What is a Stroke?
Your brain needs a constant blood supply which provides vital nutrients and oxygen to the brain cells. A stroke happens when the blood supply to part of the brain is cut off and brain cells are damaged or die.

STROKES ARE SUDDEN AND SHOW IMMEDIATE EFFECTS:

A person suffering a stroke may become numb, weak or even paralysed to one side of the body. Their speech may be slurred and they may find it difficult to find words or understand speech. Some people lose their sight or have blurred vision, and others become confused or unsteady.
There are many cases recorded where people suffering strokes have been thought to be simply tipsy or high, and delayed treatment from this misdiagnosis have proven fatal.

Testing a casualty for a suspected stroke is quite simple. If the patient is in a sitting position ensure they are safe from falling off the chair, and then do the following:

1. Ask them to give you a smile. If their smile is crooked or lopsided that may indicate a stroke.
2. Raise their arms and ask them to hold them in that position. If unable to, that may indicate a stroke.
3. Ask them to say something. If their speech is slurred that may indicate a stroke.
   If one or more of the above tests indicates a possible stroke you must ring 999 asap.
   Time being of the essence.

If they are not in a sitting position refrain from moving them any more than necessary to perform the above checks. Sitting upright on the floor whilst being fully supported will allow the required checks.

Would YOU know if a family member was having an Angina attack?
It’s a cold winters day and you and your partner park the car at the bottom of a steep path, planning a brisk walk up the slope.
You have only walked 200 yards when your partner suddenly says he will have to sit down on this bench, he feels really breathless.
He also says he feels a bit dizzy, which he would if he was breathless wouldn’t he. You sit down with him so that he can get his breath back, and ask him if he is ok. He admits he was getting some pain in his chest as well, but that is easing up now. 10 minutes later he feels fine, and says he thinks he will forget the walk for today.

Do you simply go back home and let him rest up, or do you delve deeper into any other symptoms he might be feeling?

Angina symptoms can include any or all of the following:

1. Discomfort or pain in the chest which may feel tight, the pain could be a dull or heavy pain. It can also spread to the left arm, neck, jaw or back.
   Apart from walking up steep slopes the pain could also be caused by emotional stress or develop after eating a meal.
   Even the cold weather alone can cause the pain.
   The pain will usually ease up when at rest because your body is no longer trying to force blood quickly through the narrowed artery. Therefore the stress on your heart is eased.
2. Breathlessness.
3. Dizziness.
4. Feeling sick.
5. Unusually tired or restless.

Dial 999 if you THINK that you or someone you are with is experiencing the symptoms of angina for the first time.
If they do suffer from Angina they will probably know from previous episodes how to control it with their prescribed medication. If it is still deemed necessary to call for an ambulance inform the crew on their arrival of any medication taken.
If they have no medication with them (GTN spray) call for an ambulance.

Breathing problems may be experienced for numerous reasons such as an Anxiety Attack, Asthma, Allergies, Heart Conditions or such as COPD. It is essential to establish if this is a known condition that they have and do they carry any medication for it. Always try and help them to control their breathing pattern.

However, even if it is a known condition and they have medication, if you are seriously concerned for their welfare call for an ambulance.

Would YOU know if a family member was having a Heart Attack?
It’s a nice summers day, not too hot, and you and your partner are doing some serious landscaping in the garden.
You have only been going 30 minutes when your partner suddenly says she will have to sit down, she feels breathless and a bit sick.
She is sweating profusely, obviously out of condition.
You suggest that she takes a breather and makes you both a cup of tea while you carry on with the gardening.
However, you look up 5 minutes later and she hasn’t gone to make you a cup of tea, she is still sat there.
However, she now looks a bit ashen, and she is pulling funny faces?
Perhaps you should have asked a few questions when she first said she didn’t feel well, but certainly now is the time to be asking questions.
If you suspect that she may be having a heart attack the symptoms you should be looking for are:

• chest pain: usually located in the centre of your chest and can feel like a crushing sensation, tightness or a squeezing sensation.
• pain in the arms, possibly radiating to the jaw, neck, back and abdomen
• shortness of breath
• feeling sick
• being sick
• ashen complexion
• Cyanosis to the lips (blue tint)
• an overwhelming sense of anxiety
• feeling dizzy
• coughing
• wheezing
• profuse sweating

If she informs you that she is having chest pains, and they have not eased since she sat down to rest, this could indicate a Heart Attack rather than an Angina Attack.
It is not the level of chest pain that is important in determining whether she is having a heart attack, it’s the overall pattern of symptoms that is important.
If you THINK she is having a Heart Attack call 999 immediately.
If you know that she is not allergic to aspirin, and aspirin is readily available, give her an adult size tablet (300 mg) to chew while you are waiting for the ambulance. Inform the crew on arrival of medication taken.

DO NOT:

1. Do not move her into the house.
2. Do not lay her down, a comfortable sitting position with knees raised is the best position for her.
3. Do not leave her alone if avoidable. Shout for help if necessary.
4. If it happens when you are out and about, do not attempt to take her back to the car or back home.
5. Do not delay in calling 999. If it happens during the night do not wait until a ‘reasonable’ hour to call.
6. Do not assume that young people do not have Heart Attacks.
7. Do not panic, she needs reassurance.

Always be ready to perform CPR with or without a defibrillator should she stop breathing.

In simple terms Cardiac Arrest occurs when the patient ceases to breath normally and their heart suddenly stops pumping blood around the body.
Although Cardiac Arrest often follows symptoms of the above conditions, Sudden Cardiac Arrest can occur without any of the above symptoms presenting themselves beforehand, the patient simply collapsing in a non-breathing condition and often without warning.

What is cardiac arrest?
Cardiac Arrest may be the result of life threatening conditions or occur suddenly and often without warning. It is triggered by an electrical malfunction in the heart that causes an irregular heartbeat (arrhythmia). With its pumping action disrupted, the heart cannot pump blood to the brain, lungs and other organs. Seconds later, a person loses consciousness and has no pulse. Death occurs within minutes if the victim does not receive treatment.

Recognising Cardiac Arrest:
It is essential that confirmation of the patient being in Cardiac Arrest is determined before commencing CPR and using a defibrillator as he may have just passed out, which then only requires the patient to be put in the recovery position.
Check for breathing by tilting the chin back to open the airway and place your ear close to his mouth and listen for 10 seconds to determine whether or not he is breathing. He should take 2 to 3 normal breaths in that period. Be aware that if he is showing signs of agonal breathing, an abnormal pattern of breathing characterized by gasping, laboured breaths and strange sounds, he should be deemed as non-breathing.
Whilst listening for breathing also be alert to the feel of his breath on your face, and be looking down his chest and stomach for signs of movement as he breathes.

If you have confirmed whether or not he is breathing during your 10 second breathing check, you would then proceed accordingly.

Proceeding from that point will normally only involve 1 of 3 options.

1. The patient is breathing normally, and you are satisfied that he has suffered no other injuries requiring consideration, place him in the Recovery Position.
2. The patient is breathing but there are indications of other serious injuries, possibly even to the spine or neck. At this point, although still crucial to control his airway, if your training does not cover this aspect ring 999 and follow the advice given.
3. The patient is not breathing, commence CPR immediately regardless of any potential secondary injuries.

Remember, we do not want to perform CPR on someone who has only fainted and we certainly do not want to put a deceased person in the recovery position.