Stroke:
Recognising and Responding to a Medical Emergency Using the F.A.S.T. Protocol

A stroke is a serious, life-threatening medical condition that occurs when the blood supply to a part of the brain is disrupted. Strokes can lead to long-term disability or even death if not treated promptly. Recognising the signs of a stroke and acting quickly using the F.A.S.T. protocol can significantly increase the chances of survival and recovery.

What is a Stroke?

A stroke occurs when the blood flow to a part of the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Without oxygen, brain cells begin to die, leading to brain damage. There are two main types of strokes:

• Ischaemic Stroke: This is the most common type and occurs when a blood clot blocks or narrows an artery leading to the brain.
• Haemorrhagic Stroke: This occurs when a blood vessel in the brain bursts, causing bleeding in or around the brain.

A Transient Ischaemic Attack (TIA), often referred to as a “mini-stroke,” happens when the blood supply to the brain is temporarily interrupted. The symptoms are similar to those of a full stroke but usually last only a few minutes or hours. TIAs are a warning sign of a potential future stroke and should never be ignored.

Signs and Symptoms of a Stroke

The symptoms of a stroke appear suddenly and vary depending on which part of the brain is affected. Common signs include:

• Sudden weakness or numbness: This often affects one side of the body, particularly the face, arm, or leg.
• Difficulty speaking: The person may slur their speech, have trouble finding words, or be unable to speak at all.
• Confusion: The person may suddenly become confused or have difficulty understanding what others are saying.
• Loss of balance or coordination: They may have trouble walking or maintaining their balance.
• Severe headache: A sudden, intense headache with no apparent cause, especially if accompanied by vomiting or dizziness, may indicate a haemorrhagic stroke.
• Vision problems: They may experience blurred or double vision, or lose vision in one or both eyes.

F.A.S.T. Protocol: Recognising a Stroke

The F.A.S.T. protocol is a simple and effective way to identify the most common signs of a stroke and act quickly to get help. F.A.S.T. stands for:

• F – Face:
  • Ask the person to smile or show their teeth. Look for drooping on one side of the face, as this can be a sign of muscle weakness.
• A – Arms:
  • Ask the person to raise both arms. If one arm drifts downward or they are unable to lift one arm, this may indicate weakness or numbness on one side of the body.
• S – Speech:
  • Ask the person to repeat a simple sentence, such as “The sky is blue.” Listen for slurred or garbled speech, or check if they struggle to find words.
• T – Time to call 999:
  • If any of these signs are present, call 999 immediately. Time is critical when dealing with a stroke, and early treatment can make a significant difference in the outcome.

First Aid for a Stroke

1. Call 999 Immediately:

• As soon as you suspect someone is having a stroke, dial 999 and explain that you believe they are having a stroke. The faster they receive medical treatment, the better their chances of recovery.

2. Keep the Person Calm and Reassured:

• Strokes can be frightening for the person experiencing them. Keep them calm and reassured while waiting for emergency services to arrive.

3. Lay the Person Down (if Conscious):

• If the person is conscious but unable to sit up, help them to lie down on their side with their head slightly elevated. This helps reduce pressure on the brain and improves blood flow.

4. Monitor Their Condition:

• Keep a close eye on their condition, especially their breathing and level of consciousness. If they lose consciousness, be prepared to place them in the recovery position and monitor their airway.

5. Do Not Give Them Food or Drink:

• Do not offer food, drink, or medication, as they may have difficulty swallowing, which increases the risk of choking.

Treatment for Stroke

• Emergency Treatment: Once in hospital, the treatment for a stroke depends on whether it is an ischaemic stroke or a haemorrhagic stroke. For an ischaemic stroke, clot-busting drugs (thrombolysis) may be given to dissolve the clot. For haemorrhagic strokes, surgery may be required to repair the damaged blood vessels and stop the bleeding.
• Long-Term Care: Stroke recovery can be a long process and often involves rehabilitation to help regain mobility, speech, and other lost functions. The sooner treatment begins, the better the chances for recovery.

Transient Ischaemic Attack (TIA)

A TIA (mini-stroke) causes similar symptoms to a stroke, but the effects are temporary, often lasting only a few minutes or hours. While the symptoms may resolve quickly, a TIA is a serious warning sign that a full stroke could occur in the future. It’s essential to seek medical attention even if symptoms disappear.

Risk Factors for Stroke

• High Blood Pressure: The leading risk factor for strokes, high blood pressure damages blood vessels and makes clots more likely.
• Smoking: Smoking increases the risk of blood clots and damages blood vessels.
• High Cholesterol: Elevated cholesterol levels can lead to the build-up of plaques in the arteries, increasing the risk of stroke.
• Diabetes: Diabetes increases the risk of stroke due to its effects on blood vessels.
• Obesity and Lack of Exercise: Maintaining a healthy weight and staying active reduces the risk of stroke.
• Age and Family History: The risk of stroke increases with age, especially after 55, and those with a family history of stroke are at higher risk.

Prevention Tips for Stroke

• Manage Blood Pressure: Keep your blood pressure within a healthy range by reducing salt intake, maintaining a healthy diet, and taking prescribed medications if needed.
• Quit Smoking: Stopping smoking can significantly reduce your risk of stroke and other cardiovascular diseases.
• Exercise Regularly: Aim for at least 30 minutes of moderate exercise, such as walking, most days of the week.
• Eat a Healthy Diet: A diet rich in fruits, vegetables, whole grains, and lean proteins can help lower cholesterol and blood pressure.
• Control Blood Sugar Levels: If you have diabetes, keeping your blood sugar under control reduces the risk of stroke.

Key Points to Remember

• Use the F.A.S.T. test to recognise the signs of a stroke and act quickly.
• Call 999 immediately if you suspect a stroke – time is critical.
• Keep the person calm and in a comfortable position while waiting for emergency services.
• Do not give them anything to eat or drink, as this could cause choking.