Heart attack and stroke

If you took Strength and Fitness, you've already met this lesson's first list. Its safety box told you to stop training and get help straight away for pain or pressure in the chest, neck, jaw or arms, for dizziness or palpitations, or for breathlessness out of all proportion to the effort, and to call your emergency number for chest pain. That was about your own body. This lesson is about the person in front of you: a father on the stairs, a colleague who says it's only indigestion, a neighbour whose words come out wrong for a minute and then come right.

Heart attack and stroke share one hard fact. The person is often awake and talking, often embarrassed, and hoping it will pass. Your job is short: recognise it, make the call before anyone talks you out of it, and know the one medicine question that comes up in every kitchen, which is aspirin.

The US guidance is the AHA and American Red Cross's 2024 first aid guideline, sections 6.2 and 6.4, which grade every recommendation.¹ The UK guidance is RCUK's 2025 first aid guideline, which adapts the European Resuscitation Council's and prints no grades.²³ Public pages from each country fill in the detail.

Two different emergencies

Lesson 1 promised to separate a heart attack from a cardiac arrest, and the public bodies do it in plain terms.

A heart attack is a blocked blood supply to part of the heart muscle. The NHS says heart attacks are usually caused by a blood clot stopping enough blood getting to the heart, and St John Ambulance says the same.⁵⁷ The American Red Cross says what happens next: the muscle cells in that area do not get the oxygen and nutrients they need, so they are damaged and can die, the heart may stop pumping normally, and if it is not treated it can stop pumping blood altogether.¹⁰

A cardiac arrest, lesson 2's subject, is the heart stopping: the person collapses, does not respond and is not breathing normally. The British Red Cross says a heart attack can lead to cardiac arrest.⁸ The difference that matters to you is that someone having a heart attack may be awake and talking (American Red Cross), while in a cardiac arrest they lose consciousness (NHS). The NHS and the BHF both say plainly that the two are not the same thing.¹⁰⁵⁹

A stroke is the same kind of problem in the brain. St John: the blood supply to the brain is disrupted, and it is caused by either a blockage or a bleed in the brain's blood vessels.⁷ The NHS names the two: an ischaemic stroke, when a clot blocks blood flow to the brain, which is the most common type, and a haemorrhagic stroke, when a blood vessel bursts.⁶ And it names the hospital tests that can show which type someone has had: blood tests, an ECG, and CT, MRI and ultrasound scans.⁶

Hold on to that: the type is something hospital tests show, and nobody at the kitchen table has those tests (this course's inference, not the NHS's words). It comes back with aspirin.

Recognising a heart attack

The AHA/Red Cross guideline gives the common signs as chest pain or pressure, shortness of breath, nausea, sweating, or pain in the jaw, arm(s) or back.¹ The public pages add detail you can use:

• The chest. The NHS says it may feel like crushing or squeezing, spreading to the arm, neck and jaw; the British Red Cross says vice-like, and that it will not ease with rest.⁵⁸ The AHA's warning-signs page adds that it can last more than a few minutes, or go away and come back.¹¹
• Beyond the chest. The NHS lists feeling sick or being sick, sweating, shortness of breath, and pale, blue or grey skin, which on black or brown skin may be easier to see on the palms.⁵ St John adds dizziness, and a feeling of impending doom.⁷
• Not always sudden. The AHA: some heart attacks are sudden and intense, and others start slowly with mild pain or discomfort.¹¹

The ones people talk themselves out of

The NHS lists a symptom that most people would never connect with the heart: "feeling like you have indigestion", with a burning feeling in the chest.⁵ That's the first reason people wait. The second is that the pain isn't where they expect it, or isn't there at all. The AHA/Red Cross guideline's supporting text:

"some people such as women, people who have diabetes, and older people may experience other symptoms, including dyspnea; pain or discomfort in the back, neck, jaw, or stomach; sweating; nausea; or lightheadedness."¹

