F—FACE: Ask the person to smile. Does one side of the face droop?
A—ARMS: Ask the person to raise both arms. Does one arm drift downward?
S—SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
T—TIME: If you observe any of these signs, call for a paramedic response immediately. Do not attempt to drive to the hospital yourself.
Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke. It is important to note the time when the symptoms first appeared. There is a FDA-approved clot-buster medication that may reverse or reduce long-term disability if given within 3 hours of when the 1st symptoms occurred.
Prevention: Do You Know Your Stroke Risk Factors?
Controllable Risk Factors
- Hypertension: High blood pressure is a major stroke risk factor if left untreated.
- Atrial fibrillation: Afib is an abnormal heartbeat that can increase stroke risk by 500%. Afib can cause blood to pool in the heart and may form a clot and cause a stroke. A doctor must diagnose and treat Afib.
- Smoking: Smoking doubles the risk of stroke. It damages blood vessel walls, speeds up artery clogging, raises blood pressure and makes the heart work harder.
- Alcohol use: Alcohol use has been linked to strokes in many studies. If you drink, drink in moderation: no more than two drinks each day.
- Elevated cholesterol levels: High cholesterol levels can clog arteries and cause a stroke. See a doctor if your total cholesterol level is more than 200.
- Being overweight/obese: Excess weight strains the circulatory system.
- Other circulation problems
Uncontrollable Risk Factors
- Age: A stroke can happen to anyone, but risk of stroke increases with age. After the age of 55, stroke risk doubles for every decade a person is alive.
- Gender: Women suffer more strokes each year than men... Additionally, women are two times more likely to die of a stroke than breast cancer annually.
- Race: African Americans have twice the risk of stroke when compared to Caucasians. Hispanic and Asian/Pacific Islanders also have higher risk than Caucasians.
- Family history: If a family member has had a stroke, everyone in the family has a higher risk of stroke.
- Previous stroke or TIA: Up to14% of the people who have a stroke this year will have a second one. Within the next 5 years, stroke will recur in 24 percent of women and 42 percent of men.
- Younger people are more likely to get strokes due to atypical risk factors: underlying medical disorders, genetic disorders, blood clotting abnormalities, and patent foramen ovale (a hole in the wall between the right and left atria of the heart).
You should review all of your risk factors with your physician
Tips Specifically for Law Enforcement
You, your agency, or your detentions facility are liable for failure to identify stroke symptoms. There are several cases when the detained individual was not assessed appropriately to determine a possible stroke. Many stroke symptoms can mimic alcohol impairment or resistance: slurred speech, blurred vision, inability to exit a car, confusion, dizziness/trouble walking/lack of balance.
The following is a true case: On May 11, 2012 Daniel Hicks, 51, was found stopped in his car on the side of a highway in Tampa. Witnesses had called 911 after they saw Hicks' car swerving west into a guardrail. When highway troopers arrived Hicks could not speak coherently; he was unable to move his left arm. It was noted that he did smell of an alcoholic beverage and that he was not acting erratically. Deputies from the sheriff’s department also responded to the scene. Nonetheless, officers arrested Hicks on a charge of obstructing a law enforcement officer when he failed to respond to commands to exit his car. He was taken to Orient Road Jail; he received no medical screening at intake. Hicks was placed in a cell, where he laid facedown and tried to crawl using the one working side of his body; he soaked himself with urine. It wasn’t until the following day that he received a medical evaluation at the jail. He was then taken to Tampa General Hospital and diagnosed with an ischemic stroke. 36 hours had lapsed since his first symptoms. He slipped into a coma and died within three months. On July 30, 2013 the Hillsborough County Sheriff's Office and the private company that provides medical care to county prisoners was ordered to pay $1 million in a wrongful-death settlement to the children of Daniel Hicks. Additionally the Hillsborough County S.O. has instituted new training on recognizing stroke symptoms for deputies.