Quick answer
Use FAST. Face — has their mouth drooped? Arms — can they lift both? Speech — is it slurred, and do they understand you? Time — if you see any one of these, call Triple Zero (000) straight away. Note what time the symptoms started. Give them nothing to eat or drink, and if they are unconscious but breathing, lay them on their side. Call even if the signs disappear.
Do not give aspirin for a suspected stroke
This is the opposite of the advice for a heart attack, and getting the two mixed up can kill someone. About one stroke in five is caused by bleeding in the brain rather than a clot — and no first aider can tell which is which without a CT scan. Aspirin thins the blood, so giving it during a bleed makes the bleed worse. Leave it to the hospital.
A stroke is the emergency where minutes translate most directly into permanent disability. Brain tissue starved of blood begins to die, and as the Stroke Foundation puts it, “the longer a stroke remains untreated, the greater the chance of stroke-related brain damage.”
The good news is that recognising one needs no training and no equipment — just four checks that take about twenty seconds.
The FAST test
FAST is the standard recognition tool in Australia, used by the Stroke Foundation and by Australian resuscitation guidance. Ask the person to do three things, then act.
| Check | What to ask | What you are looking for |
|---|---|---|
| F — Face | “Can you smile for me?” | Has their mouth drooped on one side? |
| A — Arms | “Can you lift both arms?” | Can they only raise one, or is one arm weaker? |
| S — Speech | “Repeat this after me.” | Is their speech slurred? Do they understand you? |
| T — Time | — | Any one sign is enough. Call 000 immediately. |
You do not need all four. One is enough to call. And you are not being asked to diagnose anything — only to notice, and to dial.
The signs FAST does not cover
FAST catches most strokes but not all of them. Australian guidance lists these as well, and they are the ones people talk themselves out of:
- Weakness, numbness or paralysis of the face, arm or leg — on either or both sides
- Dizziness, loss of balance, or an unexplained fall
- Loss of vision, or sudden blurred or decreased vision in one or both eyes
- A severe or unusual headache
- Difficulty swallowing
- Drowsiness, confusion, or reduced consciousness
A sudden, unexplained change in someone — especially confusion or a fall with no obvious cause — is worth taking as seriously as a drooping face.
What to do if you suspect a stroke
- Call Triple Zero (000) immediately and say you think the person is having a stroke. Saying the word matters — it changes how the call is prioritised and which hospital they go to.
- Note the time the symptoms started. If you did not see it begin, note when the person was last seen normal. Treatment options depend on this, and it is the first thing the hospital will ask.
- Stay with them. Keep them calm and comfortable, and do not let them go and lie down alone.
- Give them nothing to eat or drink — not even a sip of water. A stroke can impair swallowing, and fluid can go into the lungs.
- Do not give any medication, aspirin included. See the box at the top.
- If they are unconscious but breathing normally, lay them on their side and make sure the airway is clear — the recovery position.
- If they are unresponsive and not breathing normally, start CPR and follow DRSABCD.
- Gather their medications and medical history if you can do it without leaving them. Blood thinners in particular change what the hospital can safely do.
Do not drive them to hospital. An ambulance can pre-notify the stroke unit, and paramedics can begin assessment on the way. Getting to the right hospital matters more than getting to the nearest one, and only the ambulance service knows which is which.
If the signs disappear, it is still an emergency
This is the single most commonly ignored piece of stroke advice. Australian resuscitation guidance is unambiguous: send for an ambulance immediately if a stroke is suspected, even if the symptoms were brief or have completely resolved.
Symptoms that come and go may have been a transient ischaemic attack (TIA), often called a mini stroke. The Stroke Foundation describes a TIA as “a warning that you may have a stroke and an opportunity to prevent this from happening.”
Read that twice. The symptoms resolving is not the good news it feels like — it is a window, and it closes. People who act on a TIA can often be treated before the stroke arrives. People who go to bed and see how they feel in the morning frequently cannot.
Stroke, heart attack, or something else?
Three conditions get confused with stroke, and each needs something different.
| Looks like | Tells you apart | What changes |
|---|---|---|
| Heart attack | Chest pain or tightness, often spreading to arm, neck or jaw. No facial droop or one-sided weakness. | Aspirin is suggested for a heart attack. It is not for a stroke. See heart attack warning signs. |
| Low blood sugar | Common in people with diabetes. Sweaty, shaky, confused or aggressive; may improve quickly with sugar. | Australian guidance recommends FAST specifically when a blood glucose reading is not possible — because a hypo can mimic a stroke closely. |
| Seizure or a faint | Collapse with jerking, or a brief faint with quick full recovery. | See seizure first aid and fainting first aid. |
If you cannot tell, call 000 and describe what you see. Sorting it out is the call taker's job, not yours.
