subject: After A Stroke: The First 24 Hours [print this page] The doctors have two main goals while a patient is in the ER: Determine what type of stroke he's having, and treat him to minimize brain damage and prevent more strokes.
Strokes are categorized as either ischemic or hemorrhagic. Ischemic strokes (also called white strokes) occur when a blood vessel to the brain is blocked, preventing blood from flowing to part of the brain. Hemorrhagic strokes (also called red strokes) are caused by a broken or torn blood vessel bleeding into or around the brain.
To determine what kind of stroke or medical event someone is having, ER staff will:
* Monitor vital signs (blood pressure, heart rate, breathing, and body temperature)
* Draw blood to determine if he has a clotting disorder that might preclude treatment with the clot-busting drug tPA
* Check heart function (with an electrocardiogram, or EKG)
* Perform a CT scan to detect bleeding in or around the brain
* Run additional tests, such as an MRI, if the CT scan doesn't show what's causing the stroke
* Possibly perform a spinal tap if bleeding still isn't detected but doctors suspect an aneurysm
* Insert an intravenous (IV) line into one of his veins so the staff can deliver fluids and medications
Doctors will treat your friend or relative to minimize brain damage and the chance of more strokes. If he's having an ischemic stroke that began less than three hours ago, he will probably be given tPA (tissue plasminogen activator). However, tPA is not used for transient ischemic attacks (TIA), whose symptoms will clear up on their own. If tPA isn't used, he'll probably be given a different drug to minimize the risk of more clots forming. Ultimately, the cause of the original clot will need to be determined, but this can be done later.
If the person you're caring for is having a hemorrhagic stroke, he'll be admitted to a special stroke unit or intensive care unit (ICU) as quickly as possible.
If the patient was transported to the hospital by ambulance, the ER staff should already know the nature of his emergency. Still, he needs you to serve as his advocate, which you can do in a number of ways:
* Speak up! Don't be shy or embarrassed to advocate for your good friend or relative. In his book Stroke for Dummies, John Marler says that something is wrong if someone who's had a stroke has been in the ER for more than five minutes without attention. You're not being pushy if you insist on his being seen immediately;
But your role doesn't end once you're comfortable with how your loved one is being cared for in the ER. Next he'll be moved into a hospital bed, where you can continue to be his staunch supporter and learn how to deal with the aftereffects of the stroke.
