What to do until the ambulance service is there in case of a stroke?
In principle one should pay attention to the fact that the person concerned is never left alone, but always a person is with her, calms her down and recognizes possible worsening of the situation. Since swallowing disorders can occur, after suspicion of a stroke, no more food or drink should be given and removable dentures should be removed. Furthermore, the upper body should be positioned about 30° upwards, e.g. with a large cushion in the back.
If vomiting or even loss of consciousness occurs, the affected person should be placed in a stable lateral position to keep the airways clear and prevent swallowing. Respiration and, if possible, pulse should always be checked. In the event of respiratory failure or loss of pulse, resuscitation should be carried out immediately until the emergency doctor is on site.
How should the person be stored in case of a stroke?
The correct positioning of a stroke patient depends on the acute state of consciousness. If the person is still awake and shows no signs of nausea or vomiting, the upper body should be positioned slightly upwards (approx. 30°), for example with a pillow or an armchair.
However, if the person becomes unconscious, he or she should be moved to a stable lateral position. In this position, the person is turned on one shoulder and the leg of the upper side is bent and placed on the floor as a support. Further, the hand of the upper side of the body should be pushed under the back of the head so that the head is slightly tilted and any vomit drains forward and cannot be swallowed. In addition, the head should be slightly overstretched to ensure that the airways are secured.
Resuscitation measures for stroke
As a general rule, resuscitation is always indicated when breathing and heart activity are no longer detected.These two criteria can be determined by checking the respiration or pulse. In the former, the person is placed on his or her back and you can hear at a short distance from the mouth and nose whether breathing is present. Also, a slight draft of air should be observed, which can be felt at the ear when breathing sufficiently.
In addition, attention should be paid to the movement of the rib cage. The pulse is felt at the carotid artery. This is located about 2 finger widths below the lateral edge of the jaw.
However, since palpation of the pulse is very error-prone, it is now recommended that the decision to initiate resuscitation measures should be based on the absence of breathing. If this is the case, resuscitation should be started immediately according to the 30:2 scheme. This means that after 30 chest compressions, 2 ventilations should be performed.
Ventilation is mouth-to-mouth, with the patient’s nose covered and the head overstretched. Then blow in 2 times for one second so much air that the patient’s ribcage is visibly lifted. The heart-pressure massage is performed as follows: in the lower third of the sternum, use both hands 120 times per minute to press down on the ribcage so hard that it sinks 6 cm and then release it again. To keep the rhythm, the song “Breathless” can be sung in the head, for example.
