When a person is having a stroke, every second counts. And what you do in those critical moments can potentially help save someone’s life.
Kelley A. Humbert, MD, Assistant Professor of Clinical Neurology at Penn Medicine, spells out important do’s and don’ts, so you can be ready to give your loved one the best chance of surviving a stroke.
A stroke is often described as a “brain attack.” Part of the brain is robbed of the oxygen and blood supply it needs to function, because a blood vessel to part of the brain either has a clot or blockage, or bursts.
The longer a stroke goes untreated, the more brain cells die. But there are treatments that can be given if a person reaches the hospital in time.
Three Things to Do When Someone Is Having a Stroke
1. Call 911 immediately
If you do nothing else, act quickly to call 911.
“The hardest thing you have to do is recognize symptoms of a stroke,” Dr. Humbert explains. “If you do observe any symptoms, you should call 911 immediately. You should also immediately tell the 911 dispatcher, ‘I think I’m having a stroke’ or ‘I think my loved one is.’”
Not sure what the symptoms of a stroke are? Give someone you think is having a stroke this FAST test from the National Stroke Association.
2. Note the time you first see symptoms
A clot-busting medication called tPA, or tissue plasminogen activator, can be given to someone if they’re having a stroke, potentially reversing or stopping symptoms from developing. But it has to be given within 4.5 hours of the start of symptoms, Dr. Humbert says.
Patients may also be candidates for more advanced therapies, such as endovascular treatments, at Penn Medicine. Endovascular treatments can involve surgically removing a clot that caused a stroke, or fixing an aneurysm — which is a swollen blood vessel that bursts and causes bleeding and pressure build-up in the brain. Endovascular treatments for ischemic stroke, which are strokes related to blood clots or blockages and are the most common type of stroke, must be administered within 24 hours of symptom onset, and earlier treatment improves outcomes so time is critically important.
“If a witness sees someone develop symptoms of a stroke, the first step is always to call 911. But closely after this, it would be helpful if they look at what time the symptoms started; or if the person was found already with stroke symptoms, it is helpful to try to figure out the last time you or someone else saw that person without any symptoms and as their normal self,” she says. “That way, the emergency staff can make a more informed decision about treatment options and ensure these are as safe as possible.”
3. Perform CPR, if necessary
Most stroke patients don’t require CPR, Dr. Humbert notes. But if your friend or spouse is unconscious when you find them, check their pulse and breathing. If you find none, call 911 and start CPR while you’re waiting for the ambulance to arrive.
You can also ask the 911 dispatcher to walk you through how to perform CPR if you don’t know or are uncertain, which consists of repeated, steady chest compressions, according to the American Heart Association.
Three Things Not to Do When Someone Is Having a Stroke
1. Do not let that person go to sleep or talk you out of calling 911
Stroke survivors often complain of suddenly feeling very sleepy when a stroke first happens.
“A lot of patients come in and say they went to sleep for a few hours before they came to the hospital because they were tired,” Dr. Humbert notes.
But time is of the essence. “The medication and any surgical treatments we can give a stroke survivor are incredibly time-sensitive,” she adds. “They should not go to sleep, and they should not call their primary care doctor first. Instead, they should just go immediately to the emergency room.”
And no matter how much someone might try to talk you out of taking them to the hospital, don’t let them, says Dr. Humbert.
2. Do not give them medication, food, or drinks
There are two kinds of strokes:
- Hemorrhagic stroke, caused by a ruptured blood vessel leading to brain bleeds
- Ischemic stroke, caused by a clot leading to blockage in a blood vessel
“80 percent of strokes are ischemic ones, but if you’re in that 20 percent and your stroke was caused by a ruptured blood vessel in the head, you don’t want to take aspirin,” Dr. Humbert says. “And you can’t tell which one it is until you get to the emergency room and you get a CAT scan.” Aspirin actually might hurt your loved one more, and cause more bleeding if in fact they are having a hemorrhagic stroke, because aspirin is a blood thinner.
To be safe, don’t give someone who has stroke symptoms any medication.
