Stroke First Aid: Spot the Signs With FAST and Call at Once

Stroke first aid is a race against time. A stroke occurs when blood flow to part of the brain is blocked by a clot or interrupted by a burst blood vessel, and brain cells begin to die within minutes. Treatments that dissolve clots or remove them work best when given early, so recognising the signs and calling an ambulance immediately is the most valuable thing a bystander can do. Some strokes are brief and resolve within hours, known as transient ischaemic attacks, but they are warnings and need emergency assessment too.

Recognising a Stroke With FAST

• F – Face: ask the person to smile. Does one side of the face droop?
• A – Arms: ask them to raise both arms. Does one drift downward or can they not lift it?
• S – Speech: is speech slurred, confused or lost? Can they repeat a simple sentence?
• T – Time: if you see any of these signs, call the emergency number at once and note the time they started.

Other signs include sudden severe headache, loss of vision, loss of balance, confusion, trouble understanding speech, loss of bladder control, unequal pupils, vomiting and unconsciousness. Some versions of the test add balance and eyes (BE-FAST).

Stroke First Aid: 6 Steps

1. Call the emergency number. Say the word stroke, give the time symptoms began or when the person was last seen well, and describe the signs.
2. Keep the person calm and comfortable. Help them lie or sit in a half-sitting position, with the head and shoulders supported on pillows.
3. Loosen tight clothing and gently wipe away saliva. If speech is difficult, do not ask lots of questions.
4. Give nothing to eat or drink, because swallowing may be affected and choking is a risk. Do not give aspirin, as some strokes are caused by bleeding.
5. Stay and monitor alertness, breathing and pulse, and keep a vomit bowl nearby.
6. Reassure them, even if they cannot answer. Hearing is often the last sense to go, so speak kindly and avoid discussing their condition negatively.

If the Person Is Unconscious

Clear the airway and follow the DRABC primary survey. If they are breathing normally, place them in the recovery position with the weaker side uppermost, and start CPR if breathing stops. Oxygen is not routinely given in stroke first aid. Trained responders use it only if the person is low in oxygen and local protocol allows.

Why Time Matters in Stroke First Aid

Every minute during a large stroke, millions of brain cells can be lost. Clot-dissolving medicines are effective only within a limited window, and clot retrieval procedures can extend that window for selected patients. For that reason, always record when symptoms began and never wait to see whether they improve.

Who Is at Risk and How to Reduce It

High blood pressure is the strongest risk factor, followed by smoking, diabetes, high cholesterol, irregular heartbeat (atrial fibrillation), obesity and inactivity. Taking blood pressure medicines as prescribed, stopping smoking, eating well and being active lower the risk. Warning signs should never be dismissed because they pass, and anyone with a transient episode should see a doctor the same day. Our guide to fainting first aid explains how to tell a stroke from a simple faint.

Frequently Asked Questions

What if the symptoms go away?
Call anyway. A transient ischaemic attack is a warning stroke, and urgent assessment can prevent a major one.

Should I drive the person to hospital?
Call an ambulance. Paramedics can alert the stroke team and take the person to the most suitable hospital.

References and Further Reading

• NHS, Stroke
• American Heart Association and American Red Cross, Guidelines for First Aid

Last updated: October 2026
Prepared by: EHS Guidelines Editorial Team

This article is general educational information and is not a substitute for accredited first aid training or professional medical care. In an emergency, call your local emergency number immediately. Emergency numbers, medicines and protocols differ between countries, so follow local guidance.

Related Guides

• Heart Attack First Aid: Recognising Symptoms and Acting Within Minutes
• Fainting First Aid: What to Do When Someone Collapses and Recovers
• Recovery Position: A Step by Step Guide
• Vital Signs Observations: Pulse, Breathing, Conscious State and Skin
• Airway Management: How to Open, Clear and Protect an Airway