Stroke First Aid: Immediate Actions While Waiting for 911

Stroke is a time-critical emergency. Every minute of delay costs ~1.9 million neurons. Call 911 immediately—do not drive the patient yourself.

⚡ IMMEDIATE ACTION: CALL 911

Say: "Suspected stroke." Give address, callback number.
Note exact time of symptom onset (or "last known well") — critical for thrombolysis/thrombectomy eligibility.
Unlock door for EMS.

Position: Lay flat or slightly elevated (30°) — recovery position (left lateral) if decreased consciousness, vomiting, or airway risk. Do NOT elevate head >30° (may reduce cerebral perfusion).
Loosen: Tight clothing (collar, tie, belt).
Monitor Breathing: If absent → CPR (compressions only if untrained).
Reassure: Calm voice, "Help is coming." Reduces catecholamine surge.
Gather: Medication list, allergies, medical history, emergency contacts.
Note: Time of onset, symptom progression, any fall/head trauma.

Give anything by mouth (water, food, aspirin, meds) — aspiration risk; dysphagia present in 50%+ acute stroke
Give aspirin — may worsen hemorrhagic stroke; EMS/hospital will decide
Let patient walk, stand, or move — fall risk, hemodynamic instability
Apply ice, heat, or topicals
Delay calling 911 to "wait and see"

EMS performs prehospital stroke scale (Cincinnati, LAMS, RACE)
Pre-notifies stroke center → activates stroke team
Direct to CT → tPA decision (window: 4.5 hrs) / thrombectomy (window: up to 24 hrs select patients)

Time is brain. Call 911 at first sign. Do not wait. Do not drive.

Letter	Sign	Action
B	Balance loss / dizziness	Sudden onset
E	Eyes: vision loss / double vision	One or both eyes
F	Face drooping (asymmetric smile)	Ask to smile
A	Arm weakness (drift down)	Ask to raise both
S	Speech: slurred, wrong words, unable	Ask to repeat phrase
T	Time to call 911	Note exact time