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Thread: Stroke

  1. #11
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    Yes it would...
    leave the gun... take the cannoli...

    In times of strength prepare for times of weakness...

  2. #12
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    LOL.

    Take the aspirin...easier to dose than the rat poison. After clearing it with your physician, of course.
    Good medicine in bad places

  3. #13
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    ^^ when one clears it with their doc it might be a little late. Also one should regulate intake of greens high in vitamin K too much will lower INR numbers.

  4. #14

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    I had a TIA stroke in 09. Weirdest feeling in the world IMO. I was aware or everything around me and what people were saying and even knew how to respond but I couldn't. Everything seemed jumbled up. Hubs got me to the ER. They ran some tests and prediagnosed a stroke. I was them life flight to St. Joes hospital in Bryan. By the next morning I was able to talk but my left leg was dragging when they tried to help me walk. I stayed in the hospital 9 days with tons of other tests from one end to the other and was finally diagnosed with a TIA stroke. The only real problem that lingered was my short term memory. I had hell with that the first couple of years after but my memory gradually got better. I still, from time to time have minor problems with it but it's not as note worthy. Most people chalk it up to OLD AGE~CRS.
    I considered it a wake-up call and changed my life style completely.
    Making good people helpless, doesn't make bad people harmless!

  5. #15
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    milkman/Cammie - sorry to hear that. My Mother had a TIA last year which is the main reason I brought up the topic.

    Found the abstracts from a couple studies that were done on the use of aspirin immediately following ischaemic strokes, the "Chinese Acute Stroke Trial" and the "International Stroke Trial", about 20,000 participants in each study.

    The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke.

    INTERPRETATION: Neither heparin regimen offered any clinical advantage at 6 months. The results suggest that if heparin is given in routine clinical practice, the dose should not exceed 5000 IU subcutaneously twice daily. For aspirin, the IST suggests a small but worthwhile improvement at 6 months. Taking the IST together with the comparably large Chinese Acute Stroke Trial, aspirin produces a small but real reduction of about 10 deaths or recurrent strokes per 1000 during the first few weeks. Both trials suggest that aspirin should be started as soon as possible after the onset of ischaemic stroke; previous trials have already shown that continuation of low-dose aspirin gives protection in the longer term.


    One of the findings in the above study was:

    "Aspirin-allocated patients had significantly fewer recurrent ischaemic strokes within 14 days (2.8% vs 3.9%) with no significant excess of haemorrhagic strokes (0.9% vs 0.8%), so the reduction in death or non-fatal recurrent stroke with aspirin (11.3% vs 12.4%) was significant."

    And the second study:

    CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke.

    INTERPRETATION:There are two major trials of aspirin in acute ischaemic stroke. Taken together, CAST and the similarly large IST show reliably that aspirin started early in hospital produces a small but definite net benefit, with about 9 (SD 3) fewer deaths or non-fatal strokes per 1000 in the first few weeks (2p = 0.001), and with 13 (5) fewer dead or dependent per 1000 after some weeks or months of follow-up (2p < 0.01).


    "There was a significant 14% (SD 7) proportional reduction in mortality during the scheduled treatment period (343 [3.3%] deaths among aspirin-allocated patients vs 398 [3.9%] deaths among placebo-allocated patients; 2p = 0.04). There were significantly fewer recurrent ischaemic strokes in the aspirin-allocated than in the placebo-allocated group (167 [1.6%] vs 215 [2.1%]; 2p = 0.01) but slightly more haemorrhagic strokes (115 [1.1%] vs 93 [0.9%]; 2p > 0.1)."

    The below is a position paper from the The Royal College of Physicians on the prehospital administration of aspirin by paramedics for strokes that relied heavily on the two studies above.

    Paramedics should delay giving aspirin to patients with stroke

    Aspirin has been shown to reduce the risk of early recurrent ischaemic stroke when given within 48 hours of acute stroke. However, any benefit in reducing the severity of the acute stroke seems to be small, and there is no evidence that overall benefit would be reduced by delaying the administration of aspirin by an hour or so.