A stroke can take away speech entirely — which is exactly when a hospital most needs to know about blood thinners.
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Stroke in women
Worth being precise here, because this topic attracts a lot of loose claims. According to the Better Health Channel, the signs of stroke are the same for men and women. FAST is FAST.
What genuinely differs is risk and awareness:
- Stroke is the second biggest killer of Australian women, and kills more women than breast cancer.
- Some risk factors are specific to women — pregnancy, some types of oral contraceptive pill, and the drop in oestrogen after menopause.
- Many women are not aware of the FAST signs and so do not recognise them in themselves.
So the useful takeaway is not that women should look for different signs. It is that the same signs are more likely to be dismissed — and that the less typical presentations, like confusion, nausea or sudden fatigue, deserve the same phone call.
Related reading: what to say when you call an ambulance, heart attack warning signs, and the recovery position. If you or someone close to you takes a blood thinner, or has already had a TIA, that is exactly what a responder needs to know — you can create your emergency profile in a few minutes.
Stroke FAQs
What are the signs of a stroke?
Use the FAST test. Face: has their mouth drooped on one side? Arms: can they lift both, or is one weaker? Speech: is it slurred, and do they understand you? Time: any one of these signs means call 000 immediately. Other signs include numbness or weakness on either or both sides, dizziness or an unexplained fall, loss or blurring of vision, a severe or unusual headache, difficulty swallowing, and confusion or drowsiness.
Should you give aspirin to someone having a stroke?
No. This is the opposite of the advice for a suspected heart attack. Roughly one stroke in five is caused by bleeding in the brain rather than a clot, and nobody can tell which without a CT scan. Aspirin thins the blood, so giving it during a bleed makes it worse. Australian first aid guidance for stroke does not include aspirin. Call 000 and let the hospital decide.
What should you do while waiting for the ambulance?
Stay with the person, keep them calm, and note the time the symptoms started or when they were last seen normal. Give them nothing to eat or drink, because a stroke can impair swallowing. Do not give any medication. If they are unconscious but breathing normally, lay them on their side with a clear airway. If they are not breathing normally, start CPR. Gather their medication list if you can do so without leaving them.
What if the stroke symptoms go away on their own?
Still call 000. Australian guidance says to send for an ambulance immediately even if the symptoms were brief or have fully resolved, because it may have been a transient ischaemic attack, or mini stroke. The Stroke Foundation describes a TIA as a warning that a stroke may be coming and an opportunity to prevent it. Waiting to see how you feel later wastes that opportunity.
What is the difference between a stroke and a heart attack?
A stroke interrupts blood flow in the brain and shows up as facial droop, one-sided weakness, slurred speech or confusion. A heart attack interrupts blood flow to the heart muscle and shows up as chest pain or tightness, often spreading to the arm, neck or jaw. The critical practical difference is aspirin: Australian first aid guidance suggests it for a suspected heart attack, but not for a stroke.
Are stroke symptoms different in women?
No. According to the Better Health Channel the signs of stroke are the same for men and women, so FAST applies equally. What differs is risk and awareness: stroke is the second biggest killer of Australian women and kills more women than breast cancer, some risk factors are specific to women such as pregnancy, some oral contraceptives and the fall in oestrogen after menopause, and many women do not know the FAST signs well enough to recognise them.
Can low blood sugar be mistaken for a stroke?
Yes, and closely. Australian resuscitation guidance recommends the FAST test specifically for situations where measuring blood glucose is not possible, which acknowledges that a hypoglycaemic episode can look like a stroke. If the person has diabetes, mention it when you call 000. Either way the call is the right move.
Sources
- Stroke Foundation — Signs of stroke — the F.A.S.T. test, the additional signs, and TIA as a warning and an opportunity.
- ANZCOR Guideline 9.2.2 — Stroke — FAST wording, calling an ambulance even if symptoms resolve, nothing by mouth, positioning, and FAST where blood glucose cannot be measured.
- Better Health Channel — Women and stroke — signs being the same for men and women, women-specific risk factors, and stroke mortality in Australian women.
- healthdirect — Stroke — symptoms, the FAST test and treatment overview.
- Triple Zero (000) — when and how to call.
Disclaimer: This article is general first aid information, not medical advice or a substitute for accredited first aid training. In an emergency, always call Triple Zero (000). For non-urgent health advice, call healthdirect on 1800 022 222 (NURSE-ON-CALL 1300 60 60 24 in Victoria, 13 HEALTH 13 43 25 84 in Queensland) or speak with your GP. Never give, withhold or change a medication on the basis of a web page. MedibandPlus stores and provides access to a member’s own medical information; it does not assess, diagnose or treat any condition.
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