A stroke is a medical emergency that demands an immediate response to save brain tissue and maximize the chance of a successful recovery. The phrase “Time is Brain” underscores that for every minute a stroke goes untreated, the patient loses approximately 1.9 million brain cells, leading to potential long-term disability or death. This rapid cell loss occurs because a stroke, typically caused by a blood clot blocking blood flow to the brain, deprives the affected area of the oxygen and nutrients it needs. Recognizing the symptoms and initiating emergency care without delay is the single most important factor influencing the outcome.
Recognizing the Warning Signs
The most effective way to quickly identify a stroke is by using the simple FAST acronym. This tool focuses on the three most common and easily observable physical signs, which appear suddenly. The “F” stands for Face drooping, which you can check by asking the person to smile. If one side of the face appears numb, droops, or the smile looks uneven, this is a positive sign.
The “A” represents Arm weakness, assessed by asking the person to raise both arms simultaneously. If one arm cannot be raised or drifts downward, it indicates weakness on one side of the body. “S” is for Speech difficulty, where you listen for slurred speech, an inability to speak clearly, or confusion when the person tries to repeat a simple phrase.
These signs often affect only one side of the body because a stroke typically impacts one hemisphere of the brain. The final letter, “T,” stands for Time, which serves as a reminder that if any of these symptoms are observed, even if they are mild or resolve quickly, it is time to call emergency services. Even symptoms that pass quickly, known as a transient ischemic attack (TIA), require immediate medical attention.
The Critical First Step
Upon recognizing any of the FAST signs, the immediate action is to contact emergency medical services (EMS) using your local emergency number, such as 911. Do not attempt to drive the person to the hospital yourself, as this delays specialized care that can begin in the ambulance and prevents the hospital from preparing for the patient’s arrival. You must clearly state the exact address or location and immediately inform the operator that you suspect a stroke.
You should relay the specific symptoms observed using the FAST criteria to help the dispatcher understand the urgency and severity of the situation. Crucially, you must report the precise time the symptoms first began or when the person was last observed acting normally. This “last known well” time is essential because clot-busting medications, like tissue plasminogen activator (tPA), have a narrow window of effectiveness, typically within four and a half hours of symptom onset. Providing this time allows the hospital stroke team to prepare for time-sensitive treatments even before the patient arrives.
Providing Care While Waiting
After placing the emergency call, your role shifts to keeping the person safe and calm while waiting for EMS to arrive. If the person is conscious, position them lying on their back or side with their head slightly elevated and supported. This positioning helps prevent choking on saliva or vomit, which is a risk if their ability to swallow is impaired.
Do not give the person anything to eat, drink, or any medications, including aspirin. A stroke can severely affect swallowing reflexes, and giving anything by mouth could lead to aspiration, where food or liquid enters the lungs. Aspirin is avoided because it can worsen hemorrhagic strokes, which involve bleeding in the brain.
Continuously monitor the person’s breathing and level of consciousness for any changes until professional help takes over. Reassure the person with a calm, steady voice, as they may be confused, frightened, or anxious due to their sudden symptoms. While waiting, gather any current prescription and over-the-counter medications the person is taking, along with their identification and insurance information. This package allows paramedics and hospital staff to quickly understand the patient’s medical history and streamline the admission process.