The stroke. What help can be done.

Stroke is an acute violation of the cerebral circulation, considered one of the most devastating deceases of the nervous system. According to the statistics acute violations of the cerebral circulation is on the third place among the death causes after heart pathologies and oncological deceases. 35 out of 10000 people suffer from it. The stroke may be caused by the blood vessel rupture (cerebral apoplexy) and vessel obstruction by the thrombosis, embolus or spasm of the vessel wall (cerebral infarction).

The pathology has the tendency to appear at earlier age than it used to be, which is caused by unfavorable ecological conditions, stresses, alcohol and smoking abuse.

It should be clearly understood that the person which faced an acute violation of cerebral circulation should receive qualified treatment at the specialized neurological department.

How to take care of the person after stroke?

It is difficult to give recommendations on patients rehabilitation after stroke in a small article. Nevertheless I allow myself to stop on some aspects of taking care of the most difficult contingent of patients, which can be done by relatives and the paramedical personnel.

First of all it is necessary to control the blood pressure, pulse and keep control of the recommended medicine consumption. The control of body temperature, amount of the urine and stool excretion is also should be done. In case  In case of absence of defecation for three days the enema should be performed. In case of absence of urination and temperature rise the physician should be informed as soon as possible.

The room where the patient is placed should be bright and noiseless. It should be wet scavenged 1-2 times a day, regularly aired, avoiding draughts. The preferable air temperature is +18 -+18C⁰. The bed where the person is lying should not weight down. The most hygienic and comfortable is foamed mattress. In case if person is not able to control his physiological functions the oil cloth should be placed on the mattress, under the sheet or the diaper should be put on. During the changing of the bed clothes, which should be done as necessary, the patient should be carefully turned to the edge of the bed. The used sheet should be rolled as a bandage and on that place the new sheet should be placed where the patient is «rolled».

It is reasonable to perform breathing exercises few times a day. The most simple exercise which can be done even by weakened patients is air balloons and rubber toys inflating. In order to prevent bed-sores and lung congestions the patient should be turned on the bed every 2-3 hours. The massage with light hitting of the lateral thorax and under the shoulder blade with the cup like bent hand is should be done at those periods.

In case if the person is not able to move it is necessary to wash the patient 2-3 times a day and to keep attention on the condition of the visible mucous membranes and skin integuments. Also it is necessary  to regularly wipe  the body with a towel that is wet in soap solution and wipe dry the patient. The special attention should be paid to the mouth cavity and to the perineum.

At slightest signs of maceration (redness of the skin  integuments) the skin should be wiped with the help of wet in the pink solution of potassium permanganate or the camphor alcohol gauze. For the purpose of preventing the bed-sores maceration areas should be dried with the help of fan or special rubber rings and matrasses.

The Seabucktorn oil or the Sermion ointment  are recommended in cases if the bed-sores had appeared.

Bed regime is not a barrier for patients activization. The passive gymnastics of the paralyzed limbs should be performed. Passive movements are performed in the full motion on every joint and  with the other hand-below it.

The patient should move by himself under the supervision. The person should be placed sitting on the bed for few minutes to begin with. Next he may walk around the house with the support. It is important to compare own and patients abilities to avoid traumatism. One should walk the patient having patients weakened hand on his shoulder  on the side that is paralyzed. Very often happens that the patients  inadequately value their abilities and try to walk by themselves. It is preferable to be close to the patient at that period and leave the urine bag on the bedside table and the bed should be fenced in. The patient should be reminded gradually reminded that he should work with his paralyzed hand: grab articles of daily use, turn the book pages, set the alarm clock, get dressed himself, fasten buttons.

Anyway if the insult had taken place it should be remembered that the part of brain cells and neurons had died and the question of a complete recovery is problematic enough, despite the compensatory abilities of the brain. The recovery takes a long time and requires the proper treatment of the patient and his own desire to live  beside taking medicines. The success of recovering is connected with process of studying, therefore there  may be more or less able, active or passive patients. It is necessary to remember that the patients own active position and physicians prescriptions may reduce to the minimum the consequences of the decease.

Healthcare Establishment «Kalinkovichi central district hospital». The head of the neurological department Chernenkov Konstantin Evgenievich.