Stroke – Go To Hospital F.A.S.T: Advice from Bangkok Hostpital Hua Hin

[Jonathan Fairfield]

Stroke – Go To Hospital F.A.S.T

HUA HIN:-- The Bangkok Hospital Hua Hin has begun a campaign to make sure everyone understand the signs, dangers and treatment options for Stroke. What’s the main message?

We asked to three resident neurology specialists that question and the answer was unanimous. “Time is important, get to hospital as soon as you possibly can.” October 29th is World Stroke Day, which was established by the World Stroke Organization in 2006 to help spread public awareness of the world’s high stroke risk and stroke prevalence. When dealing with stroke, acting F.A.S.T. is key to treatment and recovery. This is the main platform of the Stroke Campaign; understanding the signs of a stroke and seeking early intervention. ‘Saving your brain’ depends upon reducing every moment that it is deprived of oxygen!

What Is Stroke?

Stroke is a rapid loss of brain function caused by a reduction in blood flow to the brain, often caused by either blocked blood vessels leading to the brain or a ruptured blood vessel within the brain itself. There are two main types of stroke. Ischaemic strokes happen when something blocks an artery that carries blood to the brain. There are several possible causes: a blood clot forms in a main artery to the brain a blood clot, air bubble or fat globule forms in a blood vessel and is carried to the brain there is a blockage in the tiny bloody vessels deep inside the brain.

Haemorrhagic strokes happen when a blood vessel bursts and bleeds into the brain (a haemorrhage). The haemorrhage may be due to: a vessel bursting within the brain itself, or a blood vessel on the surface of the brain bleeding into the area between the brain and the skull.

What Are The Risk Factors For Stroke?

You can’t prevent stroke but a healthy lifestyle will significantly reduce the risks.

Controllable Risk Factors:

High Blood Pressure Atrial Fibrillation – Irregular heart beat High Cholesterol Diabetes Atherosclerosis – Thickening and hardening of the arteries Circulation Problems Tobacco Use and Smoking Alcohol Use Physical Inactivity Obesity

Uncontrollable Risk Factors:

Age Gender Race Family History Previous Stroke or TIA (a transient ischaemic attack, also called a mini-stroke). Fibromuscular Dysplasia – Narrowing of the arteries Patent Foramen Ovale (PFO or Hole in the Heart)

What Are The Treatment Options?

If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot. To be effective, this treatment must be started within 3 to 4 1/2 hours of when the symptoms first started. Other treatments given in the hospital will depend on the cause of the stroke.

These may include: Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix) Medicine to control symptoms such as high blood pressure Special procedures or surgery to relieve symptoms or prevent more strokes Nutrients and fluids Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes. Recovery from your stroke will begin from the moment you in care, including in the ambulance on the way to hospital. It will continue when you go home.

About Bangkok Hospital Hua Hin Stroke Response Team

The mainstay of the neurology team at The Bangkok Hospital are Doctors Yutthana Sriwichit, Paweena Narathong and neurosurgeon, Doctor Parnamus Piyavechvirat. By saying ‘mainstay’ we know that apart from these specialist doctors and nursing staff, training all Bangkok Hospital staff to understand the symptoms and need for rapid responses is a priority of the hospital. This includes reception staff, car park attendants and everyone who may first come across someone experiencing a stroke. The doctors are all residents of the hospital in more ways than one.

They say in hospital accommodation virtually ‘on site’ and are available 24 hours / 7 days. The hospital can also arrange rapid transfer (including by air) to Bangkok facilities in critical cases when even more specialist facilities are required. The emergency line is 1719, this will always ensure a rapid response. An ambulance is likely to attend within 5 minutes, the preferred way of starting treatment as soon as possible. There is even a service to provide communications in your language so that your call will be understood.

Our thanks to the ‘brainy’ doctors at Bangkok Hospital for their hospital-ity, time and insights into Stroke! Suffering a Stroke incident may be a scary event, but knowing that ‘best practice’ is available in Hua Hin should provide all the confidence you need.

