A stroke occurs when blood flow to a part of the brain is interrupted, either by a blockage or a ruptured blood vessel. Without the oxygen and nutrients carried by blood, brain cells begin to die rapidly, making a stroke an immediate medical emergency. Recognizing the signs and acting quickly can significantly influence the outcome for the affected person.
Recognizing the Signs of Stroke
The most effective way to remember the common symptoms of a stroke is by using the acronym B.E. F.A.S.T.. This framework helps a bystander quickly assess a person for these signs. The “B” stands for Balance, meaning a sudden loss of coordination, dizziness, or trouble walking. The person may stagger or appear suddenly off-balance.
The “E” represents Eyes, indicating a sudden change in vision, such as blurred sight, double vision, or the loss of vision in one or both eyes. Next, “F” is for Face, where you should check for a facial droop or numbness on one side. Ask the person to smile, and observe if the smile is crooked or uneven.
The “A” stands for Arm, which involves weakness or numbness in an arm or leg. A simple test is asking the person to raise both arms; if one arm drifts downward, it is a significant warning sign. Finally, “S” is for Speech difficulty, manifesting as slurred words, an inability to speak, or difficulty understanding what you are saying. Ask them to repeat a simple sentence and note any confusion or garbled speech.
Immediate Emergency Response
If you observe any of the B.E. F.A.S.T. symptoms, the final “T” means it is Time to call emergency medical services immediately. Do not attempt to drive the person to the hospital yourself. Emergency services can begin life-saving treatment en route and alert the receiving hospital, allowing them to prepare a specialized stroke team before the patient arrives.
When communicating with the emergency dispatcher, provide your location first to ensure a rapid response. State clearly that you suspect a stroke and describe the symptoms you observed using B.E. F.A.S.T.. Crucially, you must provide the “Last Known Well Time,” which is when the person was last seen acting and feeling completely normal. This time point is paramount for determining eligibility for time-sensitive medical treatments.
Providing Care While Waiting
After contacting emergency services, remain with the person and ensure their immediate safety. Help the person lie down or sit in a comfortable, safe position to prevent falls or further injury. If the person is conscious, you can gently support their head and shoulders.
If the person becomes unconscious or begins to vomit, carefully move them into the recovery position, lying on one side. This positioning helps keep the airway clear and prevents choking or aspiration. Loosen any tight clothing, such as a collar or tie, that might impede breathing. Reassure the person that help is on the way, as anxiety can affect their condition. Do not give the person any food, water, or medication, including aspirin, as this could be harmful depending on the type of stroke.
Time is Brain
Time is Brain because, during a stroke, nearly 1.9 million brain cells can die every minute the brain is deprived of blood flow. This rapid loss of neurological tissue underscores the need for urgency. Immediate intervention is necessary to minimize permanent damage and improve the chances of functional recovery.
Medical diagnosis must differentiate between an ischemic stroke, caused by a clot, and a hemorrhagic stroke, caused by bleeding. The main clot-busting medication, tissue plasminogen activator (tPA), is effective when administered within the first three hours of symptom onset, with an extended window up to 4.5 hours for certain eligible patients. Since tPA treats only clot-caused strokes and would worsen a bleeding stroke, medical professionals must perform immediate diagnostic imaging before starting any treatment.