What to Do If Someone Is Having a Stroke: Emergency Response Guide

Every 40 seconds, someone in the United States has a stroke. When it comes to stroke response, every single second matters. Brain cells begin to die within minutes when deprived of oxygen-rich blood, making stroke one of the most time-sensitive medical emergencies you’ll ever encounter. Knowing what to do if someone is having a stroke can mean the difference between full recovery and permanent disability, or even life and death.

This comprehensive guide will walk you through the essential steps to recognize stroke symptoms and take immediate action that could save someone’s life.

Understanding What Happens During a Stroke

A stroke occurs when blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. There are two main types of stroke:

• Ischemic stroke: The most common type, occurring when blood vessels to the brain become blocked by blood clots or fatty deposits
• Hemorrhagic stroke: Happens when a blood vessel in the brain ruptures or leaks, causing bleeding in or around the brain

Regardless of the type, both require immediate emergency medical attention. Brain cells start dying within 3-4 minutes of being deprived of oxygen, and the damage can become irreversible quickly.

Recognizing Stroke Symptoms: The FAST Method

The FAST acronym is the gold standard for remembering and recognizing stroke warning signs. This simple test can help you quickly identify if someone needs emergency stroke care:

F – Face Drooping

Ask the person to smile. Does one side of their face droop or feel numb? Is their smile uneven or lopsided? Facial weakness or numbness, especially on one side, is a classic stroke symptom.

A – Arm Weakness

Ask the person to raise both arms. Does one arm drift downward? Is one arm weak or completely numb? Can they not lift one arm at all? Weakness or numbness in one arm or leg is a major red flag.

S – Speech Difficulty

Ask the person to repeat a simple sentence like “The sky is blue.” Is their speech slurred? Do they have trouble speaking or seem confused? Are they unable to repeat the sentence correctly? Speech problems indicate a possible stroke.

T – Time to Call 911

If you observe any of these signs, even if they come and go, call 911 immediately. Time lost is brain lost. Note the time when symptoms first appeared, as this information is crucial for emergency responders and hospital staff.

Additional Stroke Warning Signs

While FAST covers the most common symptoms, other stroke warning signs that require immediate emergency care include:

• Sudden numbness or weakness in the leg
• Sudden confusion or trouble understanding speech
• Sudden trouble seeing in one or both eyes, including blurred vision, blackened vision, or double vision
• Sudden severe headache with no known cause, often described as “the worst headache of my life”
• Sudden trouble walking, loss of balance, or lack of coordination
• Sudden dizziness or vertigo

These symptoms typically come on suddenly and without warning. Even if symptoms seem to resolve on their own, this could indicate a transient ischemic attack (TIA) or “mini-stroke,” which requires immediate medical evaluation as it often precedes a major stroke.

Immediate Actions: What to Do Step-by-Step

Step 1: Call 911 Immediately

Do not wait to see if symptoms improve. Do not drive the person to the hospital yourself. Call 911 or your local emergency number right away. Paramedics can begin lifesaving treatment en route to the hospital, and calling ahead allows the emergency department to prepare for the patient’s arrival.

Step 2: Note the Time

Write down or remember the exact time when symptoms first appeared. This “time last known well” is critical information that determines which treatments doctors can safely administer. Some stroke treatments must be given within specific time windows to be effective.

Step 3: Keep the Person Calm and Comfortable

Help the person lie down in a comfortable position with their head slightly elevated (about 30 degrees). This position helps prevent choking and promotes better blood flow to the brain. Loosen any tight clothing, particularly around the neck.

Step 4: Monitor Their Condition

Stay with the person and continuously monitor their breathing and consciousness. Be prepared to perform CPR if they stop breathing or lose consciousness. Keep them calm and reassured while waiting for emergency responders.

Step 5: Do Not Give Food, Drink, or Medication

Do not give the person anything to eat or drink. A stroke can impair swallowing ability, creating a choking hazard. Even water should be avoided. Do not give them any medication, including aspirin, unless specifically instructed by emergency medical personnel.

Step 6: Gather Important Information

If possible, collect information to share with emergency responders:

• List of current medications
• Known allergies
• Medical conditions or history
• Recent surgeries or procedures
• Contact information for their regular healthcare provider

What NOT to Do During a Stroke Emergency

Knowing what to avoid is just as important as knowing what to do:

• Don’t wait: Never adopt a “wait and see” approach. Even if symptoms seem mild or improve, permanent brain damage may be occurring
• Don’t drive them yourself: Ambulance transport is faster and allows treatment to begin immediately
• Don’t let them fall asleep: Keep the person awake and responsive if possible
• Don’t give medication: Aspirin or other medications could be harmful depending on the stroke type
• Don’t give food or drink: This creates a choking risk if swallowing is impaired
• Don’t leave them alone: Their condition could deteriorate rapidly

Why Speed Is Critical: The Treatment Window

The phrase “time is brain” perfectly captures the urgency of stroke treatment. Here’s why acting fast matters:

• For ischemic strokes, clot-busting medication (thrombolytic therapy) works best when given within 3-4.5 hours of symptom onset
• Mechanical clot removal procedures are most effective within 6-24 hours, depending on the case
• Every minute of a stroke, approximately 1.9 million brain cells die
• Faster treatment significantly reduces the risk of permanent disability and death
• Early intervention can mean the difference between full recovery and long-term impairment

What Happens at the Hospital

Understanding the emergency response can help reduce anxiety during this stressful time:

Immediate Assessment

Emergency physicians will quickly evaluate the patient using neurological exams and imaging tests like CT scans or MRIs to determine if the stroke is ischemic or hemorrhagic.

