Spotting a Stroke

You’re alone with your grandfather, when he suddenly looks and acts strangely. His speech slurs.  He can hardly move.  The left or right side of his face droops.

Chances are, he’s having a stroke. 

Dr.  Jo Ann Soliven, Clinical Head of The Medical City (TMC) Acute Stroke Unit and Neurological Intensive Care Unit (ACSU/NICU); Course Director of TMC -  Emergency Neurological Life Support  (ENLS) Live Course conducted in 2017, and former  head of TMC’s Neurologic Emergency/Critical Care Services, gives the following signs to watch out for.

“In the US, the acronym to remember is FAST, for Face, Arm, Speech and Time. At  The Medical City, Dr. Anthony Piano coined the acronym Kambio, for Kamay, Mukha, Bigkas at Oras.”

One must check the person’s hands. Dr. Soliven says some stroke patients are easily identified because a part of their body is paralyzed.  You need to do some tests for others.

Ask the person to stretch his arms and close his eyes. Count up to 10. If a stroke weakened the muscles, one arm – or both – will slowly go down.

Both arms must be at the same level from the ground.  Otherwise, a stroke can be a strong possibility.

Ask the person to smile.  Weak facial muscles will cause part of the stroke victim’s face to fall.  Others will show no such sign.

Next, ask the person to speak. Slurred speech means danger.

When you see these signs, Dr. Soliven says it’s time to rush the person to the hospital.  

She adds that the patient should be in the hospital within one to four hours of the attack. If not, the stroke can worsen. The blood clot can spread and the medicine can’t do its work.

Besides, the patient must first undergo a series of tests, like MRI, CT Scan and others to help the doctor and his staff determine the right course of action to take.

This is where the value of ENLS comes in. It consists of 14 protocols health care providers should follow during emergencies.  These consist of Acute Ischemic Stroke, Acute Non-traumatic Weakness, Airway, Ventilation, and Sedation, Approach to the Patient with Coma, Intracerebral Hemorrhage, Intracranial Hypertension and Herniation, Meningitis and Encephalitis, Pharmacotherapy, Resuscitation Following Cardiac Arrest, Subarachnoid Hemorrhage, Spinal Cord Compression, Status Epilepticus, Traumatic Brain Injury, and Traumatic Spine Injury.

ENLS training is important because it allows health care providers to detect what causes an emergency – say a stroke.  This way, they can recommend what steps must be taken (e.g. CT scan) or what kind of health specialist is needed to help the patient as soon as possible, because every minute counts.

“What happens to the patient depends on what is given to him during the first hour of the emergency,” says Dr. Soliven.  This makes ENLS crucial in saving or prolonging lives.

Last year, TMC trained 322 doctors, nurses, and other allied healthcare professionals in a two-day ENLS symposium that turned out to be the most well-attended around the world, and which impressed the representatives from the US-based Neurocritical Care Society.

Dr. Soliven and her team are more inspired than ever to push for ENLS certification for as many health care providers as possible.

“We dream of seeing the country mature as far as neurological emergency is concerned,” she says.

She wants to propose a plan for network hospitals (e.g. TMC Pangasinan, TMC Clark, etc.) to apply standardized neurocritical care during emergencies.

Dr. Soliven knows the country only has 100 neurosurgeons to take care of the rising cases of dementia, stroke, and other ailments involving the body’s neurons.  The country needs more health providers to look into these cases. Here’s where the need for ENLS is a crucial as ever.

Who knows, the life you save may be your own, or that of your loved one.

For more information about ENLS, you may call the Department of Neurology at

9881000 ext. 6270. ###