First steps if you think someone is having a stroke

During a stroke, time is of the essence. Call emergency services and get to the hospital immediately.

Stroke may cause loss of balance or unconsciousness, which may result in a fall. If you think you or someone around you may be having a stroke, follow these steps:

  • Call emergency services. If you’re having stroke symptoms, have someone else call for you. Stay as calm as possible while waiting for emergency help.
  • If you’re caring for someone else having a stroke, make sure they’re in a safe, comfortable position. Preferably, this should be lying on one side with their head slightly raised and supported in case they vomit.
  • Check to see if they’re breathing. If they're not breathing at all, perform CPR. If they’re having difficulty breathing, loosen any constrictive clothing, such as a tie or scarf.
  • Talk in a calm, reassuring manner.
  • Cover them with a blanket to keep them warm.
  • Do not give them anything to eat or drink.
  • If the person is showing any weakness in a limb, avoid moving them.
  • Observe the person carefully for any change in condition, and be prepared to tell the emergency operator about their symptoms and when they started. Be sure to mention if the person fell or hit their head.

Know the signs of a stroke

Depending on the severity of the stroke, symptoms may be subtle or severe. Before you can help, you need to know what to watch for. To check for warning signs of a stroke, use the FAST acronym, which stands for:

  • Face: Is the face numb or does it droop on one side?
  • Arms: Is one arm numb or weaker than the other? Does one arm stay lower than the other when trying to raise both arms?
  • Speech: Is speech slurred or garbled?
  • Time: If you answered yes to any of the above, call emergency services immediately.

Other stroke symptoms are:

  • blurred or dim vision or loss of vision, especially in one eye
  • tingling, weakness, or numbness on one side of the body
  • nausea
  • loss of bladder or bowel control
  • loss of balance or consciousness
  • dizziness or lightheadedness
  • headache

If you or someone else has stroke symptoms, don’t take a wait-and-see approach. Even if symptoms are subtle or go away, take them seriously. It only takes minutes for brain cells to start dying. The risk of disability decreases if clot-busting drugs are administered within the first few hours.

Learn more: Recognizing the signs of a stroke »

Causes of stroke

A stroke occurs when the blood supply to the brain is interrupted or when there’s bleeding in the brain.

An ischemic stroke happens when arteries to the brain are blocked by a blood clot. Many ischemic strokes are caused by a buildup of plaque in your arteries. If a clot forms within an artery in the brain, it’s called thrombotic stroke. Clots that form somewhere else in your body and travel to the brain may cause embolic stroke.

A hemorrhagic stroke occurs when a blood vessel in the brain bursts and bleeds.

A transient ischemic attack (TIA) may be hard to identify by symptoms alone. It’s a quick event, often less than five minutes. TIA is caused by a temporary block of blood flow to the brain. It’s a sign that a more severe stroke may be coming.

Learn more: Different types of strokes »

Stroke recovery

After first aid and treatment, the stroke recovery process varies. It depends on many factors, such as how fast treatment was received or if the person has other medical conditions.

The first stage of recovery is known as acute care. It takes place in a hospital. During this stage, your condition is assessed, stabilized, and treated. It’s not unusual for someone who has had a stroke to stay in the hospital for up to a week. But from there, the recovery journey is often just beginning.

Rehabilitation is usually the next stage of stroke recovery. It may take place in the hospital or an inpatient rehabilitation center. If stroke complications aren’t severe, rehabilitation may be outpatient.

The goals of rehabilitation are:

  • strengthen motor skills
  • improve mobility
  • limit use of the unaffected limb to encourage mobility in the affected limb
  • use range-of-motion therapy to ease muscle tension

Caregiver information

If you’re the caregiver of a stroke survivor, your job may be challenging. But knowing what to expect and having a support system can help you cope. In the hospital, you’ll need to communicate with the medical team about what caused the stroke. You’ll also need to discuss treatment options and how to prevent future strokes.

During recovery, some of your caregiving responsibilities may include:

  • evaluating rehabilitation options
  • arranging for transportation to rehabilitation and doctor’s appointments
  • evaluating adult day care, assisted living, or nursing home options
  • arranging for home health care
  • managing the stroke survivor’s finances and legal needs
  • managing medications and dietary needs
  • making home modifications to improve mobility

Even after they’re sent home from the hospital, a stroke survivor may have continuing speech, mobility, and cognitive difficulties. They may also be incontinent or confined to bed or a small area. As their caregiver, you may need to help them with personal hygiene and daily tasks such as eating or communicating.

Don’t forget to take care of you in all of this. You can’t take care of your loved one if you’re ill or overstressed. Ask friends and family members for help when you need it, and take advantage of regular respite care. Eat a healthy diet and try to get a full night’s rest each night. Get regular exercise. If you feel overwhelmed or depressed, reach out to your doctor for help.

Stroke recovery: What to expect »

Outlook

The outlook for a stroke survivor is hard to predict because it depends on many things. How quickly the stroke was treated is critical, so don’t hesitate to get emergency help at the first sign of a stroke. Other medical conditions such as heart disease, diabetes, and blood clots may complicate and prolong stroke recovery. Participation in the rehabilitation process is also key to regaining mobility, motor skills, and normal speech. Finally, as with any serious illness, a positive attitude and an encouraging, caring support system will go a long way in aiding recovery.