Online ACLS Course

Chapter 17 : Acute Stroke

Stroke is one of the leading causes of death in the United States. Approximately 700,000 people suffer from stroke every year in the US and 1 in 15 deaths are stroke related. Early detection of stroke is vital as IV fibrinolytic treatment needs to be administered within 3 hours of the onset of symptoms.  Understanding the signs and symptoms of stroke and speed of response is vital in not only saving a life, but also maintaining quality of life of an individual.  Stroke occurs due to insufficient blood supply to the parts of the brain. There are 2 major types of strokes:

  1. Ischemic stroke which accounts for 85% of all stroke cases and is caused by blockage of an artery in the brain.
  1. Hemorrhagic stroke (includes intracerebral & subarachnoid) occurs less often and is caused by rupture of a blood vessel in the brain.
Video Demonstration

Acute Stroke
ischemic and hemorrhagic stroke

Adequate stroke care involves reducing brain injury and increasing chance of patient’s survival and recovery.  According to the American Heart Association there are 8D’s of stroke care which are important in diagnosis and treatment of a stroke.

Detection: Rapid recognition of stroke symptoms
Dispatch: early activation and dispatch of EMS by 911
Delivery: Rapid EMS identification, management, and transport
Door: appropriate triage to stroke center
Data: Rapid triage, evaluation, and management within ED
Decision: Stroke expertise and therapy selection
Drug: Fibrinolytic therapy, intra-arterial strategies
Disposition: Rapid admission to the stroke unit or critical care unit

Reference: American Heart Association.  Advanced Cardiac Life Support (ACLS) Student Provider Manuel.  Dallas: American Heart Association, 2011. Print

Stroke Chain of Survival
Brain injury and risk of death will be reduced if the chain of survival is used:

  • Quick identification and reaction to the signs of stroke
  • Quick EMS dispatch
  • Quick transport by EMS and notification prior to arrival to the hospital
  • Quick diagnosis and treatment upon arrival of the patient to the hospital

The Cincinnati Prehospital Stroke Scale from strokecenter.org shows ways in recognizing signs and symptoms of a stroke.