Stroke
Getting medical help for a stroke
Recognising a stroke
Stroke symptoms can vary in type and severity and sometimes people experience unusual symptoms (see 'The event' a stroke or TIA').
The Stroke Association recommend the FAST test to help recognise a stroke.
Use the Face-Arm-Speech Time test (FAST)
Three simple checks can help you recognise whether someone has had a stroke or minor stroke (Transient Ischaemic Attack - TIA).
If you see any of the following signs, call 999 immediately or 112 from a mobile.
F - Facial weakness' Can the person smile? Has their mouth or an eye drooped?
A - Arm weakness' Can the person raise both arms?
S - Speech problems' Can the person speak clearly & understand what you say?
T - Time to call 999.
Although the FAST campaign contains many of the most common signs of stroke, one person felt that it was not comprehensive enough.
Michelle experienced a TIA before her stroke and feels that her symptoms did not correspond to the signs outlined in the FAST campaign.
Michelle experienced a TIA before her stroke and feels that her symptoms did not correspond to the signs outlined in the FAST campaign.
Many people that we spoke to were not aware that they were having a stroke but most knew something was wrong and sought help. Younger people or people that had previously been fit and well did not recognise the symptoms or realise that they could be having a stroke. Those whose stroke had been due to high blood pressure often commented that it was a silent condition with no warning signs [Interview 01]. One older woman thought you would feel worse with a stroke and was surprised when the paramedics said they were taking her to hospital as she felt okay. In some cases, the person recognised they were having a stroke, but experienced long delays in getting help.
Susan recognised that she was having a stroke and called to her husband to get help but her speech impairment made it difficult to get his attention.
Susan recognised that she was having a stroke and called to her husband to get help but her speech impairment made it difficult to get his attention.
He was very appreciative of a friend because she phoned 999 quickly which meant there was little delay in the operation he required for his haemorrhage.
He was very appreciative of a friend because she phoned 999 quickly which meant there was little delay in the operation he required for his haemorrhage.
Well, my stroke was in fact a brain haemorrhage. And, it came upon me without any warning. And I think the most extraordinary thing about it was that it wasn't as if there was any activity I was doing which was likely, or would have been thought likely, to endanger me. I was working very hard. I was approaching my sixtieth year and I wasn't working any harder particularly than I had over a long period of time. But one day I travelled to the North West of England and broke my train journey in order to see and old friend.
I was sitting in her kitchen drinking a cup of coffee and suddenly in the middle of drinking this cup of coffee I became aware that I was loosing my ability to articulate. I didn't know what had happened. In fact I was completely confused and bemused by it. But, the friend of mine who I was sitting with immediately got on her mobile phone to the emergency services and said that, she thought, she was very sorry, but she thought that the person she was just sitting with was having a stroke. And it was at that moment that I thought, 'My goodness, is this what's happening to me?'
Anyway her quickness and her general speed and alacrity of response helped me enormously because it got me into, onto an operating table much faster, I think, than is normally the case. But it think what I take away from that myself is that it is possible to be very ill indeed, suddenly without, even looking back on it, without any warning sign. And I suppose the reason is that what I had wrong with me was very high blood pressure which I now realise having examined this many times doesn't necessarily have any tell tale symptoms. You know, no sort of, no heart flutters, no things like that, no, you know, no obvious precursors to what in the end was a very severe illness.
Her daughter heard that her voice was slurred on the phone and got help. She felt okay and was surprised when the paramedics wanted to take her to hospital.
Her daughter heard that her voice was slurred on the phone and got help. She felt okay and was surprised when the paramedics wanted to take her to hospital.
