Urgent & emergency
Signs of a Stroke: Act FAST — This Is a Medical Emergency
Sudden face drooping, arm weakness, and slurred speech are the classic FAST warning signs of a stroke. Call 911 immediately — do not drive or wait to see if symptoms improve. Note the exact time symptoms started, because roughly 1.9 million brain cells are lost every minute a stroke goes untreated.
Call 911 if you see any of these signs
Use the BE-FAST mnemonic — an expanded version of FAST that also captures the balance and vision symptoms that stroke teams use 2Ref 2Aroor S, Singh R, Goldstein LB (2017).BE-FAST (Balance, Eyes, Face, Arm, Speech, Time): Reducing the Proportion of Strokes Missed Using the FAST Mnemonic.BE-FAST mnemonic and the rationale for expanding beyond FAST to include balance and eye symptoms to reduce missed strokes:
B — Balance: Sudden loss of balance, dizziness, or trouble walking.
E — Eyes: Sudden blurred vision, double vision, or vision loss in one or both eyes.
F — Face drooping: Ask the person to smile. Is one side drooping or numb? Is the smile uneven?
A — Arm weakness: Ask them to raise both arms. Does one drift downward or feel weak or numb?
S — Speech difficulty: Ask them to repeat a simple phrase. Is speech slurred, strange, or impossible to understand?
T — Time to call 911: If any of these are present — even one, even if mild — call 911 immediately and note the time symptoms began.
Do not wait for all signs to appear. Do not wait to see if it improves. Some strokes cause symptoms that fluctuate — this does not mean they are not serious 1Ref 1Prabhakaran S, Gonzalez NR, Zachrison KS, et al. (2026).2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association.Emergency response for stroke, contraindication to aspirin in hemorrhagic stroke, tPA time window, TIA as a stroke warning requiring same-day evaluation.
Other warning signs of stroke
Strokes can also cause: - Sudden severe headache with no known cause — often described as the worst headache of a person's life - Sudden numbness or weakness in the face, arm, or leg, especially on one side - Sudden confusion or trouble understanding what others are saying - Sudden trouble walking, loss of balance, or dizziness
Any one of these appearing suddenly and without warning is a reason to call 911 1Ref 1Prabhakaran S, Gonzalez NR, Zachrison KS, et al. (2026).2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association.Emergency response for stroke, contraindication to aspirin in hemorrhagic stroke, tPA time window, TIA as a stroke warning requiring same-day evaluation.
What to do while waiting for the ambulance
- Keep the person calm and seated or lying down comfortably.
- Do not give them anything to eat or drink.
- Do not give aspirin — unlike a heart attack, some strokes are caused by bleeding, not clotting, and aspirin can worsen a hemorrhagic stroke 1Ref 1Prabhakaran S, Gonzalez NR, Zachrison KS, et al. (2026).2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association.Emergency response for stroke, contraindication to aspirin in hemorrhagic stroke, tPA time window, TIA as a stroke warning requiring same-day evaluation.
- Note the exact time the first symptom appeared. This is critical — it determines which treatments are available. The clot-dissolving medication tPA has a 4.5-hour window from symptom onset, and mechanical thrombectomy may be possible in select patients up to 24 hours — but only if the team knows when it started 1Ref 1Prabhakaran S, Gonzalez NR, Zachrison KS, et al. (2026).2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association.Emergency response for stroke, contraindication to aspirin in hemorrhagic stroke, tPA time window, TIA as a stroke warning requiring same-day evaluation.
- Unlock the front door so paramedics can enter.
- Stay on the phone with 911 if the dispatcher asks you to.
What types of stroke can cause these symptoms?
Ischemic stroke (the most common type): A clot blocks blood flow to part of the brain. Time-sensitive treatment with tPA or mechanical clot removal is possible if the person arrives quickly 1Ref 1Prabhakaran S, Gonzalez NR, Zachrison KS, et al. (2026).2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association.Emergency response for stroke, contraindication to aspirin in hemorrhagic stroke, tPA time window, TIA as a stroke warning requiring same-day evaluation.
Hemorrhagic stroke: A burst blood vessel bleeds into or around the brain. Often presents with a sudden, severe headache. Treatment is different from ischemic stroke — which is why emergency imaging is essential and aspirin must not be given.
Transient ischemic attack (TIA, 'mini-stroke'): Stroke-like symptoms that resolve within minutes to hours. Even when symptoms fully resolve, a TIA still requires emergency evaluation today — a larger stroke may follow soon 1Ref 1Prabhakaran S, Gonzalez NR, Zachrison KS, et al. (2026).2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association.Emergency response for stroke, contraindication to aspirin in hemorrhagic stroke, tPA time window, TIA as a stroke warning requiring same-day evaluation.
The type cannot be determined without imaging. This is why the emergency team's rapid response, and your call to 911, matters so much.
Common questions
What does the T in FAST stand for, and why does it matter?
T stands for Time — the time to call 911. It also means noting the exact time symptoms started. This is critical because the clot-dissolving treatment available for ischemic stroke must be given within a specific window from symptom onset. Even a 30-minute delay can affect what treatments are available.
If the symptoms go away, does that mean it was not a stroke?
No. Symptoms that resolve may indicate a TIA (transient ischemic attack), which is a medical emergency requiring same-day evaluation. A TIA is a strong warning sign that a major stroke may follow — and that warning window is the best opportunity to prevent it.
Should I give aspirin to someone who may be having a stroke?
No — unlike a heart attack, do not give aspirin for a suspected stroke. Some strokes are caused by bleeding, not a clot, and aspirin can worsen bleeding. Wait for the emergency team to assess and treat.
Can young people have strokes?
Yes. Strokes occur across all ages. While risk increases with age and conditions like high blood pressure and atrial fibrillation, strokes also occur in younger adults. The same warning signs apply regardless of age.
Stroke warning signs — call 911 for any of these
- —Sudden face drooping or an uneven smile.
- —Sudden weakness or numbness in one arm or leg.
- —Sudden slurred, garbled, or absent speech.
- —Sudden severe headache — the worst of your life — with no obvious cause.
- —Sudden vision loss, blurred vision, or double vision.
- —Sudden loss of balance, coordination, or ability to walk.
- —Any sudden neurological symptom that resolves on its own — this may be a TIA and still requires emergency evaluation today.
Call 911 immediately. Do not drive yourself or the affected person to the hospital — an ambulance crew can begin assessment and alert the stroke team while en route. Note the time symptoms started before you call.
This is an emergency reference, not a diagnostic tool. If stroke is suspected, call 911 immediately — do not use this article to decide whether care is needed.
References
- 1.Prabhakaran S, Gonzalez NR, Zachrison KS, et al. (2026). 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke. doi:10.1161/STR.0000000000000513 ✓Emergency response for stroke, contraindication to aspirin in hemorrhagic stroke, tPA time window, TIA as a stroke warning requiring same-day evaluation
- 2.Aroor S, Singh R, Goldstein LB (2017). BE-FAST (Balance, Eyes, Face, Arm, Speech, Time): Reducing the Proportion of Strokes Missed Using the FAST Mnemonic. Stroke. doi:10.1161/STROKEAHA.116.015169 ✓BE-FAST mnemonic and the rationale for expanding beyond FAST to include balance and eye symptoms to reduce missed strokes
2 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.