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In this lesson, we're going to go over what a stroke is, what the signs and symptoms are that will indicate to you that there's an emergency, and what to do if you suspect a stroke. And we'll even teach you an easy-to-remember acronym to make your stroke assessment a little easier.

What is a Stroke?

A stroke, also called a cerebrovascular accident (CVA), is a disruption of blood flow to a part of the brain, which may cause permanent damage to brain tissue if not appropriately treated in a timely manner.

There's a common analogy that works well to describe what a stroke is – a stroke is like a heart attack in the brain. This analogy works because what typically causes a stroke is usually what causes a heart attack – a blocked blood vessel – only in the brain rather than the heart.

When a blood vessel blockage occurs, it starves the brain of oxygenated blood, which will quickly result in neurological effects in the patient's body.

A stroke can also be caused by a bursting of a blood vessel rather than a blockage. In these cases, the condition is known as a hemorrhagic stroke, and is normally the result of an aneurism. The important takeaway is that hemorrhagic stroke is treated differently than strokes that occur from blood vessel blockage.

What are the Signs and Symptoms of a Stroke?

Using the acronym FAST, you'll be able to navigate quickly through the list of stroke symptoms and systematically check them off as you go. And ultimately, if the patient is having a stroke, call 911 and activate EMS.

F – Facial Droop

If you're having a difficult time assessing the patient for facial droop, ask them to smile at you. If the droop isn't initially very pronounced, it will be when the patient tries to smile.

Does the smile look normal? Or is one corner of the mouth lower than the other?

A – Arm

Raise both of the patient's arms out in front of them and ask the patient to hold that position. Does one arm fall lower than the other? Or do they both remain in the position you left them?

If one arm does begin to fall, as the patient cannot hold it up, it will likely be the arm on the same side of the body as the facial droop.

S – Slurred Speech

During medical emergencies, patients are naturally panicked, and it can affect their speech. To better assess for this stroke sign, ask them a question – like what their birth date is – or to repeat a certain phrase, like I love blueberries.

If the patient answers with slurred speech, you can check another item off your FAST checklist.

T – Time

Time is of the essence when it comes to treating stroke victims. But it's also important to know what time symptoms began in each victim, as this will matter when healthcare professionals begin trying to recirculate oxygenated blood back into the brain's tissue.

Your quick actions and attention to detail will go a long way to helping the patient recover with as little long-lasting damage as possible.

What to do if You Suspect a Patient is Having a Stroke

If you haven't already called 911 and activated EMS, do so immediately. Expediting treatment is key to the patient regaining as much quality of life as they can.

While waiting for EMS to arrive, reassure the patient. Tell them you're not going anywhere and that you'll take good care of them. And make them as comfortable as possible while you wait.

A Word About the Signs and Symptoms of Stroke

Other than the stroke alert criteria in FAST that you should be looking for, there are a few other signs and symptoms of stroke that may help you assess the patient better.

  • Loss of vision or disturbed vision in one or both eyes; the pupils may also be of unequal size
  • Sudden severe headache; you may hear the patient describe the pain as the worst headache ever
  • Confusion, dizziness, agitation, loss of consciousness, or other severe altered mental states
  • Loss of balance or coordination, trouble walking, or ringing in the ears
  • Incontinence

Pro Tip #1: it's important to understand the difference between a full-blown stroke and a TIA (Transient Ischemic Attack), sometimes called a mini-stroke. The latter is caused by reduced blood flow to a part of the brain, but unlike a stroke, the signs and symptoms disappear within a few minutes or hours of onset.

With a TIA, after a short time, blood flows again and the symptoms go away. With a stroke, the blood flow stays blocked, and the brain is more likely to suffer permanent damage.