This time, the stroke victim will recover
The patient is a year younger than my mother was when she lost her ability to function; this time, everything is going right
Updated May 9, 2016
This time, I’m going to make a difference.
Everything is working; the family called 911 five minutes after the symptoms began, Engine Company 11 arrived three minutes after that, oxygen was administered immediately, vital signs and neurological function assessed and a report transmitted to me.
This time, everything is going my way. The family has her medications ready, the stair chair is assembled, the patient lays in bed, unable to speak, eyes fixed to the right, facial droop, nothing on the left side. I’m not waiting; I don’t care about my back. I’m closest, I reach into her bed and pick her up and place her in the chair.
She’s 55, a year younger than my mother was on her last day as a functioning person.
This time, this patient will get to the hospital quickly, and this time the medications that will restore her functions will be effective, and she will regain her mobility and ability to communicate. This time, she won’t spend the last nine years of her life in a nursing home, half alive, her mind sharp but body unable - days and years of steady decline as family members watch her waste away until eventually the feeding tube goes in, the light in her eyes goes out, and she dies slowly, a week before Christmas.
Use FAST to access stroke victims
Not this time. We used what I call my fast and rosier response, FAST, a simple way to assess potential stroke victims.
F - Face: Does the face droop on one side when the person smiles?
A - Arm: After raising both arms, does one of the arms drift downwards?
S - Speech: After repeating a simple phrase, does the person’s speech sound slurred or strange?
T - Time: If any or all of the above are observed call 911nd ask for medical assistance.
Rosier is more often used in the emergency room to recognize the signs of a stroke. In my telephoned report to the triage team while enroute, I was concise and clear, the staff at the ER was ready, and there was no time wasted on neurological examinations.
Time is of the essence
This time we are in the trauma room, the stroke is team assembling, and only half an hour has passed since the onset of symptoms. Of all the doctors who could have been working, this time it’s the one I like more than all of the others; she listens, and she just happens to speak fluent Russian, the same language as the lady having the massive stroke.
The doctor is able to communicate with the patient, calm her a little, and figure out what is wrong. She calls her mother from her cell phone, and finds the Russian word for "stroke." A mother-daughter connection happens in the trauma room, and the power of the moment is not lost on me. This time everything is going to work out well.
This time I sit and watch, a front row spectator as the 55-year-old lady gets a second chance. She’s a candidate for TPA, which I have seen work miracles, and she is on her way to the CT scanner before my freshly washed hands have a chance to dry.
This time I don’t forget about the patient as soon as the triage nurse signs my report. This time, every time I return to the ER with a different patient I check on her, and watch, and talk with the family, and offer encouragement.
Every time I’m able to have an effective intervention with a stroke patient I take a moment to remember my mother, whose active life ended at 56-years-old. Then I think of the families that will not have to endure the next nine years that mine did.
Medics on the street are not supposed to take things personally, but I’m only human.
May is Stroke Awareness month, but it’s not the only month I’m aware of the damage a stroke can have on a person who suffers one, and those they leave behind.