Suffering a Stroke at Sea: Know the Signs

The U.S. Coast Guard recently received an alarming call; a 44-year-old male appeared to be suffering a stroke while working on the fishing vessel GOLDEN ALASKA, which was located approximately 60 miles northeast of Cold Bay. Time is of the essence when treating a stroke, but what happens when the victim is out at sea? The U.S. Coast Guard forward deployed assets are crucial for this type of incident, as they are saving precious time getting crewmembers to proper medical services.

However, it is up to crewmembers to recognize stroke symptoms, report them, and get help as quickly as possible. March 12th marks the beginning of National Brain Awareness week, and this case reminds us just how important it is to know the signs of a stroke and what to do if you or a crewmate suffer the same fate. According to The American Stroke Association, stroke is the 5th leading cause of death in our nation, and the leading cause of disability. Someone suffers a stroke every 40 seconds (about 800,000 strokes happen per year).

What is a stroke?

A stroke is a blockage, usually caused by a blood clot (ischemic stroke) or a ruptured blood vessel (hemorrhagic stroke) within the brain. When a stroke occurs, oxygen rich blood is unable to travel to that part of the brain. When the brain is deprived of oxygen, brain cells die.

Who is at risk for a stroke?

There are three main risk factors for stroke, and at least half of all Americans have at least one. Risk factors include high blood pressure, smoking, and high cholesterol.

Aren’t most people who work at sea too young to have a stroke?

The risk for having a stroke does increase with age, but statistics show an increase in strokes among people between the ages of 35 to 44.

How do I know if someone is having a stroke?

Think F-A-S-T! Every crew member should know this acronym and look for these signs:

F – Facial weakness or drooping: Ask the person to smile.
A – Arm weakness: Ask the person to raise both arms. Is one weak or numb?
S – Speech difficulty: Is the person slurring their speech? Ask them to repeat a sentence.
T – Time: Call for help! Being out at sea exacerbates the problem. Time is the enemy in stroke victims; they must get to medical help immediately.

According to Kenneth Gaines, MD, Medical Director of the Ochsner Neuroscience Institute, it is fairly obvious when someone is having a stroke. Others will notice the F-A-S-T symptoms, and the stroke victim (if conscious) will usually be aware that something is wrong. Even if the symptoms go away, it is important to seek medical attention immediately. What may have started as a “mini stroke” could become a full stroke in a matter of hours.

How are strokes treated?

When an ischemic stroke occurs (most strokes are this type), there is a very short window of time for treatment with the clot-busting drug Alteplase. The drug must be administered within 3 to 4.5 hours for a positive effect.

What should be done if a crewmember or seaman suffers an illness or stroke while working on a vessel?

If you are a crewmember or seaman and suffer an illness or stroke, your employer must use reasonable care to get you to shore for emergency medical treatment. Failure to evacuate an injured or ill worker in a timely manner from the vessel may be considered negligence.

Who is responsible to pay for medical expenses?

The Jones Act provides compensation rights to those who have been injured or fallen ill while working aboard or in connection with a vessel. The worker has the right to “maintenance and cure.” “Maintenance” is a daily living allowance paid to a seaman while recovering from injury or illness. These payments continue until the worker has reached maximum medical improvement or until fit to return to work at the previous level. “Cure” means medical expenses associated with an injury or illness. An injured or ill worker always has the right to choose his or her own doctor, and in most cases, the employer must pay all reasonable and necessary expenses associated with the injury or illness. These expenses may include doctor and hospital bills, therapy expenses, nursing bills, MRI and CT scans, diagnostic testing, transportation costs, and other reasonable medical-related expenses.

The good news is that people working at sea are usually together in close proximity, which means they will be aware if a crewmember falls ill. With a bit of education, the symptoms of a stroke may be easy to spot, saving valuable time getting the worker to the help they immediately need.