Recognizing stroke and acting fast (FAST and beyond)
Most people can learn to spot a stroke in seconds with one word: FAST. Recognising it quickly — and calling for help immediately — is the single most important thing a bystander can do, because the fastest treatments only work within a few hours
Why this matters
Recognising a stroke in seconds and calling immediately is the single most valuable thing a bystander can do, because the fastest treatments only work within a few hours
FAST — the core signs
FAST stands for Face, Arms, Speech, Time. Ask the person to smile (does one side droop?), to raise both arms (does one drift down?), and to repeat a simple sentence (is it slurred or strange?). If any of these is abnormal, it’s Time to call emergency services
You don’t need all three signs — any one is enough to act
For example: “Smile for me” — one side of the mouth stays flat. “Raise both arms” — the left drifts down. That’s two FAST signs; call immediately
Beyond FAST (B.E. FAST)
FAST catches most strokes but not all. Some versions add B and E — Balance and Eyes — because a stroke can begin with sudden loss of balance or sudden vision trouble. Also treat as emergencies: sudden numbness (especially one-sided), sudden confusion or trouble understanding, and a sudden severe headache with no known cause
The common thread is sudden. Stroke symptoms appear abruptly, not gradually over days
For example: A sudden “worst headache of my life” with no explanation can be a hemorrhagic stroke — don’t wait it out
Last known well
“Last known well” is the last time the person was seen completely normal — not when symptoms were noticed. Treatment eligibility depends on this time, so note it precisely and tell the paramedics
If someone wakes up with symptoms, last known well is when they were last normal before sleep, not when they woke
The right next action
Call your local emergency number — don’t drive the person yourself if you can avoid it. Paramedics begin care on the way and route to the right stroke hospital. Don’t give food, drink, or medication while you wait
Watch and connect
3 early warning signs of a stroke (recognize FAST) - A quick refresher on the core FAST signs to look for.
How to recognize and respond to a stroke - Watch the bystander response in action — spot the signs, then call for help immediately.
In practice
You find your neighbor confused and unable to lift her right arm; you’re not sure when it started. Should you drive her to the clinic? No — call emergency services. Tell them the last time you know she was normal (“I spoke to her at 2pm and she was fine”). An ambulance starts treatment en route and takes her to a hospital equipped for stroke, which a car ride can’t do
★ Key takeaways
- FAST = Face droop, Arm weakness, Speech trouble, Time to call
- Any one sign is enough — act immediately
- B.E. FAST adds sudden Balance and Eye (vision) problems; also watch for sudden numbness, confusion, or severe headache
- Note “last known well” and call emergency services rather than driving
Lesson quiz
Check this lesson
Answer these lesson-specific questions before continuing. They focus on the decisions, scenarios, and safety points covered above.
0 of 6 answered
Complete every question, then submit once to see all correct and incorrect answers.
References
- Tier 1American Stroke Association2024Stroke Symptoms (F.A.S.T. / B.E. F.A.S.T.)
- Tier 1NINDS / National Institutes of Health2024Stroke Information Page