Think stroke, think FAST

Doctors and patients in Norfolk are backing a new Department of Health campaign designed to raise awareness of stroke and the signs to watch out for.

Strokes happen when the blood supply, carrying essential nutrients and oxygen, to part of the brain is cut-off. This can be caused by a blood clot (ischaemic stroke) in a blood vessel or by a burst blood vessel (haemorrhagic stroke) that causes a bleed in the brain.

A stroke can leave brain cells damaged or destroyed, affecting body functions. For example, if a stroke damages the part of the brain that controls how limbs move, the person will have difficulty moving their arms.

Symptoms occur suddenly and can include:

– numbness, weakness or paralysis on one side of the body (signs of this may be a drooping arm, leg or lower eyelid, or a dribbling mouth)
– slurred speech or difficulty finding words or understanding speech
– sudden blurred vision or loss of sight
– a severe headache.

Stroke can cause:

– paralysis or loss of muscle control, usually on one side of the face and body
– difficulty with language – speaking, understanding what people say, reading and writing
– blurred or double vision or loss of eyesight
– problems in thinking, memory, concentration and alertness
– depression, anxiety, mood swings and extreme tiredness.

But studies show that if the patient is treated immediately, the risk of long-term damage is reduced, which is why a simple assessment called FAST is so important in spotting the signs.

The campaign informs the public about FAST – Face, Arm, Speech, Time to call 999. FAST is a simple test to help people to recognise the signs of stroke and understand the importance of fast emergency treatment.

The FAST acronym was created by the Stroke Association and is used by paramedics to assess three symptoms:

– Facial weakness. Can the person smile? Has their mouth or eye dropped?
– Arm weakness. Can they raise both arms?
– Speech problems. Can you understand what they are trying to say? Are they speaking clearly?
– Time to call 999.

NNUH stroke consultant Dr Kneale Metcalf said: “Many people do not understand what a stroke is and they don't know what the danger signs are. The FAST campaign is very welcome as it will encourage people to recognise the symptoms and take prompt action”.

Anne Medd, of Beetley, near Dereham, had a stroke in 2005 and has made a good recovery. Mrs Medd, 74, said: “I had two or three mini-strokes before I had my full-blown stroke. It was a shock to me and at the time I didn't fully realise what was happening to me. It's extremely important that not just the public but also doctors and nurses all recognise the signs of a stroke and use the FAST test.”

In Norfolk, new services commissioned by NHS Norfolk are being launched with the aim of reducing the number of deaths and disabilities caused by stroke.

Patients are already benefiting from a pilot Thrombolysis service which was launched at the Norfolk and Norwich University Hospital (NNUH), in December. A similar pilot is expected to be launched at the Queen Elizabeth Hospital (QEH), in King’s Lynn this year.

Thrombolysis treatment – or clot busting treatment – is given to suitable stroke patients who arrive at hospital within three hours of onset of acute stroke. It can have a major impact on the patient’s recovery and reduce the risk of brain damage and resulting disabilities.

With over a thousand patients with acute stroke admitted to the NNUH and QEH each year and, when the service is fully developed, it is estimated that around 10% of these patients will be suitable for the treatment.

Dr Ian Mack, a member of NHS Norfolk's clinical executive and a GP, said this development was really good news for stroke patients and would see significant improvements in services right across NHS Norfolk’s area.

“In May we announced how we were commissioning a more ‘joined up’ Stroke Care service with more specialist care for patients in their own homes, as well as within dedicated health facilities, all aimed at ensuring our patients had better access to better services, and therefore a much greater chance of recovery from stroke,” he said.

“Our plans are based on the most up-to-date research evidence. It’s a major commitment for NHS Norfolk and will involve some significant changes in services. We are working to deliver this ambitious plan with the support of doctors, nurses, therapists and managers across our area.”