What To Do If Someone Has a Stroke

  • 1st Revision: Isobel Lester
  • 2nd Revision: Sophia Bradshaw
  • 3rd Revision: Wasi Karim

A stroke is a very serious and life-threatening medical emergency. A stroke occurs every five minutes in the UK. It can happen to anyone, of any age, at any time. ¹

Strokes occur when the blood supply to the brain is cut off. This blood supply carries essential nutrients and oxygen to brain cells. When the blood supply is disrupted, brain cells receive no nutrients or oxygen and begin to die within a very short time frame. The body cannot function without brain cells.

Types of Stroke

There are three main types of strokes1:

Ischemic stroke

This is the most common type of stroke which is caused by the blockage of blood flow to a region of the brain and is the most common type of stroke.

Hemorrhagic stroke

Caused by the bursting and bleeding of a weakened blood vessel supplying the brain.

Transient ischemic attack (TIA)

Sometimes termed a “mini-stroke”, caused by a temporary blockage in blood flow. Symptoms usually last for just a few minutes or may go away in 24 hours2

When a person has a stroke, every second counts. So, what can we do if someone is having a stroke?

What is the first thing to do?

Usually, it can be difficult to determine when someone is having a stroke. 

Therefore, the very first thing you do before you call an ambulance is to check if the person is having a stroke. Here is a simple and quick guidance protocol called FAST3-5:

  F – Facial Weakness: Check the person’s face. If part of the person's face starts to droop, making it difficult for them to smile, it’s likely they’re having a stroke.

 A – Arm Weakness: Ask the person to raise both of their arms. They may only be able to raise one and they may be unable to fully lift their arms.

 S – Speech Problems: The person is unable to speak clearly or their speech is slurred. Ask the person to repeat a simple sentence or ask a simple question such as their name. Can they respond appropriately?

T – Time: Strokes act quickly. If the person has any one or more of the symptoms mentioned above, it’s time to call an ambulance.

Sometimes, people are very worried if their beloved one is experiencing a stroke and the first instinct is to drive the patient to the hospital. But always remember not to drive yourself. Instead, call the ambulance. An ambulance is faster and more professional in dealing with emergencies. Paramedics are well equipped to handle strokes and the medical workers can offer life-saving assistance on the way to the hospital, which can potentially reduce the damaging effects of the stroke.6

Do’S and Don’ts

DO’S 6-7:

When you call the ambulance and request help, use the word “stroke”. 

You need to notify the operator that you suspect that someone is having a “stroke”3 so that the medical team can prepare paramedics that best suit the needs and the hospital can prepare for the arrival of the patient. Explain that you have followed FAST guidance.

Keep track of symptoms. 

Sometimes, the patient might not be able to speak and thus cannot communicate at the hospital. Therefore, it is important and will be very helpful if you could provide information such as the patient’s medical conditions and medical history. If you know the patient, then it’s easy for you to know his/her medical history. If the patient is a stranger to you, then try to talk to the patient (if the patient can still speak) while waiting for the ambulance. Ask about any medications they’re taking, health conditions they have, and known allergies.

Note the time you first see symptoms.

Within 4.5 hours of the start of symptoms,3 clot-busting medication can be given to the patient, potentially reversing or stopping the development of symptoms. Surgeries can be conducted to remove a clot that caused the stroke or fix an aneurysm (a swollen blood vessel that bursts and leads to stroke). However, there is still a time limit for the surgery: it must be administered within 24 hours of symptom onset, and the earlier, the better. Therefore, if you could note the time you first see symptoms on the patient, it can be very vital and helpful information for doctors to give certain treatments to the patient.

Encourage the person to lie down if the patient is sitting or standing up.

Help them lie down on their side with their head elevated. This position helps blood flow to the brain. However, do not move the person if they’ve fallen. You could try to loosen their clothing to keep them comfortable, if appropriate.

Perform CPR, when necessary.