Well, I got up in the morning and I was feeling OK' and my daughter phones me every morning of course and she phoned but I'd, I got up, been to the toilet, put my dentures in, came through, put the kettle on and I was fine. And then my daughter phoned, I answered the phone, she said, 'Are you feeling OK the day, mum?' I said, 'Yeah.' She said, 'Your voice isn't right.' I said, 'Well, I feel OK'. She said, 'Have you got your dentures in?' I said, 'Yeah'. I said, 'Yeah'. She said, 'Mum, there is something wrong with you, your voice is just not right at all' so that was all I knew' but oh I forgot to tell you this. I have a chain on my door, which I always put on my door. Anyway, my daughter phoned my son and he came right down and on the, his road down, he phoned the ambulance to come and he was only two minutes in but he came to the door and at that time, they didn't all have keys' so , he buzzed of course and I let him in, came up and I tried with my left hand to open, I opened the door, the lock with the right hand, tried to get the thing out, the chain off, just couldn't, couldn't use this hand at all and by that time, he thought, I started crying and I'm saying, 'Oh, there is something wrong here', you know, but he said, 'Mum, can you not open the door?' I said, 'No, it's just the chain'. He said, 'Well, just take your time'. I said, 'OK'.
So then of course the door was open but I managed with this hand but no way was I ever going to get the chain off. So, and of course, by the time I came through here, and I felt this was a bitty different and I looked in the mirror and I saw and of course he told me that the ambulance was coming and I said, 'Well, I'm not going any place'. He said, 'You're going to the hospital mum, there's something far wrong with you' and whenever the ambulance man came in, he said what was my name and that, [my son] said, '[Mum]', ken. 'Mum, [Mum]' and he said, 'Well, Mum' and he said to the other, 'You'll have to go down the stair and get a chair'. I said, 'What for?' I said, 'I'm not going any place, I'm fine.' He said, 'No you're not, I think you've had a stroke' and then of course the tears came and all the rest of it but they were really awfully good, you know. But it was going down the stair, I was like in a push, a push chair like a baby [laughs] but anyway' I still, in my mind, I felt OK but in the ambulance, I felt there was something here, you know, that just wasn't, because this side, there was not a thing but then that was because the nurse said, 'Well, that was because there was nothing here', you know.
Occasionally friends, family and even passers-by spotted that the person was having a stroke. The landlord in a man's local pub had noticed a drop in his face and called an ambulance [Interview 28]. A woman had spoken to her daughter on the phone and the daughter knew something was wrong because her speech was slurred (See Interview 33 above). Several people whose speech had been affected realised they were having a stroke and had written it down to alert others to get help.
The landlord at the local pub noticed his face had dropped on one side and called an ambulance.
The landlord at the local pub noticed his face had dropped on one side and called an ambulance.
Witnessing somebody having a stroke can be a very frightening experience and some people said that those around at the time understandably panicked. People were very appreciative that others had reacted quickly to get help and valued someone taking control of the situation and being calm and supportive until help arrived (See Interview 01 above).
Getting help
Most called 999 for an ambulance or called their general practitioner as soon as they experienced symptoms even if they did not know that it was a stroke.
For those who called an ambulance some experienced a long wait which became quite worrisome. One individual called 999 with much difficulty as he was limited in movement and speech.
Gavin was home alone when he suffered a haemorrhagic stroke. With much difficulty he managed to call 999.
Gavin was home alone when he suffered a haemorrhagic stroke. With much difficulty he managed to call 999.
A few people put off phoning the general practitioner or going to Accident and Emergency (A and E) and some reflected that they should have got help sooner. One man's brother told him he should have phoned straight away as they can do more to help in the first few hours.
His brother told him that he should have phoned the doctor as soon as he felt unwell because more can be done to help in the first few hours.
His brother told him that he should have phoned the doctor as soon as he felt unwell because more can be done to help in the first few hours.
Well, I woke up about 3 o'clock in the morning to go to the toilet, which is just through the door up the stairs and I felt' dizzy, giddy and I wondered what was wrong' then I sort of, sort of looked about me and realised there was something wrong. And I went, 'Right, the best thing I can do is get and lie down' so I just went back to my bed and apparently that's the worst thing you could do because you're supposed to contact the doctor within 2 hours and they've got a better chance of managing to do some more for you that way.
