Signs of a stroke – act FAST and call an ambulance
The FAST test, the less obvious stroke signs people miss, why time is brain, and what to do and not do while you wait for help.
The FAST test
A stroke happens when the blood supply to part of the brain is cut off, either by a clot or by a bleed. Brain tissue starts dying within minutes, so the treatment that can limit the damage is time-critical — and only available at a hospital.
- Face — ask them to smile. Has one side of the face dropped?
- Arms — ask them to raise both arms and hold them up. Does one drift down?
- Speech — ask them to repeat a simple sentence. Is it slurred, jumbled, or are they unable to find words?
- Time — if any one of these is present, call an ambulance immediately and note the time the symptoms started.
The signs people miss
- Sudden numbness or weakness of the face, arm or leg, especially on one side.
- Sudden confusion, or trouble understanding what is being said.
- Sudden loss or blurring of vision in one or both eyes, or double vision.
- Sudden severe dizziness, loss of balance or coordination, or difficulty walking.
- A sudden severe headache with no known cause — often described as the worst ever, and sometimes with vomiting or a stiff neck.
- Sudden difficulty swallowing.
While you wait for the ambulance
- Keep them still and comfortable, lying down with the head and shoulders slightly raised if possible.
- Do not give anything to eat or drink. Swallowing is often affected and it can go into the lungs.
- Do not give any medicine, including aspirin. Some strokes are caused by bleeding and aspirin makes those worse. Only a scan can tell the difference.
- If they are unconscious but breathing, roll them onto their side.
- Gather their medicines and identity document to take with them.
- Write down the time the symptoms started and tell the paramedics immediately.
Afterwards
Most strokes in South Africa follow high blood pressure that was either undiagnosed or not controlled. If someone in your family has had a stroke, get your own blood pressure checked — it is free at any public clinic and it takes a minute.
Common questions
- What does FAST stand for in a stroke?
- Face drooping, Arms unable to stay raised, Speech slurred or jumbled, and Time to call an ambulance. One sign is enough to act on — do not wait for all three.
- Should I give aspirin to someone having a stroke?
- No. Some strokes are caused by bleeding, and aspirin makes those worse. Only a scan at hospital can tell which kind it is, so give nothing by mouth and call an ambulance.
- What if stroke symptoms go away on their own?
- Still get emergency assessment the same day. Symptoms that resolve may have been a transient ischaemic attack, which is a warning that a full stroke may follow within days.
Sources
- Basic life support and resuscitation guidelinesResuscitation Council of Southern Africa
- Adult Hospital Level Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Adult Primary Care guide: symptom-based integrated approach to the adult in primary careNational Department of Health, South Africa
- Clinical and public health guidanceWorld Health Organization
Last reviewed 11 August 2026.