Check the patient and see if they are conscious and if they are still breathing. Most stroke patients don’t require CPR, but if you cannot find a pulse from the patient, start performing CPR while waiting for the ambulance. If you don’t know how to perform CPR, the emergency operator can walk you through the process until help arrives.

Stay calm.

Try the best you can do and wait for help.

Don’ts 6-7:

Do not let the patient go to sleep.

 Many stroke survivors describe that they feel sleepy when the stroke happens. But remember, for stroke patients, time is life. The medications, surgeries or any other treatments doctors can give to the patient is time-sensitive. Sleeping after the stroke occurs is very dangerous and the patient may miss the best time for treatment.

Do not give the patient medication.

Some might know that aspirin is a common drug given to patients with stroke to make the blood thinner and less sticky and prevent clot formation/blockage. However, you would never know what exactly caused the stroke until you have a CT scan. Even if 80% of the time, the stroke is caused by a clot that blocks the blood vessel, you cannot risk the patient’s life by giving them medication like aspirin because there is a 20% chance that the stroke is caused by a ruptured blood vessel. In the latter case, aspirin may kill the patient.

Do not give the patient any food, or drinks.

The reason is that a stroke may affect the person’s ability to swallow. To prevent the patient from choking, do not let them eat or drink anything.

Do not drive the patient to the hospital by yourself

As mentioned before, the patient can receive quicker, better and more professional medical care from the ambulance.

Causes and risk factors of stroke

Many might think that stroke only affects elderly people, but strokes can affect anyone at any time. One in four strokes in the UK happens to people of working age8

Sometimes the exact cause of a stroke is unclear: natural causes such as ageing can lead to the weakening of blood vessels over time. Certain genetic conditions will also increase a person’s risk of having a stroke. However, certain lifestyle factors and medical conditions can increase the risk of a stroke, listed as the following8:

 Lifestyle factors:

  • Smoking
  • Drinking too much alcohol
  •  Eating too much fatty and high-sugar food
  •  Lack of exercise
  • Being overweight

Medical conditions:

  • Diabetes
  • High blood pressure/ hypertension
  • Having high blood cholesterol level
  • Atrial fibrillation (people with this condition have irregular and often abnormally fast heart rate9)  

Warning signs of a stroke

During a stroke, every minute counts. So, if you could identify and recognize the warning signs of a stroke, you could save a lot of time and it could potentially be life-saving.

Below is a list of warning signs of stroke10:

  • Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
  • Sudden confusion, trouble speaking, or difficulty understanding speech.
  • Sudden trouble seeing in one or both eyes.
  • Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
  • Sudden severe headache with no known cause.

Another very important warning sign is that the person experienced a transient ischemic attack (TIA). As mentioned before, TIA is like a “mini-stroke” – symptoms usually last between minutes to hours and will often disappear within 24 hours. Many people might ignore this when the symptoms are gone, but even though the symptoms are mild, TIA is a serious condition requiring treatment. It might also be a warning sign of a real stroke in the future. Therefore, it is suggested that you should talk to your health care team or doctor right after you think you are having TIA.10  

Emergency Number and More Information to know

In the UK, if you suspect that you or someone else is having a stroke, phone 999 immediately and ask for an ambulance.

Here are the resources you could use for more information on strokes:

l  NHS Stroke Page: https://www.nhs.uk/conditions/stroke/

l  Stroke Association (UK)

Website: https://www.stroke.org.uk/

Stroke Helpline open: 0303 3033 100

This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Adina Zhao

Medical Bioscientist - Imperial College London Medical Bioscience BSc
Modules covered: Integrative Body Systems, Molecular and Cellular Biology, Chemistry of Biological Interactions.
Past projects: Investigation of the influence of amino acid mutations of in-cluster gene lmbU on LmbU protein transcription and translation efficiency in Streptomyces lincolnensis, Investigation of the influence of red fluorescence protein mCherry on the photosynthetic efficiency of Arabidopsis thaliana .

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