Your Rightful Expectation When a Stroke Brings You to the Emergency Room
Dr Romayne Edwards spells it out as to "What to expect with the unexpected disability when she states, and I quote...
"STROKE, also called "brain attack" or cerebrovascular accident, is the third leading cause of deaths in the United States of America and is the leading cause of disability in adults worldwide. It occurs when the blood supply to areas of the brain is disrupted, resulting in a loss of both sensory and/or motor functions on one side of the face and body.
The risk factors for a "brain attack" may include hypertension, diabetes mellitus or 'sugar', high cholesterol, smoking, alcohol intake, obesity, and heart disease as well as age, race, genetics, and family history.
Strokes may result from ischemia, a blockage of an artery due to thrombus or embolus in the brain or reduced blood flow from the body, or hemorrhage (bleeding) in the brain.
The most common strokes in Jamaica are ischemic, followed by intraparenchymal and subarachnoid hemorrhage, respectively.
A person experiencing a stroke may have sudden or gradual symptoms, which include the inability to move one side of the face well, the inability to control an outstretched arm, and slurred words or inability to speak. There may also be abnormal alertness, where the patient may be confused or even fall into a coma.
When these symptoms pop up, the patient should get help immediately. Timing may determine treatment options.
In countries where there is an Emergency Medical System, this should be activated. Theren was a 1-1-9 emergency number for Jamaica...a
The patient should then be transported to the nearest emergency department where a rapid assessment is done by a team of specialized doctors and nurses trained to evaluate, treat and manage the acute stroke patient." - Unfortunately this is not the case in most ER's in Jamaica. Stroke is not always treated like the medical emergency that it is.
"The patient would be assessed and stabilized by checking the airway, breathing and circulation. Oxygen would be administered, if necessary, and the vital signs - blood pressure, pulse rate, temperature, and respiratory rate - done.
An evaluation would then be done by getting eyewitness accounts as well as using various stroke scales." - This is not always possible. Sometimes it is days afterwards when a patients gets to the hospital.
"A bedside glucose and other blood tests, electrocardiogram (ECG) and a CT Scan of the brain would be done on the patient. The brain scan would indicate if there is hemorrhage in the brain or not." - How many stroke patients in our rural hospitals gets this done? Sadly, my mom was not one of them.
"If there is no hemorrhage, the patient would then be evaluated for fibrinolytic therapy "clot buster" then treated and admitted to intensive care or the stroke unit. If the patient does not meet the criteria for fibrinolytic therapy, then aspirin and other drugs would be given and the patient admitted to the hospital." -
How will the doctor know if there is hemorrhaging or a clot if nothing except a blood pressure check gets done? That's why we have this foundation...to help with awareness and support our local area clinics and hospital, making sure they have the resources available to diagnose and treat stroke patients in a timely manner.
"However, if hemorrhage is present the patient should be referred to the neurologist and or neurosurgeon who will determine if surgical intervention is necessary. If no surgery is advised then the patient would be admitted to hospital for supportive care." -
"This would include stroke rehabilitation, which assists the patient in regaining and relearning skills of daily life such as speech and walking. The relatives and caregivers are also educated regarding the prevention of secondary complications, such as bedsores and falls, which may lead to the death of their relative."
Stroke rehabilitation is available to those who have money...and connections. Unfortunately, the rehabilitation facilities are few and are located in the cities, inaccessible to most of those who really need the services.
The Milka Clarke Stroke Brain Trauma Foundation is working to make some changes happen. We will be advocating for local stroke brain trauma support. This means funds will be needed, because additional services will definitely require more funding.
As a people in Westmoreland with towns such as Negril and Savanna-La-Mar, we have to get together and make some changes. We cannot depend on the goverment to do everything. People are dying, who would have lived IF there were more reliable medical service options available.
Stroke patients and individuals with terrible accident trauma should not have to go all the way to Montego Bay for an MRI/CT. We need more access to more reliable, local services. Those who rely on medical services in Westmoreland should reach out to us so we can get a better perspective of the general needs, so our advocacy efforts can reflect that.