The FAST Way For Massage Therapists To Recognize A Stroke
It was around 1am Monday morning, when I realized there was an issue.
He was one of the guys that mentored me when I started working at the mill.
We were all standing around at work telling stories and joking around. (Yes I know 1am is an ungodly time to be working).
Tonight, something seemed different but nobody else really noticed. Standing with his arms crossed almost supporting one arm with the other, our conversation seemed confused as he constantly gazed at the floor.
I invited him to come and sit down for a coffee.
Walking him into First Aid shack, I sat him down and asked how he was feeling:
How did your weekend go?
“I don’t remember, apparently I didn’t show up to work on Friday”
Did you leave the house to go to work that day?
“I remember dropping the kids off at school Friday morning, but that’s really the last thing I remember”
As we kept talking, his slurred speech became more noticeable. When he relaxed, those crossed arms became one crossed arm and one seemingly limp arm. Looking into the eyes and face of this normally strong, athletic man there was something missing. His left side was almost motionless, wilted.
Can you lift your arms above your head for me?
The right arm went up, left one didn’t move.
Can you kick your legs out for me?
The right one kicked out, left one stayed put.
We need to get you to the hospital.
“Just let me drive home and I’ll get the wife to take me in”
No, I’m calling an ambulance.
Later that morning I went to the hospital to check on him. As I walked in the room he looked at me and shouted to the nurse:
“Hey nurse there’s the little jerk that sent me in here” (they had him on some pretty good stuff)
“You should thank that little jerk, he saved your life”
The FAST Way To Stroke Recognition
Recognizing that someone suffered a stroke can be difficult depending on its severity.
Recognition is also one of the most important things in treating a stroke, since getting the person to advanced medical care increases the chance of limiting a strokes damage.
My friend in the story had gone three days without his family or friends noticing there was something wrong. He had no memory of the weekend and drove 45 minutes to work that night, with only the right side of his body working properly.
The Canadian Red Cross Emergency Care Manual gives the easiest way to recognize a stroke by using the mnemonic, F.A.S.T.
Here’s how you can use it to help figure out if the person has suffered a stroke:
- have a look at the persons face and check to see if there is weakness on one side
- look and see if there is a noticeable droop around the eyes and mouth
- have them smile and check if both sides are moving equal
- check to see if there is any loss of sensation or weakness on one side
- assess how one side moves compared to the other side (remember in the story how he could only lift one arm above his head)
- this weakness can be present in the legs as well
- difficulty speaking
- slurred speech
- remember that one side of the body is typically affected, so even motor control of the mouth and tongue will be difficult
- It is important to get them help ASAP to prevent things getting worse
- even the person’s concept of time and memory can be affected
The patient could also have sudden headaches, dizziness, confusion and a temporary loss of consciousness.
There are three main causes to a stroke.
- A clot in the brain that either develops within an artery, or a mass makes its way to the brain from somewhere else in the body.
- An artery rupturing.
Although there is nothing we can do to help as far as the cause of the stroke, our ability to recognize the issue is key. If one of your patients is ever complaining of headaches, dizziness, confusion and in any way resembles the issues associated with F.A.S.T we need to get them to a hospital.
9-1-1 And What You Can Do
Your safety is always the top priority.
In this case we can assume it is a safe environment since we are talking about your clinic and also safe to assume there is no spinal injury associated with the patient.
If you remember your last first aid course we always do a Primary and then a Secondary Survey (if everything in the Primary is okay and we aren’t doing any kind of life safety interventions). In the Primary Survey we are checking for ABCs (Airway, Breathing, Circulation).
Since the person is talking to us we already know that they have an airway, they’re breathing and of course have circulation, Primary done.
In the Secondary survey we want to do a head to toe check. This is where the F.A.S.T mnemonic will become more evident.
Having the patient move limbs and using facial expressions will show you what part of the body, and to what extent the patient is having problems.
Now that we know what the problem is we want to get the patient into their most comfortable position (which will vary, but typically will be laying down) and if we haven’t done so already call 9-1-1
After calling 9-1-1 stay with the person and try to keep them as alert as possible. Our biggest responsibility is to stay with them in case they lose consciousness or require CPR intervention.
If a person loses consciousness (or prefers to lay down for comfort) but is still breathing, we need to get them laid down with their affected side up. The side that still has motor control and sensation must be on the ground. In case they begin to vomit, having gravity and motor control working together will help to keep their airway clear.
Since they still have sensation on that side, they will be able to know if anything is underneath them causing discomfort. This helps to prevent getting pressure sores as they could be in this position for a long time during transport to hospital.
I bumped into that friend about five years after his stroke. He wasn’t the man he used to be as the stroke had taken a toll on him. But he was still upright, walking and had his same old sense of humour.
I was sure glad to see him and even happier I was able to help him years before.
He didn’t call me a little jerk that day and even though he’s bigger than me, he could have at least called me a big jerk, I’m at least 5’10”!
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