👤 By the CinnaEMS Content Team🕐 Updated 2026-09-27🏷️ Secondary Assessment🔖 Free to read, print, and share
Also known as: CVA · stroke · TIA · BE-FAST · last known well · seizure · postictal · status epilepticus
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Use this quick-reference guide to recognise, treat and hand over Stroke & Seizures on the NREMT and on the call. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Stroke
BE-FAST screen
Last known well = the clock
Check glucose
📌 Seizure
Protect the head
Nothing in the mouth
Never restrain
✅ After
Recovery position · suction
Confusion should clear
📌 Critical
5 min or back-to-back → status
Seizure in pregnancy → eclampsia
📚 Stroke & Seizures — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what changes the plan, and what to hand over.
Stroke care is a race against the clock, so the exam checks fast recognition, the time last known well and ruling out low blood sugar. Seizure care is mostly protection: keep the patient from harm, support the airway afterward and recognize when a seizure will not stop.
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Key points
Understand these first
Stroke screen: face droop, arm drift, speech trouble — plus balance and eyes (BE-FAST).
Time last known well is the clock, not the time the symptoms were found.
Check blood glucose — low sugar can mimic a stroke exactly.
During a seizure: protect the head, move hazards away, nothing in the mouth, never restrain.
After a seizure: recovery position, suction as needed, expect confusion that slowly clears.
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Treatment priorities
What to do, in order
Positive stroke screen: short scene time and early notification of the receiving facility.
Status epilepticus: seizure lasting 5 minutes or repeated without waking — treat as critical.
Give oxygen only for low saturation or distress; support ventilation if breathing is inadequate.
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Red flags — report now
Escalate immediately
Symptoms that fully resolved (TIA) — still a stroke warning
Sudden worst headache of life
A seizure in pregnancy (eclampsia)
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Patient teaching
What patients must know
A postictal patient improves over minutes; a patient who does not improve needs a new cause.
Weakness on one side after a seizure can occur, but assume stroke until proven otherwise.
❓ Stroke & Seizures: NREMT FAQs
What are the priority actions for Stroke & Seizures in the field?
Positive stroke screen: short scene time and early notification of the receiving facility. Status epilepticus: seizure lasting 5 minutes or repeated without waking — treat as critical. Give oxygen only for low saturation or distress; support ventilation if breathing is inadequate.
What findings in Stroke & Seizures change your plan or your transport decision?
Symptoms that fully resolved (TIA) — still a stroke warning. Sudden worst headache of life. A seizure in pregnancy (eclampsia).
What do I need to know about Stroke & Seizures for the NREMT?
Stroke screen: face droop, arm drift, speech trouble — plus balance and eyes (BE-FAST). Time last known well is the clock, not the time the symptoms were found. Check blood glucose — low sugar can mimic a stroke exactly. During a seizure: protect the head, move hazards away, nothing in the mouth, never restrain.
What should the crew communicate or document for Stroke & Seizures?
A postictal patient improves over minutes; a patient who does not improve needs a new cause. Weakness on one side after a seizure can occur, but assume stroke until proven otherwise.
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Quick Tip
Stroke screen: face droop, arm drift, speech trouble — plus balance and eyes (BE-FAST).