    [...]

    Firstly, the number of cases was small and the confidence intervals were wide in two studies that found that there was no evidence of harm in patients with acute stroke who had been randomly allocated to receive aspirin before having computed tomography of the brain and who were subsequently found to have had an intracerebral haemorrhage. Thus, since it is difficult to exclude intracerebral haemorrhage on clinical grounds there remains a potential risk of harm occurring with the inadvertent administration of aspirin to patients with intracerebral haemorrhage.

    Secondly, the ability to swallow safely is commonly impaired in the acute phase of stroke. Given the potential difficulties of training paramedics to assess swallowing, aspirin would have to be administered rectally in order to avoid the risk of aspiration.

    We therefore decided that if there is no evidence that a short delay in administering aspirin reduces its efficacy in acute stroke and since there is some potential for harm, the indignity of rectal administration by paramedics could not be justified.


    As often seems the case when I read the recommendations from doctors given to first responders, I have to disagree with (or at least question) their recommendations in a situation where there is no higher level of care available (ie, SHTF). Maybe I'm just brain damaged, but my take away from the above, for SHTF use only, is give them an aspirin at the first sign of symptoms and continue with daily doses afterwards because:

    1) 80 percent of all strokes are ischemic,
    2) Early administration of aspirin has a small but statistically significant benefit for ischemic strokes, both in decreased recurrence in the short term and less mortality 6 months later, and
    3) While the sample size was small, there was no indication of greater harm from administering aspirin in cases of hemorrhagic stroke.

    I'm still researching/debating with myself if there's any reasonable benefit of having a couple hours of O2 in our preps, whether for strokes or anything else. If I found an Oxy/Acetylene welding kit cheap at a garage sale or something, then maybe.
    Everything marked, everything 'membered. You wait, you'll see.

  6. #16

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    Marked, have you thought about getting an Oxygen Concentrator instead? Thats what I have in my preps. Its a just in case.
    Making good people helpless, doesn't make bad people harmless!

  7. #17
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    Cammie, isn't amazing how spouses save our bacon?

  8. #18

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    Amen! Mine has saved mine countless times. I'd be lost without him.
    Making good people helpless, doesn't make bad people harmless!

  9. #19
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    Quote Originally Posted by Camouflaged View Post
    Marked, have you thought about getting an Oxygen Concentrator instead? Thats what I have in my preps. Its a just in case.
    Looked at them, step father (67) has emphysema and a young cousin (13) has asthma. Neither have been prescribed the concentrators (or supplemental oxygen) but then EMS is only 10 minutes away too. That either would be able to make it to my home if the SHTF is iffy, Mom and Step Dad are 800 miles away, cousins family is about 200 miles. I do have Albuteral and epinephrine inhalers (Primatene Mist, stocked up before they were discontinued) in my preps for my cousin.

    After her TIA I asked my Mom, "EMS give you oxygen on the way to the hospital after your TIA?".
    Her: "yes".
    Me: "why don't you ask your Dr for a prescription for a small tank, just in case, so you have some while waiting for EMS to arrive if it happens again?".
    Her: "Maybe I should".

    We've had this discussion at least 5 times, but she never does ask, and it's not due to memory loss...

    It always comes down to cost and risk/reward, especially when prepping for other people ya know? The good concentrators aren't cheap, if me or the wife needed one I'd have 3 minimum. If they made a <$1000 one that could fill a portable tank with any reasonable amount of concentration/pressure, I'd get one for sure too.

    Thanks for the suggestion, and re:spouses - I don't deserve mine and try to make her feel the same way
    Everything marked, everything 'membered. You wait, you'll see.

  10. #20

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    An airsep 5ml would do the trick. Thats what I got. You dont need a script for one and you can pick up a cam at any med supply store. Look in to it.. You can run one off a gen easily.
    Making good people helpless, doesn't make bad people harmless!

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