Positioning patients with excessive bending or extension of the neck during transportation can easily lead to spinal cord injuries resulting in quadriplegia.
Stroke or cerebrovascular accident is an emergency condition that requires patients to go to the hospital as soon as possible for appropriate diagnosis and timely treatment. However, more than 70% of stroke cases arrive at the hospital late.
According to Dr. Pham Thi Ngoc Quyen from the Neurology Department at Ho Chi Minh City University of Medicine and Pharmacy, a common mistake in first aid for stroke is allowing the patient to rest at home, waiting for the body to recover on its own rather than taking them directly to the hospital. In many cases, family members give the patient sugary water, lemon juice, or An Cung Ngưu Hoàng pills… The doctor notes that this is extremely dangerous, as stroke patients often experience shortness of breath and swallowing difficulties. Eating or drinking during this time can lead to choking, aspiration, and worsened respiratory distress.
Administering antihypertensive medication immediately is also a counterproductive first aid method. The doctor explains that there are two types of stroke: ischemic stroke (caused by a blood clot blocking a vessel, accounting for about 80%) and hemorrhagic stroke (caused by a ruptured blood vessel, about 20%). These two types share similar symptoms but require different treatment methods. In the case of ischemic stroke, a sudden drop in blood pressure can lead to more severe cerebral ischemia; whereas in hemorrhagic stroke, it can cause dangerously low blood pressure, increasing the risk of death.
Another mistake in treating stroke patients is improper transportation.
According to Dr. Tran Quoc Tuan, a specialist in the Neurosurgery Department at Ho Chi Minh City University of Medicine and Pharmacy, when a family member suffers a stroke, relatives often feel confused and uncertain about the initial response, especially regarding transportation to the hospital for emergency care. There have been cases where relatives, not knowing how to handle the situation, have moved the victim incorrectly, inadvertently causing injuries to the head, cervical spine, limbs, or exacerbating existing injuries.
Doctors in the Neurosurgery Department frequently receive emergency patients due to strokes who have been improperly transported, resulting in unfortunate disabilities. Dr. Tuan shared a recent case of a 65-year-old female patient from Ho Chi Minh City with a history of cervical disc herniation. Early in the morning, she was found by family members in a state of unconsciousness and was rushed to the hospital. Upon arrival, doctors discovered that she was quadriplegic; a CT scan revealed a small unilateral hemorrhagic stroke, which did not explain the cause of her paralysis. An MRI of the cervical spine was ordered, revealing spinal cord damage.
Family members reported they brought her to the hospital by carrying her while allowing her neck to move freely with their pace. Dr. Tuan noted that it was highly likely that during this transportation, the patient was positioned with excessive bending or extension of the neck, leading to further spinal cord injury. This was the cause of her quadriplegia.
In another case, a 42-year-old male patient living in Ho Chi Minh City was found by family members who saw him fall on the bathroom floor and intended to carry him for immediate emergency care. Unexpectedly, the bathroom floor was slippery, causing the person carrying him to slip and fall, resulting in injuries to both. A subsequent CT scan revealed that the male patient had suffered a stroke along with a traumatic brain injury.
A stroke patient who fell during transportation, worsening their injuries. (Photo: TT).
Dr. Tuan warns that improper transportation of stroke patients, as described above, often exacerbates their condition. Many stroke patients who fall may suffer additional injuries that family members fail to recognize for immediate first aid. During improper transport, existing injuries or new injuries can lead to severe consequences. Arriving at the hospital on time is important, but managing both the stroke and accompanying injuries becomes much more complex. The risk of paralysis or even death is significantly higher.
According to doctors, the primary reason for many unfortunate incidents during the transportation of stroke victims is the lack of skills and knowledge among first responders in assessing the initial condition, leading to unsafe transportation methods. They often do not recognize the severity of the situation that requires cardiopulmonary resuscitation, and delayed resuscitation can worsen the patient’s condition. Therefore, this step is more crucial than the transportation to the hospital. Most recorded cases of improper transport often involve not securing the patient’s body parts. In some instances, both the carrier and the patient have fallen, resulting in additional physical injuries. Many cases lack medical personnel support during transportation, preventing the early detection of deteriorating conditions that require immediate resuscitation.
Doctors emphasize that proper transportation of patients is extremely important. Medical personnel specializing in transportation need training to understand how to move stroke patients and must have the appropriate equipment. Essentially, transporting stroke patients follows these principles:
- First, ensure the airway and heartbeat are maintained.
- Second, stabilize and protect potentially injured areas such as the head, neck, and limbs.
- Third, do it as quickly as possible.
Therefore, to transport a patient correctly, family members need to assess the pulse and breathing, ensuring the airway and heartbeat follow standard cardiopulmonary resuscitation principles. They should know how to stabilize important body parts, including the head, neck, and limbs of the patient during transport. If there is no specialized stretcher available, it is best to place the person on a hard surface, lying on their back, with arms and legs aligned, using heavy shoes or a blanket to secure both sides of the head to prevent cervical spine injury during transport.
In the United States, patients can directly call 911 (equivalent to 115 in Vietnam) and are transported directly by ambulance, minimizing the time to reach the hospital and improving prognosis compared to self-transportation by personal vehicles or through other channels. Countries recommend that when someone suffers a stroke, they should directly call an ambulance and quickly take the patient to the hospital.
Transporting by ambulance offers many advantages, such as always being faster than personal vehicles and having priority on the road. Medical personnel specialized in first aid can assess the patient’s condition and provide accurate initial treatment better than family members. Currently, ambulance systems have access to hospital specialty information and can decide to transport patients directly to specialized hospitals when necessary, avoiding delays that would occur if taken to intermediate hospitals.
