Stroke First Aid: Recognize and Respond Quickly

Time is brain. Stroke is a medical emergency caused by a blocked or ruptured blood vessel in the brain. Rapid recognition and calling emergency services saves brain tissue and can be lifesaving.

How to Recognize a Possible Stroke (BE FAST)

• B — Balance: sudden loss of balance, dizziness, or unsteady walking
• E — Eyes: sudden vision changes in one or both eyes
• F — Face: facial droop or crooked smile
• A — Arm: weakness or numbness in one arm or leg (often on one side)
• S — Speech: slurred speech, trouble speaking or understanding
• T — Time: if any of the above are present, treat it as an emergency now

Other red flags: sudden severe headache (especially “worst headache of life”), vomiting, confusion, incontinence, impaired consciousness, or fainting.

Immediate Actions (Do These Now)

1. Call your local emergency number immediately. Do not drive the person yourself. Emergency responders can begin care en route and alert a stroke-capable hospital.
2. Note the “last known well” time. Record when symptoms started or when the person was last seen without symptoms. Bring this information to the hospital.
3. Keep the person safe and still.
   • Sit or lay them with the head and torso slightly elevated (about 30°) if tolerated.
   • Loosen tight clothing and keep them warm.
   • Avoid unnecessary movement, shaking, or repeatedly turning the head.
4. Airway, Breathing, Circulation (ABCs).
   • If unresponsive and not breathing normally, start CPR and continue until help arrives.
   • If breathing but drowsy, place in the recovery position (on their side) to keep the airway clear.
   • If they vomit, turn the head/body to the side. Wipe the mouth with a clean cloth. Remove loose dentures.
5. Do not give anything by mouth. No food, drink, pills, or alcohol. Do not give aspirin—hemorrhagic stroke must be excluded by imaging first.
6. If trained and available, you may check blood pressure or blood sugar, but do not delay transport. Share any readings with emergency personnel.

If a Seizure Occurs

Seizures can accompany stroke.

• Protect from injury: clear nearby hazards and cushion the head.
• Do not restrain movements and do not put anything in the mouth (no chopsticks, spoons, or fingers). This can cause harm.
• Time the seizure. If it lasts longer than 5 minutes, or repeats without full recovery, this is an emergency (status epilepticus).
• After the seizure, place in the recovery position and monitor breathing.

Transport and Handover

• Use emergency medical services for transport whenever possible.
• Go to the nearest stroke-ready hospital or comprehensive stroke center (EMS can direct you).
• Bring: medication list, allergies, medical conditions, ID, and the “last known well” time. A witness who saw symptom onset is very helpful.

What Not to Do

• Don’t delay or “wait to see if it passes.” Even if symptoms improve, call emergency services.
• Don’t drive the patient yourself if EMS is available.
• Don’t give aspirin or blood pressure pills unless directed by a clinician.
• Don’t give food, drink, or supplements.
• Don’t shake the person, force them to walk, or perform neck exercises.
• Don’t put objects in the mouth during a seizure.

After the Emergency

At the hospital, clinicians will perform rapid imaging (CT/MRI) to determine stroke type. Some patients may qualify for clot-busting medication within a few hours of onset, and some for clot retrieval procedures within select time windows. Early arrival maximizes options and outcomes.

Note: This guide is for general first aid education and not a substitute for professional medical care. Always follow local protocols and directions from emergency personnel.