And when you went into the hospital, or first your brother arrived?
Yeah.
Did he know what was happening?
Well, he'd an, he'd an idea I had a stroke, because that's what I said to my brother, that was at 9 o'clock in the morning and he gave me a row because of that. He said, 'You should have phoned the doctor within 2 hours'.
Some people who had phoned their general practitioner had not been able to get help immediately particularly if it was out of hours. One man's wife was told to phone for an ambulance instead which came quickly. People who had contacted their doctor were often still taken to hospital. A few people were not taken to hospital because the stroke was not considered severe - in some cases this led to delays in getting tests and treatment.
Current advice is that everyone should be taken to hospital as soon as possible, regardless of severity of symptoms. If you do not pass the FAST test (see above) dial 999 or 112 from a mobile for an ambulance to get immediate assessment in hospital.
Many people were taken to A & E by ambulance or by a family member. Experiences of A & E varied, some felt that they were given priority because of a suspected stroke others experienced long delays. A woman whose husband had a severe stroke and went to a busy city A & E was frustrated that his form kept getting put back because people with heart attack were a priority.
People were often told that they had a stroke in A & E (see 'Getting a diagnosis').
Health professionals occasionally find it difficult to diagnose the stroke usually when the symptoms are mild or unusual. A woman who was a trained neurologist did not pick up on her mother's stroke until her speech started to become affected even though she suspects the stroke had occurred the previous day. An older woman's doctor was very apologetic that he had missed earlier balance problems which were the start of her stroke, but explained that strokes were sometimes difficult to diagnose.
A Pakistani woman who did not speak English was frustrated because when she went to hospital she was unable to explain her symptoms which she suspected were a stroke.
A woman who only spoke Punjabi knew her symptoms suggested a stroke but could not tell the doctor and was sent home from hospital. (Video & Audio clips in Punjabi)
A woman who only spoke Punjabi knew her symptoms suggested a stroke but could not tell the doctor and was sent home from hospital. (Video & Audio clips in Punjabi)
Translated from Punjabi
When you didn't understand its stroke what did you think was happening?
I did realise it was stroke, doctors wouldn't believe it they said it's nothing.
Did you tell them its stroke?
I don't know English how could I tell them.
Your family?
Family, if someone came with me they could have said.
No one went with you?
My little grandson went with me. The doctor told him her blood pressure is high and we'll get her checked at the hospital. At the hospital they took blood twice and said it's nothing then sent me home.
A few younger people were upset when staff asked them whether they had been using drugs. Although they realised why these question were being asked they felt that they could have been dealt with more sensitively. One woman in her early 30s who had unusual visual symptoms was upset when they kept asking if her husband had hit her.
The staff in A & E did not realise her symptoms were due to stroke because she was young. They kept asking if her husband had hit her.
The staff in A & E did not realise her symptoms were due to stroke because she was young. They kept asking if her husband had hit her.
Right. So we must have went by car to the hospital and I think at that point I still couldn't see a thing. No, I couldn't see a thing at that point. And we went into Casualty Department and I got took in right away and the hospital' were asking me things and I just, you know, my husband told him as well, what I've just said there and it must been throughout that night, I think I got kept in that night. I think throughout that night they were asking me the story over and over again and I was telling them exactly what had happened. I got up, I wasn't feeling too well, had a bit of a sore head, and then it got worse and worse and worse until a few hours later, it got really, really bad and I just told them the story and' they kept asking me if my husband had hit me over the head. At first, they were asking had I banged my head and I kept saying, 'No I have not banged my head, I just have a sore head'. But then they kept saying, 'Are you sure you've not had a bang to the head?' 'No'. Then they would ask my husband to leave the, the room, which I thought was a bit strange [laughter], then they said, 'Did, did your husband leave the room?' I said, 'No, is anybody listening to me, I just had a sore head'. And that went on for quite some time. So the next again morning I got let out and they said on the letter, it was a migraine.
Last reviewed June 2017.
Last updated August 2013
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