-- Hua Hin Today 2014-09-08

[eeeya]

2 strokes in my family in a month. Dad and brother in law.. lucky they got to hospital quick and damage very minimal.

Bangkok traffic scares me because this is going to reduce the time and chance for successful recovery. But good to know there is a team on hand.

[gmac]

2 strokes in my family in a month. Dad and brother in law.. lucky they got to hospital quick and damage very minimal.

Bangkok traffic scares me because this is going to reduce the time and chance for successful recovery. But good to know there is a team on hand.

The heart attack when you get the bill will probably kill you though!

[firefox999uk]

I think this site says it all, but a bit better and i more depth.

http://www.nhs.uk/actfast/Pages/stroke.aspx

Have a Nice Day.

[DoctorG]

Long article that appears to leave out the definition of F.A.S.T.

Face Check their face. Has their mouth drooped? Arm Can they lift both arms? Speech Is their speech slurred? Do they understand you? Time Is critical. If you see any of these signs call straight away.

[12DrinkMore]

.Face Check their face. Has their mouth drooped? Arm Can they lift both arms? Speech Is their speech slurred? Do they understand you? Time Is critical. If you see any of these signs call straight away.

Good lord!

I think I had a stroke in the bar last night.

[Benmart]

2 strokes in my family in a month. Dad and brother in law.. lucky they got to hospital quick and damage very minimal.

Bangkok traffic scares me because this is going to reduce the time and chance for successful recovery. But good to know there is a team on hand.

The heart attack when you get the bill will probably kill you though!

One can always find a cloud, even on the sunniest of days.

Most things come with a price, including insurance, if avilable. The other option is to exercise choice and do nothing. No one is forced to seek medical attention or receive a bill as mentioned.

[Benmart]

.Face Check their face. Has their mouth drooped? Arm Can they lift both arms? Speech Is their speech slurred? Do they understand you? Time Is critical. If you see any of these signs call straight away.

Good lord!

I think I had a stroke in the bar last night.

I hope your brain recovers. Unfortunately, based on historical data, it is most probably terminal.

[canman]

Long article that appears to leave out the definition of F.A.S.T.

Face Check their face. Has their mouth drooped? Arm Can they lift both arms? Speech Is their speech slurred? Do they understand you? Time Is critical. If you see any of these signs call straight away.

Two more checks:

Ask them to smile, if the smile is lopsided it is a possible indicator

Ask them to stick out their tongue straight, if the tongue is pointing to one side also a possible stroke indication

[Keesters]

I thought F.A.S.T. was

Find cash or credit card on patient, if

Available continue treatment, if not

Stop

Treatment

perhaps that's why Bangkok Hospital didn't say.

[JimHuaHin]

Considering how motor vehicle drivers do not pull over or allow emergency vehicles to pass, the advice in this article is wasted.

The law here needs to be changed and enforced with a hefty fine - motor vehicles should give priority to emergency vehicles ... you may be the one being rushed to hospital one day.

[hhfarang]

Does Bangkok Hospital have an ambulance with the equipment and staff to start working on the patient on the way to the hospital? If so, I would like to know the emergency number to call for this service.

[JimHuaHin]

Does Bangkok Hospital have an ambulance with the equipment and staff to start working on the patient on the way to the hospital? If so, I would like to know the emergency number to call for this service.

The people I spoke to at Bangkok Hospital Hua Hin told me 'yes', and the number is 1719. Also, on their advice, I registered with the Hospital and provided them with a map of exactly where I was living, so they would have no problem finding my abode. Although this should work in theory, knowing how cooperative the traffic is in Hua Hin, I am not so sure the ambulance would arrive quickly. On a good day, my abode is 10 minutes drive away from the Hosdpital; but if the traffic is not cooperating, it could be easily 30 minutes.

[NoshowJones]

Considering how motor vehicle drivers do not pull over or allow emergency vehicles to pass, the advice in this article is wasted.

The law here needs to be changed and enforced with a hefty fine - motor vehicles should give priority to emergency vehicles ... you may be the one being rushed to hospital one day.

