Prevention better than cure

How can you prevent stroke and what are the rules of first-aid?
Advice from Dr. Zhukova

How can you prevent stroke and what are the rules of first-aid?

O.A. Pimenov, Verkhnedvinsk, Vitebsk Region

A stroke occurs when there is an acute (sudden) abnormality in brain blood circulation: rupture or occlusion of a brain vessel. Stroke is the most widespread brain trauma in mature and elderly people, with 1-4 cases per 1,000 people annually being the normal range (depending on nationality). The figure rises considerably with age and, unfortunately, Belarus’ rate is higher than in most other European countries. Stroke is the third most common cause of death in our country, and is the number one cause of disability. Meanwhile, 25-30 percent of those suffering a stroke do not survive.  Nearly 80 percent of those who do live tend to need assistance, due to paralysis, lack of co-ordination or speech disturbance. Only 20 percent of people make a full recovery and return to their former employment.

Of course, it’s better to prevent than to cure and there are actions you can take to reduce the risk of stroke:

 Control blood pressure. If higher than 140/90 millimetres of mercury, you have hypertension and should consult a doctor. Blood pressure is higher in the morning. Anti-hypertensive drugs are available to reduce blood pressure and are effective within 24 hours.

 Reduce your consumption of salt to no more than 2-5 grams daily. Vegetable-based products (fruits, vegetables and cereals) contain less salt, as does milk, fresh fish and meat.

 Increase your physical activity with low-impact exercise: mid-speed walking, skiing or cycling, or swimming for 40-60 minutes 3 or 4 times weekly. Look out for shortness of breath, pains around the heart or arrhythmia.

 Stop smoking and cut back on alcohol. Smoking considerably increases the risk of cardiovascular complications, including stroke (by 40 percent among men and 60 percent among women) and myocardial infarction. Drinking alcohol raises blood pressure, so those already experiencing some of the risk factors in this article should consider giving up.

 Eat healthily and stay a suitable weight for your height, using the body-mass index (weight in kg / height in m). If the result is between 20 and 24.9, you are within the normal band; a figure of 25-29.9 is overweight; 30-39.9 indicates obesity; and over 40 indicates extreme obesity. Eat more fruits and vegetables, and products rich in potassium, magnesium and calcium, including fish and seafood, while limiting animal fats. Don’t eat within 3 hours of going to bed.

 Avoid stressful situations. Remember that positivity is essential to successful treatment.

If someone nearby has a stroke, you should render first aid as a matter of life or death urgency.

 First of all, call for an ambulance, telling the operator what has happened precisely, as the person who has suffered from a stroke needs a neurologist on the emergency crew and may need resuscitation.

 If the person is conscious, position them so that their shoulders and head are slightly above the rest of their body, to lower the pressure of blood on the brain. Also, keep them still, to avoid aggravating the condition.

 Ensure that the patient can breathe easily, loosening a belt or tight clothing. Open a window if necessary, to bring in fresh air.

 Do not give food or drink, as the patient may have difficulty swallowing and inhale food or liquid.

 Do not give any medication before the arrival of the ambulance!

 Ensure that airways are clear by removing discharge or objects (saliva, blood, slime or food). If vomiting, turn the head to one side, to keep airway clear, and check mouth afterwards for clots of vomit.

 If patient is unconscious, but breathing freely, turn them onto their side, and lay their head on their hand, inclined forward, bending their leg at the knee, to avoid them rolling over. 

 If not breathing, begin artificial respiration and heart massage on the patient (but only if you know how).

On the arrival of the ambulance crew, give the full picture succinctly. Fast and timely recognition of symptoms combined with pre-medical help will help save the life of the patient and aid full rehabilitation. Don’t panic or show the patient your fear. Rather, speak calmly and give encouragement. If first-aid is rendered within 2-4 hours, it is possible to avoid complications.

Stroke requires immediate qualified treatment, rendered by specialised establishments, at a resuscitation unit or in intensive therapy. The quicker that qualified medical aid is rendered, the more favourable the chance of recovery.

By Tatiana Zhukova, Doctor of higher category, D.M. Ph.D.
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