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SAVES Stroke Screen with Dr. Saha

By: | Tags: , , , , , | July 17th, 2020

This is Dr. Sam Saha, a neurologist with TeleSpecialists. We are a group of neurologists that see patients via telemedicine at various hospitals in the US. This allows stroke patients in any emergency room to be seen as soon as possible by an expert neurologist. Today I’d like to speak to you about how to use the acronym SAVES to quickly recognize symptoms of a stroke in the brain. A stroke is another name for a brain attack. Almost 2 million brain cells die every minute to the lack of blood and oxygen. In the US alone, a stroke occurs every 40 seconds. Shockingly, every four minutes a person with a stroke can die. Nearly 800,000 Americans suffer a stroke each year with a higher risk of the elderly, but growing more common even in younger people. Since so many brain cells can be damaged permanently, it is extremely important to recognize signs and symptoms of a stroke as soon as possible. Without early symptom recognition, stroke evaluation and treatment will be delayed. Believe it or not, even in the emergency department, there is no simple blood test or scan available that can recognize stroke symptoms sooner than you. Stroke symptoms have a snowball effect. A person might only have one subtle symptom early on; however, within a few hours, this will escalate quickly, and treatment options may become limited. To make it easier to remember the variety of symptoms that a stroke may cause, we have developed acronym SAVES: Smile, Arms, Vision, Even Balance and Speech. So, let’s discuss each symptom and examples of what to look out for. S stands for smile, ask the person to smile wide, showing all of their teeth. If one side of their face is drooping, or you don’t see roughly the same number of teeth on one side of the smile as the other, this may be a symptom of a stroke. A stands for arms. Ask the person to hold up both of their arms with palms facing upward. If one of the arms starts drifting downward or the palm starts turning inward, this may be a symptom of a stroke. V stands for vision. This includes blurred vision, double vision or vision loss. Oftentimes, a person will tell you that they’re having one or all of those symptoms. To detect vision loss, ask the person to stare straight at your nose and use their side vision to count one or two fingers in an imaginary box in front of them. If they have difficulty counting fingers, this may be a symptom of a stroke. E stands for even balance. This may involve weakness of the legs, difficulty walking, or dizziness and unsteadiness when standing still. Any or all of these symptoms should alert you to a possible stroke. S stands for speech. This includes both articulation and language. Articulation is being able to clearly speak in an understandable manner. Language refers to communication, both to say what you want to say and to be understood by others. If someone’s having difficulty with finding words, reading, writing, typing, or texting, or they’re having difficulty understanding you, they may be having a stroke. It is important to remember that the sudden onset of even one symptom should alert you to suspect a stroke and call 911 right away to get to the closest emergency room possible. Calling 911 activates an interconnected system of emergency personnel, including first responders, emergency physicians and nurses, and neurologists. Medical providers will be immediately notified so that they can mobilize together before the person arrives to the emergency department. In addition to the symptoms discussed above, if possible, I recommend having three important pieces of information handy for the emergency providers. Number one, a list of medications and medical problems. Most importantly, this includes blood thinners and medical problems such as blood pressure, heart attack, or recent surgery. Number two, the time of onset, which is when symptoms started, or were discovered by someone else. And most importantly, number three, the last known well time, this is the last time someone else has seen or observed the patient in their usual state of health. Keep in mind, this may be different from when the symptoms were discovered. This is especially important if a person wakes up at seven in the morning with symptoms, but the last time they were seen normal was at 10pm before bedtime the night before. Also, it’s important to ask the person themselves since they may have had symptoms earlier and did not tell anyone. I hope that with this video we will improve stroke awareness with early recognition of stroke symptoms and the early activation of emergency care. I encourage you to review the SAVES symptoms and educate your friends and loved ones with this video as well, since strokes can happen to anyone at any time.


Nattasha Acevedo, MD

Dr. Acevedo received her medical degree from the Ponce School of Medicine in Puerto Rico and did her neurology residency at Montefiore Medical Center in New York. She went on to do a clinical neurophysiology fellowship at Emory School of Medicine in Atla nta, Georgia and then joined private practice in Fort Myers, Florida. She currently resides in San Juan, Puerto Rico. She likes running, paddle boarding and spending time with family.

Bernadette Borte, MD

Dr. Borte received her medical degree from St. Matthew’s University School of Medicine in Grand Cayman. She completed her neurology residency at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Her areas of interest include inpatient neurology and acute stroke. When not working, she enjoys spending time outdoors with her family. Dr. Borte joined the TeleSpecialist family in March of 2019.

