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Stroke and FAST recognition
What is stroke (FAST)?
A stroke happens when the blood supply to part of the brain is cut off or reduced, usually by a clot or a bleed, causing sudden loss of function in the affected area of the brain. Common signs include facial weakness, arm weakness and speech disturbance, which form the basis of the FAST test used in public campaigns.
Brain cells begin to die within minutes when deprived of oxygen, so ‘time is brain’: the sooner a person with stroke symptoms reaches appropriate hospital care, the more brain tissue can potentially be saved. Some people will be eligible for clot-busting drugs or thrombectomy, which are highly time-dependent.
Every year thousands of people in the UK have a stroke, and acting FAST – Face, Arms, Speech, Time to call 999 – has been shown to improve outcomes by reducing time to brain imaging and treatment.
Who needs this skill?
Health & Social Care
In health and social care, staff should be familiar with stroke pathways and sepsis/stroke screening tools, recognising that sudden changes in speech, mobility, vision or confusion in older adults may reflect stroke until proven otherwise. Early escalation via agreed protocols is critical, especially in community and care home settings where delays are common.Licensed venues & nightlife
In nightlife and licensed venues, signs of stroke may be mistaken for intoxication or drug effects; if someone has sudden facial asymmetry, weakness, collapse or abnormal speech, staff should think FAST and call 999 rather than simply ejecting them from the premises.Schools
Although stroke is less common in pupils, staff, visitors and contractors are all at risk; recognising FAST signs and acting quickly matters during the school day as much as anywhere else.Workplaces
In workplaces, first aiders may be the first to notice that a colleague's face has dropped on one side, their speech is slurred or they cannot lift one arm; they should apply FAST and call 999 without delay even if the person feels they are 'overreacting'. Employers can use stroke awareness as part of wider wellbeing programmes.How to manage stroke (FAST)
- 1Use FAST to check for strokeAssess the Face for drooping on one side, Arms for weakness when both arms are raised, and Speech for slurring or difficulty finding words; if any of these signs are present, it is Time to call 999 immediately.Even if symptoms are mild or transient, a single FAST positive sign is enough to justify an emergency call.
- 2Call 999 immediatelyIf the FAST test is positive or you suspect stroke for any other reason, call 999, say you suspect a stroke and follow the call-handler's advice.Do not arrange routine GP or out-of-hours appointments; stroke is a 999 condition because specialist treatment is time-critical.
- 3Support and monitor the casualtyHelp the person to sit or lie in a comfortable position with head and shoulders slightly raised if this does not cause distress, while avoiding food or drink in case swallowing is affected.Monitor breathing and level of consciousness and be ready to start CPR if they become unresponsive and stop breathing normally.
- 4Gather information for handoverNote the time the symptoms started or were last seen normal, any known medical history, medications (especially anticoagulants) and any witnessed seizure-like activity or head injury, and pass this clearly to ambulance crews.Accurate onset time is crucial for determining eligibility for some stroke treatments.
- 5Reassure and protect dignityStay calm, explain what is happening and protect the person's privacy as far as possible; sudden neurological deficits can be frightening and embarrassing.Avoid moving them unnecessarily and do not attempt to correct facial droop or limb position.
This guide is a learning reference only. It does not replace attended, assessed first aid training.
Qualifying courses
Common questions
Practical answers for employers, venue managers, and healthcare teams about stroke (FAST) training.
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FAST covers the most common signs, but some strokes present with visual loss, sudden severe dizziness, imbalance or other neurological deficits without facial or arm weakness. If you are seriously concerned about sudden neurological symptoms, it is safer to call 999 and describe what you see than to rely solely on a negative FAST test.
Stroke is more common with age but can occur in younger adults and, rarely, children, especially in the presence of risk factors such as high blood pressure, smoking, atrial fibrillation, diabetes or certain blood disorders. Any sudden neurological deficit warrants serious consideration regardless of age.
Regular awareness training on FAST, clear posters in staff areas, scenario-based first aid refreshers and straightforward instructions to ‘call 999, not GP’ when FAST is positive all help reduce delay. Embedding stroke into broader deterioration recognition training (with sepsis and ACS) also supports better decision-making.