If a mouth suddenly droops, one arm goes weak or speech is slurred, call 120 (China's ambulance number) at once; don't wait and don't drive there yourself
- Top value
- Evidence A
- Buys life
- Free
- Takes minutes
- No willpower
In a real emergency, call 911 first, then read this.
In plain words
If the mouth droops, one arm is weak or speech is slurred, call 120 (China's ambulance number) at once. If a stroke can be treated with a drug that opens the blocked vessel, the earlier the treatment, the better the chance of recovery. Past 4.5 hours, or when the time of onset is unknown, don't give up on emergency care; a doctor will examine the person and decide. Note the time the symptoms started, don't give water or pills, and don't drive yourself.
- Cost
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Free. There are three actions, and you can learn them in one reading: have the person smile, raise both arms straight out, and say a full sentence.
- What you get
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A combined analysis (meta-analysis) of individual data from 6,756 patients with acute ischemic stroke in 9 randomized trials of intravenous thrombolysis. Ischemic stroke is a stroke caused by a blocked vessel, and intravenous thrombolysis means giving a drug to open the blocked vessel. The study looked at whether there was significant disability 3 to 6 months later (modified Rankin Scale score 0โ1). With alteplase given within 3 hours of onset, the odds ratio was 1.75, 95% CI 1.35โ2.27 (the plausible range). The actual shares were 32.9% for those given the drug and 23.1% for the controls, a difference of 9.8 percentage points. An odds ratio is not a ratio of probabilities, so it can't be read as a 1.75 times chance of recovery. At 3 to 4.5 hours the odds ratio was 1.26 (1.05โ1.51). After 4.5 hours it was 1.15 (0.95โ1.40); this study found no statistically clear difference. This does not mean treatment is impossible after 4.5 hours. The 2026 guideline of the American Heart Association and American Stroke Association supports extending the thrombolysis window for some patients. Patients whose time of onset is unknown, or who are 4.5 to 9 hours from onset, may still be suitable for thrombolysis after screening with specialized imaging. Whether the drug can be used is for a doctor to assess, and the earlier you get to care the better. A 2017 pre-hospital emergency consensus from the Emergency Medicine Branch of the Chinese Stroke Association (ไธญๅฝๅไธญๅญฆไผๆฅๆๅปๅญฆๅไผ) requires emergency personnel to take a suspected stroke patient "in the shortest possible time to the nearest accredited stroke center, or a hospital that can carry out intravenous thrombolysis and/or endovascular treatment," and to "notify the receiving hospital before the suspected stroke patient arrives." The consensus also states that acute stroke patients may have impaired breathing from causes such as "aspiration"
- Notes
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The earlier thrombolysis is given, the better it works, but don't give up on emergency care just because 4.5 hours have passed. The reason to call 120 and not drive yourself is that, under the pre-hospital emergency consensus, the ambulance crew must take the patient to a hospital that can give thrombolysis and notify it in advance to get ready. Note the exact time the symptoms started, because the doctor uses it to assess the chances of treatment. Don't give water or pills: this is the author's inference from the consensus's "aspiration," since a stroke patient may choke. Don't wait to "rest and see."
- Evidence grade
- A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
- Sources
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- Emberson J, Lees KR, Lyden P, et al. (2014). Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet, 384(9958), 1929-1935. https://doi.org/10.1016/S0140-6736(14)60584-5
- Emergency Medicine Branch of the Chinese Stroke Association (2017). Expert Consensus on Prehospital Emergency Care for Stroke [in Chinese]. Chinese Journal of Emergency Medicine, 26(10), 1107-1114. http://www.cem.org.cn/rhtml/20171002/index.htm
- Prabhakaran S et al. (2026). 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke. Stroke. https://doi.org/10.1161/STR.0000000000000513
- American Heart Association (2026). Top Things to Know: 2026 Guideline for the Early Management of Patients With AIS, point 3. https://professional.heart.org/en/science-news/2026-guideline-for-the-early-management-of-patients-with-acute-ischemic-stroke/top-things-to-know
Mentioned in
- If your heart races or beats irregularly, get an electrocardiogram (ECG); if atrial fibrillation is found, ask a doctor to assess you for an anticoagulant to prevent stroke, and don't use aspirin instead
- Don't count on an AI chatbot to judge your illness or legal problem on its own; before seeing a doctor, going to court or spending big money, find the original source for what it cites and check it
- If there is sudden spinning dizziness with unsteadiness, double vision, blackout in one eye, or the fingertip can't reach your own nose, treat it as a stroke and call 120 (China's ambulance number)
Translated from the Chinese original. Original book, section 13, tip 3. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer