There’s a phrase every stroke specialist lives by: “Time is brain.” During a stroke, the brain loses about 1.9 million neurons every minute that blood flow is blocked. That’s why stroke is one of the few medical emergencies where every second of delay translates directly into permanent disability — or death.
This guide from ER of Mesquite walks you through how to spot a stroke using the FAST method, what to do the moment you suspect one, and what happens when you reach the emergency room. The single most important thing to know upfront: if you suspect a stroke, call 911 immediately — don’t drive yourself or the person having symptoms. Paramedics can start the lifesaving workup en route to the ER.
1. What Is a Stroke?
How a Stroke Damages the Brain
A stroke happens when blood flow to part of the brain is suddenly interrupted — either by a clot blocking an artery or a blood vessel rupturing. Brain tissue starts dying within minutes because brain cells can’t survive without oxygen and glucose. The longer the blockage or bleeding continues, the more damage occurs and the harder it becomes to recover lost function.
The Three Types of Stroke
| Stroke Type | What Happens | How Common | Treatment Focus |
| Ischemic | Blood clot blocks an artery to the brain | 87% of strokes | Clot-busting drugs (tPA) or removal |
| Hemorrhagic | Blood vessel ruptures inside the brain | 13% of strokes | Control bleeding, reduce pressure |
| TIA (Mini-Stroke) | Temporary blockage that clears on its own | 1 in 3 leads to full stroke | Prevent the next stroke from happening |
Why “Time Is Brain” — The Treatment Window
For ischemic strokes, the clot-busting medication tPA (tissue plasminogen activator) works best when given within 3 to 4.5 hours of symptom onset. Mechanical clot removal (thrombectomy) can sometimes be performed up to 24 hours later — but earlier is always better. Every 15-minute delay in tPA treatment reduces a patient’s chance of walking out of the hospital without disability.
This is why the question “When did symptoms start?” is the most important question a paramedic or ER physician will ask. Note the exact time symptoms began, or the time the person was last seen normal — it determines what treatment is possible.
2. Recognizing Stroke Symptoms — The FAST Method
FAST is the gold-standard stroke recognition tool, taught to first responders and the public worldwide. It captures the most common stroke signs in four letters anyone can remember.
| Letter | What It Means | How to Test |
| F | Face drooping | Ask them to smile — does one side droop? |
| A | Arm weakness | Ask them to raise both arms — does one drift down? |
| S | Speech difficulty | Ask them to repeat a simple phrase — is it slurred? |
| T | Time to call 911 | If ANY sign is present, call 911 immediately |
F — Face Drooping
Ask the person to smile. In a stroke, one side of the face often droops, looks numb, or feels unequal. A smile that looks lopsided or crooked is a strong warning sign.
A — Arm Weakness
Ask the person to raise both arms straight out in front of them and hold them there. If one arm drifts downward, can’t be lifted at all, or feels numb or weak, suspect a stroke.
S — Speech Difficulty
Ask the person to repeat a simple sentence like, “The sky is blue today.” Stroke speech changes include slurring, garbling, using wrong words, or being unable to speak at all. Difficulty understanding what others are saying is also a sign.
T — Time to Call 911
If ANY of the above signs are present — even just one — call 911 immediately. Note the exact time you first noticed symptoms. Don’t wait to see if symptoms improve. Don’t drive yourself or the patient. Paramedics will begin the stroke workup the moment they arrive and notify the receiving ER that a stroke patient is incoming.
Beyond FAST — The BE FAST Extension
Some experts recommend BE FAST, which adds two earlier warning signs:
- B — Balance: Sudden loss of balance, coordination, or dizziness
- E — Eyes: Sudden blurred vision, double vision, or vision loss in one or both eyes
Sudden Symptoms That Often Get Dismissed
Strokes don’t always present like the textbook picture. Other stroke symptoms include:
- Sudden severe headache with no known cause — the “worst headache of my life”
- Sudden confusion or trouble understanding
- Sudden numbness or weakness on one side of the body
- Sudden trouble walking, dizziness, or loss of coordination
- Sudden nausea, vomiting, or loss of consciousness
The key word is sudden. Stroke symptoms appear out of nowhere — within seconds to minutes. They’re not gradual, and they’re not subtle once you know what to look for.
