Stroke continues to be the leading cause of death and disability worldwide, leaving up to 50% of survivors chronically disabled with reduced health related quality of life and depression. It is the major cause of sudden death in Nigeria and may be the next Pandemic in the country. 1 in 4 of us will have a stroke in our lifetime. Therefore, there is a greater need for stroke prevention, managing stroke risk factors like high blood pressure and diabetes, as well as taking prompt action to commence prehospital care and take a person with suspected stroke to the hospital. Prehospital care is a generic term for healthcare provided on the scene at a medical emergency or major incident, and during transfer of casualties to definitive care facilities.
According to the World Stroke Organization, stroke has become both treatable and manageable, yet there are considerable prehospital delays in patients with acute stroke symptoms presenting at the emergency hospital department. This is often due to poor awareness of symptoms and delay in calling emergency services such as the ambulance service. This causes delay in seeking medical attention after the onset of stroke symptoms often leading to missed treatment opportunities. Survival after sudden stroke is time dependent, with any potential morbidity and mortality being reliant on effective and efficient prehospital care.
When someone has a stroke, every second that goes by is crucial. As brain cells die our very lives are put at risk. Time could not be more precious. Knowing the signs of stroke and getting emergency medical treatment can make a great difference in saving the person’s life. By acting fast when a stroke happens, we can also save mobility, speech, memory, relationships and independence. The prehospital chain of survival should be an essential part of the continuum of emergency health care that is frequently initiated by a national emergency telephone number call like 112 for instance in Nigeria, to a dispatch centre. Initiating the emergency telephone call, is determined by the first responder who might be a lay person that knows how to undertake the necessary FAST assessment (Face, Arm, Speech, Test) to accurately suspect a stroke. Calling an Ambulance (if available) or other transportation may enable the patient to be transported to the appropriate health care facility, where definitive care can be provided.
The main pre-hospital delay in Nigeria is poor awareness of symptoms and calling emergency services, and poor government investment in essential services like Ambulance service. Brain cells die rapidly after stroke and any effective treatment must start as early as possible. Therefore, activating the continuum of emergency prehospital care is very essential and often starts in the community setting.
On World Stroke Day on Friday October 29th, Stroke Action Nigeria is collaborating with the World Stroke Organization’s #Precious Time Campaign, the Coalition of Special Taskforces on Stroke #Prehospital Care Campaign, and the African Stroke Organization’s #Roll Back Stroke Campaign to raise community awareness of stroke signs and the importance of acting fast to save lives.
As part of this campaign, the Nigerian emergency telephone number 112 is used as an education tool to advocate for increased FAST awareness, and influence stroke policy. The educational strategy is based on the UK FAST (Face, Arm, Speech, Time) program by using emergency phone number (112) to represent the key sign and symptom of stoke for rapid stroke recognition and action without language barrier. The education tool is an audio-visual FAST messaging in English translated into key Nigerian languages like Efik, Hausa, Igbo, Yoruba which is sent virtually to the public, people affected by stroke, health workers, government officials and policy makers. FAST messaging includes:
F = is the face bent on one side, by the mouth?
A = can you raise both arms?
S = Is the speech slurred or incoherent?
T = Time to act fast if any of the signs and symptoms is present. Call the Emergency Telephone 112 for the Ambulance to take the person to the emergency hospital department. Get “ANY” transport if the ambulance is unavailable.
Rita Melifonwu
Ashoka Fellow, Chief executive, Stroke Action Nigeria
Board Member, World Stroke Organization (WSO)
Steering Committee Member African Stroke Organization (ASO)
Champion, Coalition of Special Taskforces on Stroke (CSTS)
Tel: 0809 859 7313