Treatment Decisions

Based on the stroke type, timing, and individual patient factors, doctors will determine the appropriate treatment. For ischemic strokes caught early, this may include clot-dissolving medications or procedures to remove the clot. Treatment for hemorrhagic strokes focuses on controlling bleeding and reducing pressure in the brain.

Ongoing Care

After initial treatment, patients typically require hospitalization for monitoring and rehabilitation services to help recover lost functions.

Recognizing a Transient Ischemic Attack (TIA)

A TIA, or mini-stroke, occurs when blood flow to the brain is temporarily blocked. Symptoms are identical to a full stroke but typically resolve within minutes to hours. Despite the temporary nature, TIAs are serious warnings:

• About 1 in 3 people who have a TIA will eventually have a full stroke
• Nearly half of all strokes occur within the first few days after a TIA
• TIAs require the same emergency response as a full stroke
• Never ignore symptoms just because they resolve quickly

Risk Factors and Prevention

While knowing how to respond to a stroke is crucial, understanding risk factors can help prevent strokes from occurring:

Controllable Risk Factors

• High blood pressure (the leading cause of stroke)
• High cholesterol
• Diabetes
• Obesity
• Smoking and tobacco use
• Physical inactivity
• Poor diet
• Excessive alcohol consumption

Non-Controllable Risk Factors

• Age (risk increases after 55)
• Family history of stroke
• Previous stroke or TIA
• Gender (men have higher risk, but women have more fatal strokes)
• Race (African Americans have higher risk)

Prevention Strategies

Reducing stroke risk involves lifestyle modifications and medical management:

• Control blood pressure: Keep it below 120/80 mm Hg through diet, exercise, and medication if prescribed by your healthcare provider
• Manage chronic conditions: Work with your doctor to control diabetes, high cholesterol, and heart disease
• Exercise regularly: Aim for at least 150 minutes of moderate aerobic activity weekly
• Eat a healthy diet: Focus on fruits, vegetables, whole grains, and lean proteins while limiting sodium, saturated fats, and processed foods
• Maintain healthy weight: Even losing 10 pounds can significantly reduce stroke risk
• Quit smoking: Smoking doubles stroke risk; quitting begins reducing risk immediately
• Limit alcohol: No more than one drink daily for women, two for men
• Take prescribed medications: If your doctor has prescribed medication to reduce stroke risk, take it as directed and never stop without consulting your healthcare provider first

After a Stroke: Recovery and Rehabilitation

Stroke recovery is a journey that requires patience, dedication, and comprehensive care:

Rehabilitation Services

Most stroke survivors benefit from rehabilitation services that may include:

• Physical therapy to regain movement and coordination
• Occupational therapy to relearn daily activities
• Speech therapy to address communication and swallowing difficulties
• Cognitive therapy to improve memory and thinking skills

Preventing Another Stroke

After having a stroke, the risk of having another increases. Work closely with your healthcare team to:

• Understand what caused your stroke
• Follow your treatment plan carefully
• Attend all follow-up appointments
• Make necessary lifestyle changes
• Join support groups for education and emotional support

Teaching Others: Spread Stroke Awareness

The more people who know how to recognize and respond to stroke, the more lives can be saved. Share what you’ve learned:

• Teach family members and friends the FAST test
• Discuss stroke warning signs with elderly relatives and those at higher risk
• Keep emergency numbers easily accessible
• Consider taking a CPR and first aid course
• Participate in community stroke awareness programs

Frequently Asked Questions

Can you stop a stroke once it starts?

You cannot stop a stroke in progress, but immediate medical treatment can minimize brain damage and improve outcomes significantly. This is why calling 911 immediately is so critical.

Should I give aspirin during a stroke?

No. Do not give aspirin or any medication unless instructed by emergency medical personnel. Aspirin can be harmful in hemorrhagic strokes where bleeding is already occurring.

What if symptoms go away?

Even if stroke symptoms resolve, call 911 immediately. This could be a TIA, which is a serious warning sign that a major stroke may be imminent.

How long does it take to recover from a stroke?

Recovery varies greatly depending on stroke severity and location. Some people recover within weeks, while others may take months or years. The most significant recovery typically occurs in the first 3-6 months.

Conclusion

Knowing what to do if someone is having a stroke is knowledge that could save a life. Remember these key points:

• Learn and remember the FAST test
• Call 911 immediately at the first sign of stroke symptoms
• Note the time symptoms began
• Do not drive to the hospital or wait to see if symptoms improve
• Stay with the person until emergency help arrives
• Never give food, drink, or medication

Every second counts during a stroke. Fast recognition and immediate action can mean the difference between recovery and permanent disability. Don’t hesitate, don’t wait, and don’t second-guess yourself. When in doubt, call 911. It’s always better to be wrong about a stroke than to be too late.

Take time today to share this information with your loved ones. Together, we can improve stroke outcomes and save lives through awareness, recognition, and rapid response.

Sources:

• Centers for Disease Control and Prevention – About Stroke
• American Stroke Association – Stroke Symptoms
• Mayo Clinic – Stroke Overview
• National Institute of Neurological Disorders and Stroke
• American Heart Association – Stroke Information