Public Service: Signs of a Stroke

I received one of those e-mails this morning that had been forwarded about a million times. Generally I blow them off. This one I read. Not sure why, but I’m glad I did. It was about identifying strokes, something I’ve had years of practice doing. Strokes are something that hits home, too.

My maternal grandmother died of the complications of a stroke. If I remember family history correctly, my paternal grandmother—the one I only met once—also died of a stroke, though at a much younger age. My father had a stroke. And in the ER, as well as in my other nursing jobs, I dealt with strokes on a sadly regular basis.

Learn these identification signs, and you could save the life—or the brain function and quality of life—of someone you love.

STROKE: Remember The 1st Three Letters…. S.T.R.


If you can get the stroke sufferer to the hospital within three hours of the time the clot causing the stroke lodges in the blood vessel, there is a drug, tPA, or Tissue Plasminogen Activator, that will dissolve the clot and prevent irreparable damage.

To be effective, tPA must be administered within the first three hours of the event to be given intravenously, or within six hours to be administered through an arterial catheter directly to the site of occlusion. The guideline in Ontario, Canada hospitals for ischemic strokes is that tPA must be given within 3 hours of the onset of symptoms. Because of this, only about 3% of patients qualify for this treatment.

3%. That’s the bad news.

There’s worse news. Strokes can kill almost instantly. They can go from looking benign to being lethal with horrible speed. If you have any time at all to get this right, YOU HAVE, AT MOST, THREE HOURS. Odds are, you’ll have a lot less time.


Strokes are easy to miss and easy to misinterpret. They can look like a simple fall. Like momentary confusion. Like dizziness. Like being a little tipsy. Don’t assume everything is okay.

  • S * Ask the individual to SMILE and STICK OUT YOUR TONGUE
    (Is the smile uneven on one side? Does the tongue point to left or right? Call 911/999)
  • T* Ask the person to TALK and SPEAK A SIMPLE SENTENCE like “It is sunny out today.”
    (Is speech slurred? Do some words come out wrong? Is the person unable to speak at all, even for just a moment or two? Call 911/999)
  • R* Ask him or her to RAISE BOTH ARMS.
    (Do they go up unevenly, or does one not go up at all? Call 911/999)

If he or she has trouble with ANY ONE of these tasks, call 999/911 immediately and describe the symptoms to the dispatcher.

You can save someone’s life if you know what to look for. If you make sure enough other people learn these steps, someone might be able to save yours.

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2 responses to “Public Service: Signs of a Stroke”

  1. Liz Avatar

    The acronym the Red Cross teaches these days is FAST:
    Face – Same as S above
    Arms – Same as R
    Speech – Same as T
    Time – Note the time the symptoms started, so tPA can be administered correctly

    My mom had a stroke while with a group of her co-workers, and *nobody.did.anything*. (Long story, usually involves profanity.) Thanks for posting this on a high-traffic site. The more people who know they need to call 911, the better.

  2. Nicole Avatar

    Thanks for the reminders. My maternal grandfather had a stroke that he never fully recovered from, and it seems that if we had known the signs earlier, it might not have been as bad as it ended up. I hope others learn to recognize the signs before they need them.

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