National Emergency Medicine Assoc. (NEMA)


Stroke published by the National Stroke Council, a special program of National Emergency Medicine Association

Volume 3 Issue 1 Spring 1997

Dear Friends and Supporters,

The National Emergency Medicine Association (NEMA) frequently reminds it’s National Stroke Council members that the important issues affecting us, are not always medical. NEMA is currently addressing one of those issues- the alarming increase in gun violence among our youth. Children killing children.

We are proud to announce the completion of “In A Flash”, a gun violence prevention video and teaching resource guide which NEMA will provide free to all middle schools in the U.S. The program has been distributed in Maryland middle schools to rave reviews. Other groups such as police, public health groups, social services and youth groups are purchasing copies for use in their programs. Distribution in other states will occur as we receive funds from interested donors.

“In A Flash” consists of a 20- minute, two-part video and teaching guides for discussion topics, classroom activities, homework and other out of class assignments.

The program takes a positive upbeat approach to teaching kids to take charge of their life and be the best they can be. Viewers see the results of turning to guns to settle conflict.

They learn that gun injury is not just live or die, it can also mean living life as a paraplegic, without an arm or an eye, on a ventilator. They see kids, actual victims of gun injury, struggling through the pain of rehabilitation, both physical and emotional. They are taught positive skills for resolving conflict and how to avoid risky situations.

We hope to bring “In A Flash” to your schools soon. For information on the “In A Flash” gun violence prevention program, call NEMA at 1-410-494-0300.  

Howard Farrington, President

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Research helps you prevent stroke

The ongoing search for medical knowledge that helps diminish and prevent the devastating results of stroke, continues to identify new connections with medical conditions not normally associated with stroke. Three recent studies indicate additional conditions where physicians must update their knowledge in stroke prevention and treatment.

The first two studies connect pre-existing medical conditions to an increased risk of stroke. Dr. Richard P. Abben, director of the Arrhythmia Center, Cardiovascular Institute of the South, describes a strong link between “quivering” heart symptoms and possible stroke. He reports that “atrial fibrillation”- an inability of the upper left chamber of the heart to fully contract, prevents the proper transfer of blood from the atrium to the left ventricle. As a result, stagnate blood that remains in the atrium too long, forms clots that may later enter into the blood stream, blocking arteries and causing a stroke. The risk of stroke to those with atrial fibrillation is five to seven times greater than those without the condition. Atrial fibrillation has been identified as the (continued- page 3)

(continued from page 1)- cause of 45% of heart-related strokes. Tachycardia or run-away heartbeat is another potentially dangerous risk associated with this condition.

Some patients with atrial fibrillation may experience irregular heartbeats or flutters, others have no symptoms at all. That’s why it’s so important for people over 60 to have regular heart check-ups.

Atrial fibrillation can be treated with medication or electrocardioversion, a hospital procedure that resets the correct heartbeat pattern. In more severe cases, warfarin, a clot-fighting drug may be prescribed. Any treatment addressing the condition, helps prevent a heart related stroke.

A second study conducted at the Sleep Disorder Center of the University of Iowa correlates incidence of sleep apnea to an increased risk of stroke. Patients with obstructive sleep apnea suffer from recurring closure of the airway, resulting in heavy snoring and disrupted breathing during sleep. Researchers, led by Dr. Mark Dyken, monitored the sleep patterns of those with moderate to severe sleep apnea and those without. Results found that far more nightly occurrences of partial or blocked airway occurred among stroke patients. Statistics from a four-year follow-up indicated 21% of the stroke patients died. All had sleep apnea and 4 of the 5 suffered their original strokes during sleep.

The researchers did take into account that both sleep apnea and stroke are common among patients with hypertension, heart disease and high blood pressure. It is significant, however, that more than half of the patients suffered strokes during sleep and that sleep apnea is more frequent in stroke patients. They speculate that “hypoxemia (low blood oxygen levels) and automatic (nerve) responses associated with obstructive sleep apnea may produce acute and chronic changes that predispose patients not only to hypertension and casdiovascular disease but also to stroke.”

The American Heart Association National Center has reported on a third study by Monica Astrom, M.D., Ph.D. Dr. Astrom, associate professor and consultant at University Hospital, Umea, Sweden, concludes as many as one in four stroke survivors may have an anxiety disorder not properly treated by physicians.

