Stroke is the most time-sensitive emergency in medicine, and also the one where people most often wait. A patient who arrives within four and a half hours can be given clot-dissolving therapy. A patient who arrives the next morning cannot.
Learn BE-FAST
- B – Balance: sudden loss of balance or coordination
- E – Eyes: sudden blurred or double vision, or loss of vision in one eye
- F – Face: ask them to smile; does one side droop?
- A – Arms: ask them to raise both arms; does one drift down?
- S – Speech: ask them to repeat a sentence; is it slurred or jumbled?
- T – Time: note the exact time symptoms started and call an ambulance immediately
Why the exact time of onset matters so much
Treatment eligibility is calculated from the last moment the person was known to be normal. If someone wakes with symptoms, the clock starts from when they went to sleep. This is why we ask the question repeatedly — it decides which treatments are safe.
What happens when you arrive
Our stroke pathway is activated from the ambulance. A CT scan is done within minutes of arrival to distinguish a blocked vessel from a bleed, because the treatments are opposite. If it is a clot, intravenous thrombolysis begins in the scanner bay itself; large clots then go for mechanical retrieval.
Common mistakes families make
- Waiting to see if the weakness improves by morning
- Giving aspirin before a CT scan — dangerous if the stroke is a bleed
- Trying to make an unconscious patient drink water
- Driving to a hospital without a CT scanner and stroke team
Recovery does not end with the acute treatment. Structured physiotherapy, speech therapy and blood pressure control over the following year decide how much independence returns.
