A stroke is a medical emergency that occurs when blood flow to a part of the brain is interrupted, either by a blockage or a hemorrhage. This interruption deprives brain cells of oxygen and nutrients. The consequences of a stroke are highly time-dependent, which is encapsulated in the phrase “Time is Brain.” For every minute that passes without treatment, an estimated two million brain cells can die, underscoring the extreme urgency required for recognition and response. Acting quickly to identify the signs and call for help is the most significant step a bystander can take to improve the outcome.
Identifying the Warning Signs
The most effective tool for rapidly recognizing a stroke is the F.A.S.T. acronym, which focuses on the three most common physical symptoms. The “F” stands for Face drooping, where you ask the person to smile and observe if one side of the face is numb or droops unevenly. This asymmetry is a strong indicator of neurological impairment.
The “A” represents Arm weakness, assessed by asking the person to raise both arms in front of them. If they are having a stroke, one arm may drift downward or they may be unable to lift it at all. The “S” is for Speech difficulty, which can manifest as slurred words, difficulty finding the correct words, or an inability to speak clearly when asked to repeat a simple sentence. These three signs are caused by damage to specific areas of the brain controlling motor function and language processing.
Other signs can accompany or occur instead of the core F.A.S.T. symptoms, suggesting a broader neurological event. These include a sudden, severe headache with no known cause, which is common in hemorrhagic strokes. The person may also experience sudden trouble with balance or coordination, unexpected dizziness, or abrupt loss of vision in one or both eyes. Recognizing any single one of these symptoms should prompt an immediate emergency response.
Immediate Emergency Response
The final letter of the F.A.S.T. acronym is “T,” which stands for Time to call the local emergency number, such as 911. Upon recognizing any sign of a stroke, the priority must be to contact emergency medical services immediately, rather than driving the person to the hospital yourself. Paramedics can begin providing specialized care and communicate with the hospital while en route. This activates the hospital’s stroke team before arrival, saving valuable minutes that directly impact treatment options.
When speaking with the dispatcher, clearly state that you suspect the person is having a stroke. The most crucial information you must provide is the “Last Known Well Time” (LKW). This is the last time the person was observed acting completely normal and without any symptoms.
The LKW time determines eligibility for time-sensitive treatments, such as intravenous thrombolysis, commonly known as clot-busting drugs. The effective time window for some interventions is narrow, often requiring administration within four and a half hours of the LKW time. An accurate LKW is essential for hospital treatment planning and should be determined by asking the person or any nearby witnesses.
Actions While Waiting for Medical Help
Once emergency services are on their way, focus on ensuring the person’s safety and comfort until professionals arrive. Help the person lie down in a safe, comfortable position, ideally on their side with the head slightly elevated. This position helps prevent choking if vomiting occurs. Loosen any restrictive clothing, such as tight collars or scarves, to help ease breathing.
You must not give the person anything to eat, drink, or take any oral medication, including aspirin. A stroke can impair swallowing muscles, creating a high risk of choking or aspiration. While aspirin helps ischemic strokes (blockage), it is dangerous if the stroke is hemorrhagic (bleeding), and the type cannot be determined without a brain scan.
Remain calm and speak in a reassuring voice to reduce the person’s anxiety and discourage unnecessary movement. Monitor their breathing and level of consciousness, and be prepared to perform cardiopulmonary resuscitation (CPR) if they become unresponsive. Gather information about their medical history, current medications, and pre-existing conditions to hand over to the emergency responders immediately upon their arrival.