A stroke is blood not reaching part of the brain. About two million brain cells die every minute it continues. The treatment that dissolves the clot works best inside four and a half hours of the first sign, so a stroke is a race, and the race starts at the moment somebody notices, not the moment they decide it is serious.
BE-FAST: one sign is enough
- B — Balance. Sudden trouble standing or walking, or sudden dizziness.
- E — Eyes. Sudden trouble seeing in one eye or both, or seeing double.
- F — Face. One side of the face droops. Ask them to smile.
- A — Arms. One arm is weak. Ask them to raise both and hold.
- S — Speech. Speech is slurred or the words come out wrong. Ask them to repeat a sentence.
- T — Time. Note the time the signs started and go. Say that time at the hospital.
The most important question anyone will ask you
When was the person last seen completely normal? Not when the signs were noticed, when they were last definitely fine. If they woke up like this, the answer is the time they went to bed. The hospital needs this to decide whether the clot-dissolving treatment is still safe, and no scan can tell them instead.
Signs that come and go are still an emergency
Weakness or slurred speech that lasts a few minutes and then passes is a mini-stroke, a TIA. It is a warning shot: a large number of full strokes follow within days. Someone who has recovered completely still needs to be seen the same day.
On the way
- Lay the person on their side if they are not fully awake.
- Give nothing by mouth, not even water. A stroke can stop the swallow working, and the drink goes to the lungs.
- Do not give aspirin. Some strokes are a bleed, and aspirin makes those worse. Let the hospital decide after the scan.
- Take any medicines they are on, especially blood pressure and blood-thinning tablets.
- Go to a hospital that can scan, if one is reachable. A health centre cannot treat a stroke.
What causes most of them here
High blood pressure, by a long way. It has no symptoms until the day it does something like this. A blood pressure check costs almost nothing and takes two minutes, and it is the single most useful thing an adult in Cameroon can do about stroke.
What not to do
- Do not wait to see if it passes.
- Do not give food, drink or medicine by mouth.
- Do not go to a traditional healer first and a hospital after. The hours in between are the treatment window.
