What to Do Immediately When Someone Has a Stroke

Call 112 or 108 first

What to do immediately after a stroke starts is simple: phone for an ambulance. Dial 112 (national emergency) or 108 (ambulance). Do this before calling relatives, the family doctor or anyone else. Don't wait to see whether it passes, and don't wait for someone to come home and decide.

Say clearly, "I think this person is having a stroke." Give the full address with a landmark: society name, tower, flat number and which gate the crew should use. If you can, send someone down to the gate or lobby to guide them in and hold the lift. In large societies, minutes are often lost finding the right tower.

Treatment for the most common type of stroke works only within a few hours of it starting, and every minute of blocked blood flow damages more brain tissue. Physiotherapy plays no part at this stage. That comes much later.

BE FAST: the signs to check

Use the BE FAST check. You only need one sign to call.

• B, Balance. Sudden loss of balance, dizziness, or inability to stand or walk straight.
• E, Eyes. Sudden loss of vision in one or both eyes, or double vision.
• F, Face. Ask them to smile. Does one side droop?
• A, Arms. Ask them to raise both arms. Does one drift down or not lift at all? A leg may be weak too.
• S, Speech. Slurred, muddled, or they can't find words or understand you.
• T, Time. Time to call 112 or 108, and to note the time.

A sudden, severe headache unlike any before, or sudden confusion, also needs an ambulance. If the signs fade while you're on the phone, keep going. It may be a mini stroke, which is still an emergency.

Note the time they were last seen well

The doctors will ask exactly when the person was last normal. Not when you found them, but the last time someone saw them well. If they woke with symptoms, that time is usually when they went to bed. Type it into your phone now, because in the stress of the next hour, memories blur. This one detail decides which treatments are possible.

Do not give food, water or medicines

A stroke can affect swallowing without anyone noticing. Even a sip of water can go into the lungs. So nothing by mouth: no water, tea, food or tablets.

Don't give aspirin or a blood pressure tablet. Some strokes are caused by bleeding, and a blood thinner can make that worse; bringing blood pressure down suddenly can also harm a brain that's short of blood. Only the hospital team can decide, after a scan.

Skip the home remedies, however well-meant: pricking fingertips with a needle, rubbing oil or balm, putting ghee in the nose, holding an onion under the nose, splashing water on the face, or slapping the person to "wake them up". They waste time and some cause harm.

If the person is diabetic and there's a glucometer at home, checking the sugar is useful information for the crew. Don't put sugar or juice in their mouth if they're drowsy or their speech or swallowing seems affected.

First aid for a CVA while you wait

Keep them still and comfortable. Don't walk them to the car or down the stairs.

If they're awake, let them lie with head and shoulders raised on a couple of pillows, or sit supported in a chair if that's where they are. If they're drowsy, being sick, or not responding properly, roll them onto their side (the recovery position) so the airway stays clear and anything in the mouth drains out. Loosen a tight collar, belt or saree pleats at the waist. Support a weak arm on a pillow rather than letting it hang.

If they've fallen and are heavy, don't try to lift them alone; make them comfortable on the floor with a pillow and a blanket. Stay with them. Speak calmly and explain what's happening, even if they can't answer, because many people can understand more than they can say. If they stop breathing normally, the emergency call handler will talk you through what to do.

What to tell the ambulance team and the hospital

Have this ready, ideally written on your phone:

• The time last seen well, and what symptoms appeared since, including whether they're getting better or worse
• All medicines, especially blood thinners and insulin
• Known conditions: blood pressure, diabetes, heart rhythm problems, previous stroke
• Any recent fall, head injury, surgery or bleeding
• Allergies

Carry the actual medicine strips, any old reports, an ID card and one family member's phone number. Ask the crew to take the person to a hospital that can do an urgent brain scan and give emergency stroke treatment. If the ambulance will be badly delayed, ask the call handler's advice before deciding to go by car.

Getting ready so you know what to do immediately

A few minutes of preparation now saves time on the worst day. Save 112 and 108 in every family phone under a name you'll find instantly. Keep a small card in the wallet of anyone at higher risk with their conditions, medicines and a family contact. Find out now which nearby hospital has a 24-hour emergency department with a CT scanner, so nobody has to search for it in a panic. Teach older children BE FAST; they're often the ones at home with grandparents.

After the emergency

The first hours in hospital are about the scan and treatment decisions. Once the person is medically stable, the rehab side begins, often within days. Our stroke recovery guide explains what the coming weeks look like, and the stroke terms on reports page helps when the discharge papers arrive.

If the symptoms went away completely, read what happens after a TIA; a passing episode still needs full evaluation. For clot-related strokes, the ischemic stroke guide explains what clot-busting and clot-removal treatment mean for recovery. Swallowing checks in hospital matter for the reason given above, and chest infection risks after stroke covers why. Once home, follow-up after discharge and our physiotherapy after a brain stroke are the next steps. And because a person who has had one stroke or TIA is at higher risk of another, the household routines in life after a mini stroke are worth putting in place.

Frequently asked questions