How Can You Recognise the Signs of a Stroke Using the FAST Test?

Many years ago, while working as a probationary ambulance officer, I attended my first stroke patient.

The patient was an elderly gentleman who had rarely been ill throughout his life. His wife became concerned when she noticed a sudden change in his ability to communicate and immediately called an ambulance.

To paint a picture, the couple were washing up after dinner when he attempted to ask for another plate. Instead of speaking, only a husky breath came out. He had no obvious weakness, no facial droop, and no other classic signs of stroke—he simply couldn’t speak.

When we arrived, we conducted an assessment, checked his blood glucose levels to rule out low blood sugar, provided appropriate care, and transported him to a suitable hospital for further treatment.

This experience highlighted an important lesson that every first aider should remember.

Do All Strokes Present With Classic Symptoms?

No.

Many people associate stroke with sudden weakness or paralysis on one side of the body. While these symptoms are common, strokes can present in many different ways.

Some people may experience:

• Difficulty speaking
• Slurred speech
• Facial drooping
• Weakness in one arm
• Sudden confusion
• Loss of balance or coordination
• Changes in vision

In this case, the patient showed only one symptom: an inability to speak normally.

That’s why recognising the signs early is so important.

What Is the FAST Stroke Assessment?

The FAST test is a simple and effective assessment tool that helps first aiders identify potential stroke symptoms quickly.

Even before FAST became widely adopted, ambulance officers were assessing the same key indicators because they are often the earliest signs of a stroke.

Remembering FAST could help save a life.

What Does FAST Stand For?

F – Is There Any Facial Drooping?

Ask the person to smile or show their teeth.

Look carefully at their face.

Questions to consider:

• Is one side of the face drooping?
• Does the smile appear uneven?
• Is there weakness around the mouth or eye?

Facial weakness is one of the most common signs of stroke.

A – Can They Raise Both Arms Equally?

Ask the person to raise both arms above their head at the same time.

Observe whether:

• One arm drifts downward
• One arm feels weaker
• They struggle to lift one arm

Arm weakness may indicate that a stroke is affecting one side of the body.

S – Is Their Speech Slurred or Unusual?

Ask the person a simple question.

For example:

“Can you tell me your name?”

Listen carefully for:

• Slurred speech
• Difficulty finding words
• Confusion
• Inability to speak

Speech problems can be one of the earliest and most obvious indicators of a stroke.

As I learned from my first stroke patient, speech difficulties may sometimes be the only symptom present.

T – Is It Time to Call 000?

If the person shows any of the FAST signs, it is time to act immediately.

Call 000 and request an ambulance.

Stroke is a medical emergency, and early treatment can significantly improve outcomes and reduce long-term disability.

The faster a person receives specialist medical care, the greater their chance of recovery.

What Information Should You Give Emergency Services?

When calling 000, try to provide:

• The person’s age
• The symptoms observed
• When the symptoms first started
• Any known medical conditions
• Any medications they take

The time symptoms began is particularly important because it may influence treatment options once the patient reaches hospital.

Why Is Early Stroke Recognition So Important?

Every minute matters during a stroke.

When blood flow to the brain is interrupted, brain cells begin to die. Quick recognition and prompt medical treatment can help minimise damage and improve recovery outcomes.

That’s why first aiders play such an important role.

By recognising the signs early and acting quickly, you may help save a person’s life or reduce the long-term effects of a stroke.

How Can First Aiders Remember the FAST Test?

The FAST assessment remains one of the easiest and most effective ways to identify potential stroke symptoms.

Remember:

• F – Face
• A – Arms
• S – Speech
• T – Time

If any of these signs are present, call 000 immediately.

It only takes a few seconds to perform the FAST test, but those few seconds could make all the difference.

Written by Steve Riley