Based on a video by Corewell Health in Southeast Michigan.
Around 795,000 Americans have a stroke every year. Survival and recovery depend almost entirely on how fast the person gets to a hospital - the saying 'time is brain' captures it. Treatments that dissolve clots only work in the first few hours after symptoms start, and the sooner the better.
The F.A.S.T.E.R. acronym gives you 6 quick checks anyone can do without medical training. Memorize this sequence. The life you save with it might be a stranger's, a coworker's, or your own family member's. Walkthrough courtesy of Corewell Health.
Ask the person to smile. Look for drooping or numbness on one side of the face - an uneven or one-sided smile is a classic stroke sign.
The drooping side may be the side opposite where the stroke is occurring in the brain. Even a subtle asymmetry counts; don't talk yourself out of it because 'it could just be tiredness.'
Ask the person to raise both arms straight out in front of them and hold for 10 seconds. Watch closely.
If one arm drifts downward or they can't lift it at all, that's a stroke sign. Numbness on one side counts even if they can still raise the arm. Sudden one-sided weakness is one of the most common presentations.
Stroke can affect balance and walking. Look for sudden dizziness or trouble standing without support.
Try this quick test: have the person close their eyes and try to touch the tip of their nose with their finger. Difficulty doing this points to a coordination problem from stroke (specifically a cerebellar stroke).
Ask the person to repeat a simple sentence like 'The sky is blue.' Listen for slurred speech, garbled words, or an inability to talk at all.
Also check if they understand what you're saying. Sometimes stroke affects comprehension before speech - they hear words but can't process them. A confused or empty-stare response to a simple question is a warning sign.
Sudden vision changes are easy to miss. Ask if they're having trouble seeing out of one eye, seeing double, or only seeing one side of the room (visual field cut).
These often happen alongside the other symptoms but can also occur alone. If someone walks into furniture on one side that they wouldn't normally bump, that's a clue.
If you see ANY of the F.A.S.T.E.R. signs, call 911 right away - do not wait, do not drive them yourself, do not have them lie down to 'see if it passes.' Even if symptoms go away, get them to the hospital.
Note the exact time symptoms first appeared - that determines which treatments are still on the table at the ER. Other less common but serious signs to know: sudden severe headache, sudden confusion, numbness or tingling.
Tip
Strokes aren't usually painful - that's why so many victims don't call for help. Trust your gut: if something feels very wrong about how the person is acting, treat it as a stroke until a hospital says otherwise.
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