Stroke Self-Testing: Is It Possible?

Stroke is a medical emergency that requires immediate attention. It is the fifth leading cause of death and a leading cause of disability in the US. It is vital to know how to spot the signs of a stroke in yourself or someone else. Doctors have developed an easy-to-remember checklist called the FAST test to check for the most common symptoms of a stroke. F stands for face – to check for muscle weakness or paralysis, ask the person to smile and see if one side of the face droops. A stands for arms – ask the person to raise both arms to check for one-sided weakness. S stands for speech – check for slurred or strange speech. T stands for time – if the answer to any of these is yes, call 911 right away.

The FAST acronym

• F = Face: Ask the person to smile and check if one side of their face droops or is numb. This could be a sign of muscle weakness or paralysis, which often shows up on just one side of the body.
• A = Arms: Ask the person to raise both arms. Does one arm drop down? This could be another sign of one-sided weakness.
• S = Speech: Ask the person to repeat a simple phrase and check for slurred or strange speech. A stroke can cause difficulties in speaking clearly or understanding speech.
• T = Time: If the person exhibits any of the above symptoms, call the emergency services right away. Remember to note the time and write down when you first noticed any of these stroke warning signs.

Some health educators add two more steps to the checklist, calling it BE FAST or FASTER. "B" stands for balance, and "E" stands for eyes, as sudden loss of vision or blurred vision can be a symptom of a stroke.

Face weakness

F—Face

• Ask the person to smile.
• Check if one side of their face droops or looks numb.
• Is their smile uneven?

If you are testing yourself, try to be aware of any asymmetry in your face. For example, when talking, chewing, or smiling, check if one side of your face is not matching the other.

A—Arms

• Ask the person to raise both arms and keep them there.
• Does one arm drift downward?
• Can they lift one arm higher than the other?

S—Speech

• Ask the person to repeat a simple phrase.
• Does their speech sound slurred or strange?
• Can they even repeat the phrase?

T—Time

If you or the person you are testing exhibit any of the above, call the emergency services immediately. Note the time when any symptoms first appear. This information will help health care providers determine the best treatment.

Arm weakness

The FAST acronym (Face, Arms, Speech, Time) is a widely recognised test to quickly identify the three most common signs of a stroke. Arm weakness is the 'A' in this acronym.

To test for arm weakness, ask the person in question to raise both arms fully and keep them there. If one arm is weak or numb and drifts downward, this could be a sign of a stroke. If blood flow to the left side of the brain is compromised, the person will experience difficulty with their right arm; if blood flow to the right side of the brain is affected, the person will struggle with their left arm. This is because the frontal lobe, which is responsible for motor control of voluntary muscles, may be affected during a stroke.

It is important to remember that arm weakness is just one of the signs of a stroke. Other symptoms include face weakness, speech problems, sudden blurred vision or loss of sight, sudden memory loss or confusion, and a severe headache. If you or someone else is experiencing any of these symptoms, call 999 or 911 immediately.

Speech problems

To test for speech problems, ask the person to repeat a simple phrase. Check for slurred speech or strange speech. Listen for mumbling or robotic-sounding speech. Pay attention to the volume and pace of their speech. Do they sound too loud or too quiet? Are they speaking too fast or too slow? Are they having trouble producing certain sounds? Can they understand what you are saying?

If the person is showing any of these signs, it could be a sign of aphasia, dysarthria, or apraxia of speech, which are common after a stroke. Aphasia is a difficulty with verbalizing thoughts or understanding others. Dysarthria is weakness or incoordination of the muscles involved in speech. Apraxia of speech is when the brain has difficulty telling the muscles how to move when speaking.

If you or someone else is experiencing these symptoms, it is important to seek medical attention right away. Early treatment can improve the chances of survival and recovery.

When to call 999

Stroke is a medical emergency. If you suspect that you or someone else is having a stroke, it is important to act quickly and call 999 immediately. Remember the acronym FAST:

• Face: Check for face drooping. Ask the person to smile and observe if one side of their face droops or is numb.
• Arm: Check for arm weakness. Ask the person to raise both arms and observe if one arm drifts downward or if they are unable to lift one side.
• Speech: Check for speech difficulty. Ask the person to say a simple phrase and listen for slurred or strange speech.
• Time: If the person shows any of these signs, it's time to call 999 right away. Make a note of the time when the symptoms first appeared.

Other warning signs of a stroke include:

• Weakness or numbness, especially on one side of the body, including legs, hands, or feet.
• Difficulty finding words or speaking in clear sentences.
• Sudden blurred vision or loss of sight in one or both eyes.
• Sudden memory loss or confusion.
• Sudden dizziness, unsteadiness, or a sudden fall.
• A sudden, severe headache with no apparent cause.

If you observe any of these signs, don't delay. Call 999 immediately, as every minute counts in treating a stroke. Ambulance paramedics are trained in stroke care and will ensure the person receives the necessary emergency medical attention and specialist treatment.

It is also important to note that a transient ischemic attack (TIA) or mini-stroke is a medical emergency. If you or someone else experiences stroke-like symptoms that pass quickly, it could be a TIA. Even if the symptoms resolve within a short time, seek urgent medical attention by calling 999. A TIA is a warning sign that you are at risk of having a full stroke, and early intervention is crucial to reduce that risk.

Frequently asked questions