Mazen Almidani, MD

Dr. Almidani is board certified in pediatrics by the American Board of Pediatrics and board certified in epilepsy, as well as neurology with special  qualification in child neurology by the American Board of Psychiatry and Neurology.  Dr. Almidani is happily married with 4 children. His oldest son has autism and his daughter has complicated seizures; both were a drive for him to become a neurologist. Dr. Almidani enjoys soccer, running and spending time with his family. He is very involved with his sons’ therapy and helping with daily challenges. He is double board certified in Pediatric and Adult Neurology and Epilepsy. He sees children and adults. He also participates in charities for children in Syria who may be underprivileged and/or affected by the war. Dr. Almidani joined TeleSpecialists in August 2020.

Amanda Cheshire, MD

Dr. Cheshire received her medical degree from the University of Louisville School of Medicine in Louisville, Kentucky. She completed her neurology residency at the University of Cincinnati Medical Center in Cincinnati, Ohio. She did a fellowship in neurophysiology at the University of Michigan Medical School in Ann Arbor, Michigan. Dr. Cheshire is double board certified in neurology and clinical neurophysiology. She enjoys traveling, reading and music. She currently resides in Viera, Florida.  Dr. Cheshire joined TeleSpecialists in June 2019.

Jessica Floyd, MD

Dr. Floyd completed her neurology residency at Mayo Clinic in Jacksonville, Florida followed by fellowship training in clinical neurophysiology with focus in EEG and epilepsy at the Medical University of South Carolina in Charleston, South Carolina. She has particular interest in hospital neurology and patient education as well as the blossoming specialty of lifestyle medicine. She strives to take advantage of every encounter with patients and medical staff to empower them to do their own research into how daily thoughts, choices, and habits can add up to create greater and longer-lasting brain and neurologic health for ourselves and our loved ones. She lives in Florence, South Carolina with her awesome husband of 13 plus years and three beautiful children. She is an avid yogi, astrologer, and lover of food and all things neurology! Dr. Floyd joined the TeleSpecialist family in July 2017.

Nancy Futrell, MD

Dr. Futrell received her medical degree from the University of Utah in Salt Lake City, Utah. She also did her neurology residency at the University of Utah as well as a research fellowship in cerebral vascular disease at Jackson Memorial Hospital in Miami, Florida. She currently resides in Salt Lake City, Utah. She has authored 2 books and 50 peer reviewed papers. 

Rebecca Jimenez-Sanders, MD

Dr. Jimenez Sanders received her undergraduate degree from Emory University, and her medical degree from the San Juan Bautista School of Medicine in Puerto Rico. She completed her neurology residency at the University of South Florida in Tampa, Florida, where she also did a specialized headache medicine and facial pain fellowship. She currently resides in Tampa, Florida with her husband and her two daughters. She is also fluent in Spanish and Italian languages, and enjoys photography, baking, boating, and biking.

Cory Lamar, MD

Dr. Lamar received his medical degree from Meharry Medical College in Nashville, Tennessee. He completed his internship and residency at Wake Forest Baptist Health in Winston Salem, North Carolina. Following residency, he completed a clinical fellowship in neurophysiology, with a concentration in epilepsy. He currently resides in Florida and enjoys outdoor activities.

Clifford Meyers, MD

Dr. Meyers received his medical degree from Brown University in Providence, Rhode Island and his MBA from the Simon School of Business at the University of Rochester in Rochester, New York. He completed his neurology residency at the University of Rochester, where he also did a neurophysiology fellowship. Dr. Meyers resides in Webster, New York with his wife and daughter. When not doing teleneurology, he enjoys playing sports with his wife and daughter.

Tao Tong, MD

Dr. Tong received her medical degree from the University of Miami School of Medicine in Miami, Florida. She completed her neurology residency at Jackson Memorial Hospital in Miami, Florida, where she also did a neuromuscular/EMG fellowship.  She currently resides in College Station, Texas. Dr. Tong is married with two boys. She enjoys spending time with her family, traveling and reading.

Shubhangi Chumble, MD

Dr. Chumble attended BJ Medical School. She is a board certified neurologist with a subspeciality interest in sleep medicine. Dr. Chumble did her residency at Howard University in Washington DC and has practiced neurology since 2001 in private and corporate settings. She lives in Melbourne, Florida and loves the sunshine state. Her hobbies include yoga, meditation, cooking , traveling and meeting new people. She also loves to do stained glass, pottery and painting. She joined TeleSpecialists in June 2019.