

 

References:

1 Saver, J. Time is Brain – Quantified Stroke 2006;37:263-6 via Michael Moldoveanu “Delays in Thrombolysis for Ischaemic Stroke Patient: Implications for Paramedic Care” Response Spring 2011 (Volume 38 No. 3), Paramedics Australasia.

2 p.27, Model of Stroke Care 2012, WA Dept. of Health. http://www.healthnetworks.health.wa.gov.au/modelsofcare/docs/Stroke_Model_of_Care.pdf

3 p.24 Model of Stroke Care 2012, WA Dept. of Health. http://www.healthnetworks.health.wa.gov.au/modelsofcare/docs/Stroke_Model_of_Care.pdf

Equal numbers of neuronal and nonneuronal cells make the human brain an isometrically scaled-up primate brain

http://onlinelibrary.wiley.com/doi/10.1002/cne.21974/abstract;jsessionid=B56BA8474F1D8E28F05588AFC5CF3837.d01t01

Neurons, Synapses, Action Potentials, and Neurotransmission  http://www.mind.ilstu.edu/curriculum/neurons_intro/neurons_intro.php

 

P.S.:

If you are wondering how many neurons the human brain is actually made up of, estimates range from approximate 86 billion (4) to 200 billion (5). So in terms of percentage of neurons actually dying an hour, this equates to roughly 0.0000221% to 0.0000095%. Which would translate in to waiting approximately 45 249 to 105 263 hours (1885 days or over 5 years to 4385 days or over 12 years) for one percent of the brain to have died. Multiplied by 3.1 weeks a minute…oh sod off, I can’t be bothered. Do it yourself :-)

 

 

 

 

  • http://www.flobach.com flobach

    Normal road speed I can understand if a patient has no acute life threatening issues – but with that triage system the patient runs the risk of losing that responding vehicle to a higher priority stubbed toe, further delaying treatment.

    There needs to be a bit more revolution rather than evolution in calltaking IMHO…

  • http://adde.rs Adders

    Until MPDS is altered, at least in QLD, we will continue to go to ? CVA/TIA at road speed. The justification is that no ED will thrombolise a CVA in the department which means the ambulance has no need to go lights and sirens to or from the job.

    Ridiculous, considering we go to sore knees and man-flu code one.