| ⚠️ Suspect a stroke? CALL 911 IMMEDIATELY. Don’t drive yourself or the person having symptoms. Paramedics begin the stroke workup en route and notify the ER you’re coming. Time is brain — every minute matters. Note the exact time symptoms started. |
3. Stroke Symptoms by Demographic
Stroke Symptoms in Women — Often Different
Women are more likely to die from a stroke than men — partly because their symptoms are often misdiagnosed as something else. In addition to the FAST signs, women may experience:
- Sudden hiccups or nausea
- General weakness or fatigue
- Chest pain or shortness of breath
- Sudden behavior changes, agitation, or hallucinations
- Pain in the face, arm, or leg
These atypical symptoms often get attributed to anxiety, migraine, or menopause — costing critical time. If you have any sudden neurological symptoms, take them seriously.
Stroke Symptoms in Young Adults & Children
Strokes in adults under 50 are rare but rising — and frequently missed because doctors and patients assume “too young to have a stroke.” Causes can include cardiac issues, blood clotting disorders, recreational drug use, neck trauma (sometimes from chiropractic manipulation), and pregnancy-related complications. Children can have strokes too — caused by sickle cell disease, congenital heart defects, or unusual clotting conditions. The same FAST symptoms apply at any age.
Stroke Symptoms in Older Adults
Stroke risk doubles every decade after age 55. Older adults may have classic FAST symptoms, but they can also present with sudden confusion that gets dismissed as “normal aging” or dementia. Any sudden change in mental status, balance, or speech in a senior should be treated as a possible stroke until proven otherwise.
4. Mini Stroke (TIA) — The Warning You Can’t Ignore
What Makes a TIA Different From a Full Stroke
A transient ischemic attack (TIA) — often called a “mini-stroke” — happens when blood flow to part of the brain is briefly blocked but resolves on its own. Symptoms look identical to a full stroke but typically clear within minutes to hours, usually under 24 hours, with no obvious lasting damage.
Why Most People Who Have a TIA Will Have a Full Stroke
Here’s the most important fact about TIAs: about 1 in 3 people who have a TIA will go on to have a full stroke — and roughly half of those happen within 48 hours of the original TIA. A TIA is your brain’s warning that a full stroke is coming. Ignoring it is one of the most dangerous things you can do.
TIA Is Always an Emergency
Even if symptoms have completely resolved, a TIA requires immediate emergency evaluation. The ER will run the same workup as for a full stroke — CT scan, blood tests, EKG — to identify the cause and start preventive treatment that can stop the next stroke before it happens. Never “wait and see” after stroke-like symptoms, even when they go away.
5. What to Do — and NOT Do — During a Suspected Stroke
Step-by-Step: Call 911 Immediately
- Call 911. Don’t text, don’t post, don’t Google — call.
- Note the exact time symptoms started, or the time the person was last seen normal.
- Help the person sit or lie down in a comfortable position, ideally on their side if they’re vomiting or unconscious.
- Keep them calm and stay with them.
- Gather their medications and medical history if possible — paramedics will ask.
- Wait for paramedics. Do not drive them yourself.
What to Tell the 911 Dispatcher
Be ready to share:
- Specific symptoms you’re seeing (face drooping, weakness, speech changes)
- Exact time symptoms started, or last known normal time
- Person’s age, medical conditions, and medications
- Whether they take blood thinners (important for tPA decisions)
- Your exact location
What to Do While Waiting for Paramedics
- Unlock the front door so EMS can enter quickly
- Move pets to another room
- Don’t give the person food, water, or medication unless instructed
- If the person stops breathing, begin CPR
- Watch for changes and be ready to report them
What NOT to Do
- Don’t drive yourself or the patient. You may have a stroke en route, get into an accident, or remove the patient from the tPA treatment window.
- Don’t wait to see if symptoms go away. Even resolving symptoms (TIA) need emergency evaluation.
- Don’t give aspirin without medical guidance. Unlike heart attack, aspirin can be harmful in hemorrhagic stroke. Only paramedics or ER staff should decide.
- Don’t let the person sleep “to feel better.” Sleep delays treatment and obscures the time of onset.
- Don’t give food or water. Strokes often impair swallowing, risking choking and pneumonia.