I thought this also, but I have found out that the reason Thai drivers do not give priority to emergency vehicles is because ambulances are often privately owned, and there can be three or four heading for the same incident to try and be first to get any injured people to hospital as the hospital then pays them.

Also, those ambulances take advantage and use their red flashing lights for jumping traffic queues when there is no incident requiring them. I am not saying I am 100% right here, but I believe there is a lot in this.

[belg]

i am sure i will stroke something that day, did not know i have to go to hospital for that, or as it something to do with that hot nurse and her pictures in another article ?

[Benmart]

I thought F.A.S.T. was

Find cash or credit card on patient, if

Available continue treatment, if not

Stop

Treatment

perhaps that's why Bangkok Hospital didn't say.

Some outside of the healthcare idustry seem to subscribe to a different F.A.S.T:

F oolish

A nticipation

S tops

T hinking

Get insurance if at all possible. Per-register at a hospital of choice. Provide that information to trusted friends in the event of an emergency.

[sgtsabai]

If, big if, you get to the emergency room in time, in one piece you have a fighting chance. Emergency care outside the ER is piss poor at best. It isn't always the responders fault, you may be way out in Sakhon Nowhere, the boondocks somewhere and to the best of my knowledge there is no "life flight" available in Thailand. Even back in New Mexico those of us in law enforcement used to joke, "if I'm shot just throw me in the back and drive like hell", that is if we even had back up. We knew "life flight" was on the way, but we were so remote that response by local EMTs, damn good at their job btw, wouldn't get there in time. One of my best friends to this day was a top EMT, eventually ending up in the State office and later as an attorney. She would go through the roof at the state of emergency response/care here and she knows EMT/Emergency Care, still active in the local fire dept. Frankly even as only with the knowledge of a First Responder it scares hell out of me.

[off road pat]

My Thai wife and I were in Bang Sapan some 200 km south of Hua Hin. one morning (April 7 this year) I woke up with with a severe sharp headache on the right side of my brain and some loss of feeling on the left side of my body.....I remembered from my lessons in school that the right side of your brain controls the left side of your body and vice versa....so I made the association I knew I had a blood cloth in the brain blocking the blood flow. I really started to panic at that stage.....I taught this is it, this was my last trip.........Now, I am from Belgium. In my country around the age of 50 we get preventive medicine to prevent blood cloth....and I got some medicine to regulate my blood pressure. 1 Aspirine (or in my case 1. ASAFLOW 80.mg.) a day and a half Co.Bisoprolol for the blood pressure. Now guys I have to tell you, I never drank alcohol or smoked in my life, I used to be a bar tender in the biggest discotheque in my town and saw to many examples of what I never wanted to become in my life. And I used to be into combat sports......I had a reasonably healthy lifestyle. I understood i had to do something very fast......so I took 7 (My wife stopped me from taking more...) Asaflow's to dilute my blood and a full Co.Bisoprolol to reduce the pressure on the blood cloth....(Later on I heard I could have taken 10 Asaflow's....) we were at a nice bungalow at the sea...and one of our neighbours was a nice Swiss guy. he drove us with his pickup to the nearest hospital in Bang Sapan.....

At the hospital the doctors new nothing about strokes.....ZIP, NADA,.....NOTHING....!!!So they send us to a bigger hospital at Pratchuap Khiri Khan. 80 km further up North. were they have a CTI Scanner.... At the big hospital in Pratchuap...they new nothing about scanners !!!! And the doctor new nothing about strokes.....!!! I swear !!! the doctors new nothing about medicine !!!!

