Strokes, big and small

May 18, 2015 by Keith Murray

Often when we hear of strokes, we think of the severe kind of strokes, the ones that are obvious when you see them. The person is usually left partially or fully paralyzed, has difficulty speaking or may be unable to speak at all.

But it’s important to know that not all strokes are “The Big One”. Often, people have little or mini strokes, also called a transient ischemic attack (TIA). These mini strokes are often a warning that the big one is coming unless you seek immediate medical attention.

Recognizing and treating TIAs may reduce a person’s risk of a major stroke. Often TIA symptoms are the same as those of stroke, only temporary. The short duration of these symptoms and lack of permanent brain injury is the main difference between a TIA and a stroke.

My father had a mini stroke last year. His symptoms were not easily recognizable. I noticed a trail of peanuts throughout my home when he was visiting, dropping them while snacking as he walked around the house. My mother later noticed he shuffled, unlike his normal walk.

It was not until later when he started to experience other symptoms that we realized he needed medical attention.

After arriving at the hospital, the doctors initially saw no signs of a stroke. It was not until the second day that they discovered it was a mini stroke. Fortunately for my dad, he made a full recovery. He still has some numbness and loss of feeling in his face and arm, but otherwise he is in good condition.

When reading this column today, please ask yourself if someone under your care — the yacht owner or one of his guests — were having a stroke, heart attack or other medical emergency, would you know what to do? Could you help them?

A stroke is a life-threatening medical emergency that can cause paralysis, coma and death. It is the brain’s version of a heart attack. A stroke occurs when a blood clot blocks a blood vessel, interrupting blood flow to an area of the brain (ischemic stroke) or an artery bursts and blood leaks into brain tissue (hemorrhagic stroke). Think of a stroke as a plumbing problem. Either your pipes are blocked with rust (plaque) or the pipe is leaking.

When either of these occurs, brain cells begin to die and brain damage occurs. Where the damage to the brain occurs and how much of the brain is damaged will determine which symptoms the person will display, including:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
  • Sudden confusion, trouble speaking or understanding.
  • Sudden trouble seeing in one or both eyes.
  • Sudden trouble walking, dizziness, loss of balance or coordination.
  • Sudden, severe headache with no known cause.

It should be noted that women may also experience different symptoms, including sudden face and limb pain, sudden hiccups, sudden nausea, sudden general weakness, sudden chest pain, sudden shortness of breath, or sudden heart palpitations.

If you think someone may be having a stroke, act F.A.S.T. and do this simple test:

F-Face: Ask the person to smile. Does one side of the face droop?

A-Arms: Ask the person to raise both arms. Does one arm drift downward?

S-Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

T-Time: If you observe any of these signs, get medical attention immediately.

Though it is not part of the test, note the time when the symptoms first began. There is only about a three-hour window for clot-busting medication to be given at the hospital.

Recognizing that a person may be having a stroke and getting the person to a hospital as quickly as possible is the best way to help. Stay with the victim, place them in a position of comfort, and monitor their breathing and consciousness.

To feel confident in your ability to help in a medical emergency, take a CPR, AED and First Aid refresher class every two years. Shipboard classes are especially helpful because they allow the crew to develop plans, review first aid supplies, and talk about medical emergencies as they relate to their crew, passengers and the various ports of call.

The American Stroke Association has good information and a free app at

This 60-second video may help someone save a life.

Keith Murray, a former firefighter EMT, owns The CPR School, a first-aid training company. He provides onboard training for yacht captains and crew and sells and services AEDs. Contact him at 877-6-AED-CPR, 877-623-3277 or Comments on this column are welcome at



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