"Golden hour" in emergency stroke patient care

The golden hour in stroke is often understood as the time to perform recanalization for cerebral infarction cases from the time the patient has a stroke.

According to recommendations in Vietnam as well as in the world, the golden time for emergency treatment is between 3 - 4.5 hours from the time the first symptoms appear. Family members need to remember this time to inform the doctor. Early warning signs of stroke include limb weakness, slurred speech, slurred speech, difficulty speaking, crooked mouth, one-sided facial tilt, headache, dizziness, etc.

Dr. Kieu Manh Ha, Head of the Neurology Department at Military Hospital 7A, Ho Chi Minh City, said: “When a stroke occurs, emergency intervention must be taken advantage of every minute. However, currently, about 70% of stroke cases do not receive timely emergency care within the "golden hour". Of these, nearly half die and the rest suffer from many serious sequelae.”

CT scan of patient Nguyen Van Anh, 35 years old, residing in District 8, Ho Chi Minh City

Dr. Manh Ha shared about the case of patient Nguyen Van Anh, 35 years old (living in District 8) who recovered almost completely after 7 days of treatment at the hospital.

The patient had obesity, high blood pressure, and dyslipidemia that was not treated regularly. He was examined by doctors at Military Hospital 7A, Ho Chi Minh City, and had a CT scan of the brain to diagnose a right thalamic hemorrhage.

"At 10 p.m., the patient experienced symptoms of headache, dizziness, numbness and weakness in the left side of the body. At around 10:30 p.m., the patient was promptly taken to the emergency room by his family. At the hospital, doctors actively treated him, controlled his blood pressure, blood sugar, and temperature, leaving him with a slight numbness in his left hand," said Dr. Manh Ha.

When a patient is brought to the emergency room for a stroke during the "golden hour", depending on each case, the doctor will consider using effective, modern techniques, including: Intravenous thrombolytic therapy (rTPA), vascular intervention to remove blood clots, ruptured cerebral blood vessels, surgery...

However, nowadays, many patients with signs of stroke do not go to a medical facility immediately but treat themselves at home.

In the case of patient Tran Thi Nhi, 43 years old (living in Go Vap district, Ho Chi Minh City), there was no recorded medical history, however after 2 weeks of treatment and discharge from the hospital, she was left with very serious sequelae.

According to doctors, stroke emergency treatment should be given as soon as possible to help patients improve their chances of survival and effective recovery, allowing them to return to normal life soon.

Dr. Manh Ha added that one day before being admitted to the hospital, the patient suddenly felt numbness and slight weakness in his hand for about 15 minutes but recovered on his own. The patient subjectively did not seek medical attention. The next day, while working, he suddenly felt weakness in the right side of his body and a crooked mouth. The patient was taken into the house by relatives, given sugar water to drink, and had his finger pricked... after half a day, the patient was taken to the hospital by his family.

After examination and CT scan, the doctor concluded that the patient had a large cerebral infarction with hemorrhagic transformation at the 11th hour, so recanalization was no longer indicated.

According to Dr. Manh Ha, if the patient had come to the hospital for examination when he had symptoms of numbness and slight weakness in his right arm the day before, the doctors could have treated the patient for stroke prevention more effectively.

"The sooner stroke emergency treatment is given, the better the patient's chances of survival and effective recovery, allowing them to return to normal life soon," said Dr. Manh Ha.

Stroke can occur at any age or in any subject. However, Dr. Manh Ha said that 80% of stroke cases can be prevented through proactive early stroke screening; it is necessary to build a scientific lifestyle and if the patient is taken to an emergency medical facility within the golden hour, the mortality rate is low, leaving few sequelae after treatment.

“Absolutely do not take any medicine, including water, because of the high risk of choking, causing airway obstruction; do not tie the patient's hands or feet or use a mouth guard when the patient is having a seizure; do not arbitrarily give stroke patients blood pressure lowering drugs at home; do not scrape the wind and especially do not use folk remedies such as bloodletting, pressing the philtrum, rubbing oil, or massaging balm,” Dr. Manh Ha advised.

According to VTC News