6. Common Causes & Risk Factors
Modifiable Risk Factors — What You Can Control
- High blood pressure — the #1 risk factor; controlling BP cuts stroke risk dramatically
- Atrial fibrillation (AFib) — irregular heartbeat that can throw clots; major cause of strokes
- Diabetes — damages blood vessels and raises clotting risk
- Smoking — doubles stroke risk; quitting cuts risk within years
- High cholesterol — builds plaque in arteries
- Obesity & sedentary lifestyle — compound other risk factors
- Excessive alcohol use — more than 2 drinks per day raises risk
- Use of stimulant drugs (cocaine, methamphetamine) — major cause of stroke in young adults
Non-Modifiable Risk Factors
- Age — risk doubles every decade after 55
- Family history — stroke or heart disease in close relatives
- Gender — men have higher rates earlier in life; women’s lifetime risk is higher
- Ethnicity — African Americans, Hispanics, and Native Americans have higher rates
- Previous stroke or TIA — a major predictor of future stroke
Lifestyle Factors That Increase Risk
- Diet high in saturated fat, sodium, and processed foods
- Lack of regular physical activity
- Chronic stress without management
- Poor sleep or untreated sleep apnea
Medical Conditions That Raise Stroke Risk
- Carotid artery disease
- Coronary artery disease and previous heart attack
- Sickle cell disease
- Blood clotting disorders
- Migraine with aura
- Recent pregnancy or hormone-related conditions
7. Stroke Emergency Care at ER of Mesquite
When paramedics bring a suspected stroke patient to ER of Mesquite — or when someone walks in with stroke symptoms — every second matters. Our stroke protocol activates immediately upon arrival.
Our 24/7 Stroke Protocol
The moment a possible stroke is identified, a board-certified emergency physician takes over with a parallel workup: focused neurological exam, immediate CT imaging, blood work, EKG, and IV access — all happening simultaneously to compress the time from arrival to treatment decision.
Diagnostic Tools — Hospital-Grade, On-Site
- CT scan — the first and most important test; distinguishes ischemic from hemorrhagic stroke and guides every treatment decision. Learn about our CT scan services.
- EKG / ECG — checks for atrial fibrillation and cardiac causes of stroke. Learn about our EKG services.
- Blood work — glucose, clotting factors, kidney function — all needed to determine if tPA is safe to give. Learn about our certified laboratory services.
- Neurological assessment — measures stroke severity using validated scales (NIHSS).
Treatment Pathways & Hospital Transfer
As a freestanding emergency room, our role in stroke care is rapid stabilization, diagnosis, and arranging immediate transfer to a comprehensive stroke center when advanced interventions like mechanical thrombectomy are needed. Our team:
- Stabilizes the patient — IV access, oxygen, blood pressure control, and seizure prevention.
- Starts IV fluids and supportive care. Learn about our IV fluids and antibiotics services.
- Administers IV tPA when appropriate and within the treatment window — under strict protocols.
- Coordinates rapid transfer to partner stroke centers for advanced procedures (mechanical clot removal, neurosurgery for hemorrhagic strokes).
- For more information, see our heart attack and stroke treatment services.
What to Expect From Walk-In to Discharge or Transfer
If your symptoms turn out to be a TIA or mild stroke that doesn’t require comprehensive stroke center care, we’ll stabilize, treat, observe, and coordinate appropriate follow-up. If advanced intervention is needed, expect rapid coordination with partner hospitals and an organized handoff — minutes count, and the ER of Mesquite team is built to move fast.
8. Recovery & Life After Stroke
The Early Recovery Window
The first 3–6 months after a stroke are the most important for recovery. The brain has the most neuroplasticity during this window — meaning it’s most capable of rewiring itself and reclaiming lost function. Aggressive early therapy makes a measurable difference for years afterward.
Common Effects of Stroke
- Physical — weakness or paralysis on one side, balance problems, difficulty swallowing
- Cognitive — memory problems, difficulty concentrating, slower processing
- Speech & language — aphasia (difficulty producing or understanding language), slurred speech
- Emotional — depression, anxiety, mood swings, post-stroke fatigue
- Sensory — numbness, vision changes, neglect of one side
Rehabilitation — Physical, Occupational & Speech Therapy
Stroke rehabilitation is interdisciplinary. Physical therapy restores movement and strength. Occupational therapy helps regain independence in daily tasks like dressing, cooking, and bathing. Speech therapy addresses communication and swallowing. Most stroke survivors benefit from a combination, starting within days of the event and continuing for months to years.
