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Having a Stroke

June 21, 2019

When someone has a stroke, I emphasize this, it is crucial to get into the hospital. Let’s talk about sort of what to expect once you’re in the hospital. The first thing I would point out is if someone’s having a stroke or you believe someone’s having a stroke, the best way to get someone into the hospital fast, and again, the crucial thing here is time is brain. Fast is important, is a calling nine one one and using the emergency medical services, they are trained paramedics and EMTs are trained to recognize stroke and they will get you in fast. Once you’re in the hospital, what should you expect to sort of have happen? The first thing is you come into the ER with a stroke. Usually, things are going to move very, very quickly and immediately, you’d have a blood draw done looking for any evidence of things that would provoke stroke, getting your cholesterol in your blood sugar, making sure that you’re not anemic. And then initially a cat scan is generally the most common first test done. A cat scan is not the most sensitive test for stroke, but it can be done fast and efficiently and it actually, while it’s not sensitive for ischemic stroke like we talked about before, it is actually very sensitive for hemorrhagic stroke and subarachnoid hemorrhage. After the CT scan is done and the blood work is done, often there’s going to be the decision as to whether or not someone should get clot buster. And that’s something that we’ll talk about later. That decision has to be made very, very rapidly. And then often the person who’s had the stroke is admitted to the hospital and will often stay for a day or two. During that hospital stay the question that the physician or the team is trying to sort of ask themselves is where did the stroke come from? And that’s a crucial question to ask ourselves because that is going to dictate how we prevent another one from ever occurring. And so that’ll involve basically evaluating you from here on up. They’ll be doing an EKG, looking at your heart rhythm, looking for A fib. They’ll often have you on continuous cardiac telemetry. Again, looking at the rhythm of the heart, looking for A fib or any other irregular heart rhythm that can provoke stroke. Often you will get an echocardiogram, and this is kind of like what they use, looking at an ultrasound, like what we use for pregnant women, but instead we can actually look at it through the sternum and look at the structure of the heart, looking at the heart function, looking at the valves of the heart.

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