Dr. Astrom, described the disorder, called generalized anxiety disorder (GAD) and its effect on stroke victims. Patients display excessive anxiety, worry, motor tension, vigilance and “automatic hyperactivity” (rapid heartbeat, shortness of breath and dizziness).

Stroke victims usually feel anxious for the first few months after their attack, as they adjust to the sudden physical and emotional traumas of their condition. But patients who don’t improve within the first year, often slide into a more chronic and serious withdraw and depression.

“Contrary to the traditional view that GAD is a mild disorder, we found it had a substantial influence on social relationships and functional recovery” of the stroke victim, said Astrom. “Active treatment, both physical and social, are necessary to break this vicious circle... Otherwise, the risk is high that the anxiety will become chronic.”

Astrom feels many physicians improperly treat depression after stroke and this diminishes a patients ability to recover fully. She recommends physicians learn the benefits of antidepressant therapy and depend less on the commonly prescribed tranquilizers that can cause drowsiness and impair motor functions that interfere with stroke rehabilitation.

The National Stroke Council recommends you learn about all medical conditions that may be increasing your stroke risk. Discuss these with your physician and continue to ask questions about the latest findings in stroke research, prevention and treatment .

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Stroke Facts You Should Know

A stroke is often preceded by transient ischemic attacks (TIAs) which result in no permanent damage. Emergency treatment at this stage often prevents fatal or disabling strokes from occurring later. Get medical treatment immediately. Do not delay.
Medical treatment during the first six hours of a stroke are the most important in preventing permanent damage and disability. For every additional hour you delay, you decrease your chances for full recovery.
Acute alcohol consumption or binge drinking may increase ischemic stroke in young adults
High blood pressure increases your risk of stroke. This important stroke factor can be improved by healthy eating and lifestyle choices.

The Latest Tip A routine panoramic x-ray of your mouth during a dental check-up, may reveal the presence of stroke-threatening plaques in the carotid arteries that supply blood to the brain. Early detection and treatment of plaque by medication or surgery reduces the risk of stroke. Ask your dentist about sharing your X-rays with your doctor.

Brain Function and the Effects of Stroke

Right Brain Hemisphere

Left Brain Hemisphere

Back of the Brain

Stroke on the right side of the brain affects the left side of the body and may affect: Stroke on the left side of the brain affects the right side of the body and may affect: Strokes in the posterior (back) brain such as the cerebellum or brain stem may affect:
Movement on the left side
Movement on the right side
Sense of balance (ataxia)
Sensation on left side
Sensation of the right side
Double vision
Spatial relationships
Vision on the right side
Slurred speech
Vision on the left side
Speech and understanding
Decreased consciousness possibly including coma
Emotional aspects of language
Inability to remember how to perform routine actions
Involuntary life-support functions such as breathing, blood pressure & heartbeat
Uncharacteristically impulsive behavior
Cautious or paranoid behavior

Remember: prevention is the best treatment

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Where There’s a Will There’s a Way!!

You can continue to support the work of the National Emergency Medicine Association (NEMA) by remembering us in your will. By pledging an amount or percentage of your estate, you go on fighting stroke even after you are gone, or you may wish to make a bequest in memory of a loved one. It’s as easy as calling your attorney or us at 1-800-332-NEMA.


The Internal Revenue Service provides special incentives to encourage charitable contributions. Careful estate planning with a knowledgeable advisor allows you to benefit from tax savings now and protect your estate from unnecessary death taxes later while still protecting the inheritance of your loved ones, plus, making a charitable donation to an organization such as NEMA.

Talk to your lawyer or financial planner about Capital gifts, Life Income Gifts and Charitable Remainder Trusts or call NEMA at 410-494-0300.


NEMA produces an award winning radio health show, "THE HEART OF THE MATTER" , broadcast daily nationwide. The lively interview format provides current health, lifestyle and prevention information on a wide range of topics.

For stations that broadcast "THE HEART OF THE MATTER" call 1-800-332-NEMA. Program transcripts are available in print or cassette for $4.50. You can download transcripts and access the NEMA home page on the Internet at: To request The Heart of The Matter on your favorite radio station contact Steve Girard at 1 (410) 296-7133 with station information or e-mail him at

Remember: The best emergency is one that does not happen


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Copyright 1997 National Emergency Medicine Assoc., Inc.
Last modified: December 29, 2021