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Spot a Stroke in 60 Seconds

Researchers say quick diagnosis by bystanders could save lives

Please note: This article was published more than one year ago. The facts and conclusions presented may have since changed and may no longer be accurate. And "More information" links may no longer work. Questions about personal health should always be referred to a physician or other health care professional.

HealthDay Reporter

THURSDAY, Feb. 13, 2003 (HealthDayNews) -- Do you think you could recognize the symptoms of a stroke?

Researchers from the University of North Carolina-Chapel Hill School of Medicine say the odds are good that you could, even for a complete stranger, as long as you had been given proper instructions on spotting strokes.

Even though treating stroke patients requires extensive training, this study shows that people without training can easily learn to detect stroke symptoms, says study author Amy Hurwitz, a second-year medical student at the University of North Carolina-Chapel Hill School of Medicine.

A quick diagnosis is essential because an effective treatment is available for strokes caused by blood clots, but it's only effective if it's administered within three hours of the onset of symptoms.

"Even a delay of 20 minutes can make a huge difference," says Dr. Robert Felberg, medical director of the stroke program at Ochsner Clinic Foundation Hospital in New Orleans. He says that, ideally, you should get to the hospital within the first hour after symptoms appear because doctors need time to make the diagnosis and run a CT scan to confirm it before they can safely administer the clot-busting stroke medication.

Every year, 600,000 Americans have a stroke, and 160,000 of them die, according to the American Stroke Association. Stroke is also the leading cause of long-term disability.

For this study, the researchers recruited 100 people who were visiting the hospital as bystanders to assess stroke symptoms in strangers. The people who were to be diagnosed were actually stroke survivors who still had visible symptoms of stroke, such as arm weakness, facial weakness or slurred speech.

The bystanders were taken to a room in the emergency department where a stroke survivor and one of the researchers were waiting. They were told to answer the phone and follow the instructions they were given.

When the call came in, the bystander was told how to administer a three-item examination used by doctors to assess stroke victims. First, the bystanders were told to look at the mock patients' smile. Next, could the "patients" raise both arms and keep them raised? Finally, the bystanders had to ask the stroke survivors to speak a standard phrase. The volunteers were then asked to decide if the patient had performed normally or abnormally on the tests.

The researchers found that the visitors correctly administered the test 96 percent of the time. In patients with facial weakness, they were able to correctly identify when that symptom was present 71 percent of the time; arm weakness problem was correct in 95 percent of patients; and speech problems were found 88 percent of the time.

Hurwitz reported the findings in a presentation on Feb. 13 at the American Stroke Association's International Stroke Conference in Phoenix.

"This is a great study that could have a lot of benefit," Felberg says. "The biggest problem we have is that 75 percent of the American population doesn't know what a stroke is." Often, he says, people will ignore their symptoms or try to "sleep them off" and by the time they seek treatment, it's too late.

Teaching people to look for facial or arm weakness or slurred speech would be a great first step, Felberg says.

One big problem in educating the public about stroke, says Hurwitz, is there's no one symptom that stands out, such as chest pain or shortness of breath for heart attack victims.

"The symptoms that accompany stroke vary, depending on the location of the stroke. Therefore, educating the public requires a more elaborate list of what to look for," she says.

Symptoms can include weakness on one side of the face or body, slurred or incomprehensible speech, severe headache without a known cause, and sudden loss of vision or generalized confusion, Hurwitz says.

More information

To learn how to recognize the symptoms of a stroke, visit the National Stroke Association or the American Heart Association.

SOURCES: Amy Hurwitz, medical student, University of North Carolina-Chapel Hill School of Medicine; Robert Felberg, M.D., medical director, stroke program, Ochsner Clinic Foundation Hospital, New Orleans' Feb. 13, 2003, presentation, American Stroke Association's International Stroke Conference, Phoenix

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