Recognizing a Stroke: FAST and What Comes After

By Jointra Editorial Team, Certified EMT

Time Is Brain

In a stroke, 1.9 million neurons die every minute without treatment. That's why "time is brain" is not a slogan — it's a clinical fact. Recognizing a stroke and calling 911 immediately is the single most important thing a bystander can do.

The FAST Mnemonic

FAST stands for Face, Arms, Speech, Time. It was designed to be memorable and actionable.

F — Face drooping Ask the person to smile. Does one side of the face droop? Does the smile appear uneven or asymmetrical?

A — Arm weakness Ask the person to raise both arms. Does one arm drift downward or feel weak?

S — Speech difficulty Ask the person to repeat a simple sentence like "The sky is blue." Is their speech slurred or hard to understand?

T — Time to call 911 If you see any of these signs, call 911 immediately. Note the time when symptoms first appeared.

Beyond FAST

Types of Stroke

Ischemic stroke (about 87% of all strokes) occurs when a blood clot blocks blood flow to part of the brain. Treatment with tPA can dissolve the clot if given within 4.5 hours of symptom onset.

Hemorrhagic stroke occurs when a blood vessel in the brain ruptures. Do not give aspirin — it can worsen a hemorrhagic stroke.

TIA (Transient Ischemic Attack) symptoms appear and then resolve. Up to 15% of people who have a TIA will have a full stroke within 90 days. Do not dismiss it.

What to Do