I'm a technician, I Know how scanners or radars work......

they did not immobilized my head when they put me into the scanner.....At that point I was not very conscious any more....and everything was a blur....they kept yelling at me not to move....but I did not realize I was already into the scanner .....when they finished, the doctor said I just had a brain Infection and she gave me antibiotics and Paracetamol....they always give you antibiotics and Paracetamol in Thailand when they don't know what you have.....At that point my Thai wife started to get very angry at the Doctor......My wife had a brain scan in Belgium last year just part of a full check.....we have free Excellent Medicare in Belgium. She knows all the difference between good and bad doctors now......After she treated the doctor like the stupidest person she ever met in her life.....she decided that we should go back to Bang Sapan and she called my sister on the phone (in Belgium). My sister in turn called my insurance, who in turn contacted the nearest good hospital, which happened to be BANGKOK HOSPITAL IN HUA HIN. 200 Km north of us. they sendded a ambulance with a specialized team, witch happened to be led by the female doctor in the middle of on the Photo above, Dr. Paweena. when they arrived it was 15 hours after I realized I had a stroke.....they put me in the ambulance and started to treat me....they put a Iv, and did some tests.....She asked me to smile !!, put out your tong !!, how many fingers !! ???....put your finger on your nose.....etc.....she asked me lots of questions.....and said, according to my answers,.....that I would fully recuperate into 5 to 7 days.......At this point, !!! I swear !!!, I started to believe in a future....I had hope......

In the hospital, they strait away put me into a CTI Scanner, and these guys knew exactly what to do......My head was in a U shaped cushion wich blocked it from all movement....

I don't have to tell you guys,.. that when you have insurance, they do all the possible tests and take very good care of you.......

I fully recuperated a couple of days later......and had more tests and scan's ...but stayed in the hospital for +/- 20 days ....I was repatriated together with my Lovely Wife to my country in Business class.....Now you can imagine I don't F...g care about Business class....but it was a great feeling to be going home.

In Belgium they got a ambulance picking us up and bringing us to a great hospital for further tests and I had more scans in the following weeks.....now 6 Months later I still feel great and I am so thank full to my wife to have saved my life......and the Excellent team from Bangkok Hospital Hua Hin........Dr. Paweena.......and my excellent travel insurance.........I feel like at the OSARS !! when they thank everybody.....I won more than a Oscar I won my life back.....

Well guys this is a small part of my story......If this could help somebody and save a life it would make me very happy.

By the way !!! what I did saved me from a blood cloth, but if It would have been a hemorrhage it would have killed me....I Knew, but, give me life or death but nothing in between.......

Patrick S.

[email protected]

[super22k]

It is a good thing to carry an Asprin tablet with you at all times and leave one on your bedside locker overnight. As soon as symtoms of a Stroke or a Heart attack show ,swallow the Asprin,preferably with water,after you have crunched it up with your teeth.In a short while it will thin your blood and give you a better chance. Then go to a hospital as soon as possible.The hospitals know about taking Asprin and I think a campaign is about to be started to to promote the idea.Asprin tablets have saved many lives.

[Keesters]

I thought F.A.S.T. was

Find cash or credit card on patient, if

Available continue treatment, if not

Stop

Treatment

perhaps that's why Bangkok Hospital didn't say.

Some outside of the healthcare idustry seem to subscribe to a different F.A.S.T:

F oolish

A nticipation

S tops

T hinking

Get insurance if at all possible. Per-register at a hospital of choice. Provide that information to trusted friends in the event of an emergency.

And some have no sense of humor.

[wpcoe]

It is a good thing to carry an Asprin tablet with you at all times and leave one on your bedside locker overnight. As soon as symtoms of a Stroke or a Heart attack show ,swallow the Asprin,preferably with water,after you have crunched it up with your teeth.In a short while it will thin your blood and give you a better chance. Then go to a hospital as soon as possible.The hospitals know about taking Asprin and I think a campaign is about to be started to to promote the idea.Asprin tablets have saved many lives.

NO!!! Do NOT take an aspirin if you suspect a stroke!

There are two types of strokes: one is a blockage that prevents blood reaching the brain -- that type of stroke might benefit from aspirin.. However, another type of stroke is uncontrolled bleeding in the brain -- that type of stroke is WORSENED by taking aspirin.

ONLY if it can be DEFINTELY diagnosed which type of stroke can you know whether aspirin will help or hinder.