Preventing a Second Stroke
After a first stroke, the risk of a second is significantly higher. Prevention includes:
- Tight blood pressure control
- Daily aspirin or other antiplatelet medication (under doctor guidance)
- Anticoagulant medications for AFib patients
- Statins for cholesterol management
- Diabetes control
- Smoking cessation
- Regular exercise as approved by your medical team
- Heart-healthy diet (Mediterranean or DASH)
9. Don’t Wait — Act FAST and Get Stroke Emergency Care
During a stroke, every minute counts. The single most important thing to know: call 911 at the first sign of stroke symptoms. Don’t drive yourself. Don’t wait to see if symptoms improve. Don’t “sleep it off.” Paramedics begin the stroke workup en route, alert the receiving ER, and dramatically increase the chance of full recovery.
At ER of Mesquite, board-certified emergency physicians are on duty 24 hours a day with hospital-grade CT imaging, rapid lab capability, and established transfer protocols to comprehensive stroke centers when advanced care is needed. We’re built for the kind of emergency where seconds shape the rest of your life.
| 🚨 If you suspect a stroke — Call 911 First Call 911 immediately — do not drive yourself or the person having symptoms. Note the exact time symptoms began. This determines treatment eligibility. Once stabilized, you may be brought to ER of Mesquite at 1745 N Belt Line Rd, Mesquite, TX Phone: (214) 377-8495 (after 911) Hours: Open 24 hours a day, 7 days a week, 365 days a year Insurance: All major commercial insurance accepted |
Frequently Asked Questions About Stroke
How do I know if I’m having a stroke?
Use the FAST test — Face drooping, Arm weakness, Speech difficulty, Time to call 911. If you suddenly experience any combination of these, plus sudden vision changes, balance loss, severe headache, or confusion, call 911 immediately. Don’t wait to confirm — paramedics and ER staff can sort it out, but only if you act fast.
Can a stroke happen during sleep?
Yes — about 1 in 5 strokes happens during sleep. The challenge is that the “time of onset” defaults to the last known normal time (often when the person went to bed), which can push the treatment window past tPA eligibility. If you wake up with any FAST symptoms, call 911 immediately.
What’s the difference between a stroke and a heart attack?
| Feature | Stroke | Heart Attack |
| What’s Blocked | Blood flow to the brain | Blood flow to the heart |
| Main Symptoms | Face drooping, arm weakness, speech difficulty | Chest pain, shortness of breath, arm/jaw pain |
| Pain | Usually painless | Usually painful or pressure-like |
| Treatment Window | Best within 3–4.5 hours | Best within 60–90 minutes |
| Immediate Action | Call 911 — don’t drive yourself | Call 911 — chew aspirin if advised |
Both are emergencies, both involve blocked blood flow, and both require calling 911 — but they affect different organs and need different treatments. Learn more about heart attack symptoms and treatment.
Can young people have strokes?
Yes. About 10–15% of strokes happen in adults under 50, and rates in young adults are rising. Causes include hypertension, drug use, blood clotting disorders, neck trauma, pregnancy complications, and cardiac conditions. Children can also have strokes, though it’s rare. The same FAST symptoms apply at any age.
Should I take aspirin if I think I’m having a stroke?
No — not without medical guidance. Unlike heart attacks, where aspirin can help, strokes come in two types: ischemic (clots) and hemorrhagic (bleeding). Aspirin worsens bleeding. Until imaging confirms which type of stroke you’re having, don’t take aspirin. Wait for paramedics and ER staff to decide.
Will my insurance cover an ER visit for stroke symptoms?
Most commercial insurance plans cover emergency stroke evaluation and treatment. ER of Mesquite accepts all major commercial insurance plans. Visit our insurance coverage page or learn about our no surprise billing policy for full details. We also offer flexible payment plans for uninsured patients.
How fast can I be seen at ER of Mesquite for a stroke?
Stroke is our highest-priority complaint. Whether you arrive by ambulance or walk-in, evaluation begins within minutes, with CT imaging started immediately to determine stroke type and treatment options. No triage backups, no overcrowded waiting rooms — just rapid, board-certified emergency care designed to compress every minute that matters.