Updated 27 January 2015

Stroke - what to do in an emergency

Identifying and treating a stroke as quickly possible gives the victim the best possible chance for a full recovery. Know how to do the F.A.S.T test in case of a stroke emergency.


A stroke is a life-threatening condition that occurs when blood flow to part of the brain is disrupted, cutting off the oxygen supply. After even a few minutes without oxygen, brain cells are permanently damaged, and die if the blood supply is not restored.

Every stroke should be handled as an emergency. The victim requires urgent medical assistance to prevent death and long-lasting brain damage. Time is of the essence as the longer the victim goes without treatment, the higher the risk of permanent damage or death.

A bleeding stroke is usually sudden, and may be heralded by a severe headache, sometimes with a stiff neck, and unconsciousness. Ischaemic strokes are usually more gradual, developing over minutes, hours or days. They may be preceded by a "mini-stroke", or transient ischaemic attack (TIA), which occurs when a blood clot causes temporary stroke-like loss of function.

Act F.A.S.T

The emergency procedure for dealing with a suspected stroke can be remembered by using the acronym F.A.S.T or Face, Arms, Speech, Time and will help you to identify the key signs of a stroke:

Face: Ask the person to smile - look for difficulty smiling and facial drooping on one side
Arms: Ask them to lift both arms above their head - look for one arm that doesn't lift or moves downwards involuntarily
Speech: Ask the person to repeat a short sentence - look out for slurring, confusion or jumbled speech
Time: Make note of the time that the symptoms started and seek medical attention urgently.

Other symptoms include:

- Paralysis, weakness, numbness or tingling, usually on one side of the body
- Drooling
- Vision problems
- Difficulty walking
- Clumsiness and loss of balance
- Dizziness
- Nausea or vomiting
- Seizure

First aid for stroke

If you suspect that someone has had a stroke, it is important to get them to a hospital as soon as possible. If the person is unconscious or or stops breathing, administer CPR by following these steps. If possible, get someone else to drive you to the nearest emergency room whilst you administer CPR. Alternatively, they can call for an ambulance on 10177.

If the victim is conscious and appears more stable, get them into a car and take them to the nearest stroke unit or the nearest hospital with a stroke specialist. You can identify your nearest stroke treatment centre on this map:

If you are unable to get the victim to a hospital, call an ambulance. Keep the patient lying down on their left side.

Emergency services

Should you be unable to get the stroke victim to the hospital yourself, use the following national contact numbers to get medical assistance:

Ambulance: 10177
National Emergency Service: 10111


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Stroke Expert

Dr Naeem Brey completed his MBChB (Bachelor of Medicine and Surgery) degree in 2003 at the University of Cape Town. In 2010 he started he started specialising in Neurology at Tygerberg Hospital and graduated with his specialist exam in FCNeurol (Fellowship of the College of Neurology) in May 2013.

He has a particular interest in stroke as well autoimmune and demyelinating neurological illnesses. Read more about Dr Naeem Brey

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