You also shouldn’t give them food or drinks before the ambulance comes. “Sometimes, a stroke affects their ability to swallow,” Dr. Humbert says. This could ultimately cause more harm to the person if they choke and develop infections or trouble breathing.
3. Do not drive yourself or someone else to the emergency room
It might seem like a good idea to drive a stroke victim to the nearest emergency room. But Dr. Humbert says, “If someone is severely affected by a stroke, then you’re better off calling 911.”
Emergency responders can start life-saving treatment for that person on the way to the emergency room, the Centers for Disease Control and Prevention (CDC) says. Additionally, emergency responders will ensure the person is taken to a hospital that has the medications and treatments available to treat stroke patients immediately if that is what is going on, as not all hospitals are equipped to handle stroke patients.
You also don’t want to drive yourself to a hospital in the event that your stroke symptoms worsen and impair your ability to drive safely.
Stay Focused and Take Action Quickly
As frightening as it can be to witness someone having a stroke, taking a few key steps — and avoiding others — can potentially help your loved one have the best possible outcome. “We have a process in place to treat someone who is having a stroke critically once they get here,” Dr. Humbert notes. “But they really need to get here as quickly as they can.”
The Symptoms That Could Mean You're Having a Stroke
The symptoms of a stroke can vary from patient to patient. But they tend to have one thing in common: They take people by surprise, says Dr. Humbert.
“Stroke symptoms come on very suddenly,” she says. “People are fine one moment and then suddenly have symptoms, such as weakness, numbness, trouble talking, or loss of vision. They might wonder where it came from.”
What’s happening? A stroke occurs when the blood’s flow to the brain is impaired, either because blood flow is blocked (ischemic stroke), or a blood vessel in the brain ruptures leading to leakage and bleeding (hemorrhagic stroke).
Without normal blood flow, brain cells start to die, and the functions controlled by that area of the brain — such as speech or muscle movement or vision — are impaired or lost, the National Stroke Association says.
The effects can cause permanent brain damage and disability, depending on how severe the stroke was and how quickly the patient is able to get help.
What Does a Stroke Feel Like?
Strokes can carry a number of sudden, telltale symptoms, Dr. Humbert says. These include:
- A droop on one side of the face
- Difficulty lifting one arm to its full height or using one hand
- Difficulty moving one leg, or dragging a leg while trying to walk
- Slurred speech or difficulty with talking
- Impaired vision in one or both eyes
- Vertigo or dizziness
- Difficulty walking or sudden imbalance
The American Heart Association/American Stroke Association notes that a sudden severe headache that does not appear to be triggered by anything is another potential sign that you might be having a stroke. Quite often, though, strokes are painless, which can surprise people, Dr. Humbert says.
“Although some strokes are associated with a headache, many occur without any accompanying pain,” she says. “This doesn’t mean you’re not having a stroke. If you’re having symptoms of a stroke, you need to get medical care immediately.”
Even If Symptoms Vanish Quickly, Call for Help
You should also be aware that warning signs might last only for a few minutes before they disappear. These brief episodes are transient ischemic attacks (TIA), sometimes called “mini-strokes.” They still should be taken seriously, because they tend to be signs of underlying serious conditions that can lead to a full stroke, even possibly in the few days following a TIA event if not evaluated and treated for a TIA.
“It’s not uncommon for people who have had a TIA to ignore it because the symptoms went away and they don’t know what it was,” Dr. Humbert says. “But people who have TIA symptoms are definitely at higher risk of having a subsequent stroke, and they need to be evaluated urgently.”
Call 911 Immediately
Once you recognize that you or someone you witness is having a stroke, the next step is calling 911 quickly, Dr. Humbert stresses.
Time is critical if someone is having a stroke. The longer a stroke goes untreated, the more damage can be done — possibly permanently — to the brain.
“If you suspect you or someone you’re with is having a stroke, don’t hesitate to call 911,” Dr. Humbert says. “It could save a life.”
The Penn Stroke Center is a Joint Commission-certified Comprehensive Stroke Center. Patients who have suffered a stroke have access to the most advanced resources available for the treatment of stroke 24 hours a day, seven days a week, 365 days a year.