Every Minute Costs Brain

A stroke happens when the blood supply to part of the brain is cut off, either by a clot blocking an artery or by a bleed into the brain. Around 100,000 people in the UK have a stroke each year, and it remains one of the leading causes of death and disability. The reason we talk about time so insistently is simple: brain cells die quickly when they are starved of oxygen, and treatments such as clot-busting drugs and clot retrieval procedures only work within a narrow window, often just a few hours from the moment symptoms begin.

The practical consequence is that the single most valuable thing a household member can do is recognise what is happening and call 999 immediately. Not after a cup of tea, not after a phone call to a relative, and not after symptoms seem to improve.

The FAST Test: Four Checks in Under a Minute

FAST is the memory aid used across the UK and it takes seconds to run through:

• Face — ask the person to smile. Does one side of the face droop, or does the smile look uneven?
• Arms — ask them to raise both arms and hold them out. Does one arm drift downwards or feel weak?
• Speech — ask them to repeat a simple sentence, such as "the sky is blue today". Is the speech slurred, are the words jumbled, or can they not speak at all?
• Time — if any of these signs are present, call 999 straight away and note the time symptoms started.

If any one part of FAST is abnormal, treat it as a medical emergency. You do not need all four.

Signs FAST Can Miss

FAST catches most strokes, but not all. Some strokes, particularly those affecting the back of the brain, produce different symptoms. Be alert to:

• Sudden loss or blurring of vision in one or both eyes, or double vision
• A sudden, severe headache unlike any before, sometimes described as a thunderclap
• Sudden dizziness, loss of balance, or a feeling of spinning
• Numbness or tingling down one side of the body, including the face, arm or leg
• Confusion, difficulty understanding what is being said, or trouble finding words
• Difficulty swallowing, or a sudden change in behaviour or alertness

Symptoms that come on suddenly are the key feature. They may also fluctuate or partly improve — that still warrants a 999 call. A transient ischaemic attack, sometimes called a mini-stroke, is a serious warning sign that needs urgent assessment.

What to Say When You Call 999

Keep the call calm and brief. The call handler will guide you, but it helps to have the essentials ready. Say clearly that you suspect a stroke and give the full address, including the postcode, plus any access details such as a locked communal door or a key safe.

Useful information to pass on, or to have written down:

• The exact time symptoms started, or the time the person was last seen well
• Their age and date of birth
• Whether they take blood-thinning medicines such as warfarin, apixaban or rivaroxaban
• Any history of stroke, heart problems, diabetes or high blood pressure
• Known allergies and any other regular medicines
• Whether they have fallen or hit their head

If you live with someone at higher risk, keep this information on a single sheet on the fridge or by the phone. In a crisis, nobody remembers a medication list reliably.

Keeping the Person Safe Until Help Arrives

Your job while waiting is to protect them from injury and to keep them still and calm.

• Lie them down with their head and shoulders slightly raised, using pillows if available.
• If they are drowsy, vomiting, or having difficulty swallowing, place them on their side in the recovery position to keep the airway clear. Do not do this if you suspect a spinal injury from a fall.
• Loosen tight clothing at the neck and waist.
• Keep them warm with a blanket or coat, but do not overheat them.
• Do not give them anything to eat or drink — swallowing may be affected and there is a choking risk.
• Do not give aspirin or any other medicine, as some strokes are caused by bleeding.
• Stay with them, reassure them quietly, and keep a note of any changes in their condition and when they happen.
• Unlock the front door, put pets in another room, and turn on lights so the crew can get in quickly.

If the person becomes unresponsive and is not breathing normally, begin CPR and ask someone to fetch the nearest defibrillator. The ambulance call handler can talk you through this.

Preparing Before You Ever Need It

A little preparation makes a real difference. Learn where your nearest hyperacute stroke unit is, and remember that the ambulance crew — not you — should decide where to take the person. Never drive someone to hospital yourself with suspected stroke symptoms; an ambulance can begin assessment on the way and pre-alert the stroke team.

Keep a written medical summary for every household member, including medicines, allergies, GP details and next of kin. Consider a key safe if you live alone. And take fifteen minutes to practise the FAST test with the people you live with, so that if the moment ever comes, recognition is instant and the call is made without delay.