Dyspnea is breathlessness. The ERC's 2025 chapter gives a figure for women from the European Society of Cardiology, "a quarter of women report jaw pain, nausea or shortness of breath instead of the classic symptoms", and says people with diabetes may feel the pain in the upper stomach, or have shortness of breath.³

Three sources describe women's symptoms differently:

They do not agree on how different women's symptoms are, and you do not need them to. What they share is the practical point: the rule is not "look for the male pattern", and no chest pain, or pain that feels like indigestion, doesn't rule a heart attack out. The American Red Cross adds that some people have no chest pain at all, and its own line is: if you suspect a heart attack, respond as if it is one.¹⁰

What you do

The countries agree on almost every step, so here they are as one list, each with its source.

1. Call first, on speaker. In the US: "In adults with acute chest pain, the emergency response system should be activated to initiate transport to the closest ED by EMS." (AHA/Red Cross 2024, COR 1, LOE C-LD).¹ ED is the emergency department. In the UK, RCUK's steps are to reassure them and sit or lie them comfortably, then "Call 999" (RCUK 2025).² St John adds: tell them you think it's a heart attack.⁷
2. Do not drive them yourself. The American Red Cross says never drive a person to the hospital yourself; the NHS and the BHF tell the person with the symptoms not to take themselves, and the BHF gives the reason: the ambulance team will give the best care and do tests on the way.¹⁰⁵⁹
3. Sit them down. The NHS and St John suggest the floor, knees bent, back or head and shoulders supported; RCUK says sit or lie them in a comfortable position (RCUK 2025); the American Red Cross, stop activity and rest comfortably.⁵⁷²¹⁰
4. Their own medicine. RCUK's line is for "a person with known angina", someone already diagnosed with chest pain from the heart who carries medicine for it: help them take their own nitroglycerine spray or tablets (RCUK 2025).² The NHS calls it glyceryl trinitrate (GTN); the American Red Cross page says to offer to help with prescribed medicine such as nitroglycerin.⁵¹⁰
5. Aspirin, under your country's rule, below.
6. Stay with them (RCUK 2025) and keep checking their breathing and whether they respond (NHS; American Red Cross page).²⁵¹⁰

The British Red Cross gives two reasons for sitting on the floor: sitting eases the strain on the heart, and sitting on the floor means they are less likely to hurt themselves if they collapse.⁸

If they collapse. A heart attack can become a cardiac arrest. If they stop responding and are not breathing normally, it's lesson 2's decision (gasping is not normal breathing): CPR, with the call handler already on the line, and the AED as soon as it arrives (lessons 3 to 5).⁵¹⁰ If they stop responding but are breathing normally, quietly and regularly, it's lesson 7's recovery position, watching the breathing the whole time.

Give a job, not a crowd. Lesson 1's tactic again: one person makes the call and another goes for the nearest AED, which the American Red Cross page says to get or send for.¹⁰

Aspirin

The kitchen argument happens here, and the two countries' wording differs in ways that matter.

In the US. While waiting for EMS, first aid providers "may encourage alert adults experiencing nontraumatic chest pain to chew and swallow aspirin (162–325 mg) unless the person experiencing pain has a known aspirin allergy or has been advised by a health care professional not to take aspirin." (AHA/Red Cross 2024, COR 2b, LOE B-NR; the wording of its take-home message 3).¹

• Dose: 162 to 325 mg. The American Red Cross page spells it out as "two to four low-dose (81-mg) aspirin tablets (162 to 324 mg) or one regular-strength (325-mg) aspirin tablet".¹⁰
• Who: alert adults, with chest pain that is not from an injury. The American Red Cross page adds that the person must be awake, understand simple commands, be able to chew or swallow, and be "allowed to have aspirin", which probably covers the advised-not-to clause, though the page does not say.¹⁰
• If unsure: "If there is any uncertainty that aspirin should be taken, it is reasonable to wait for EMS arrival without administration of aspirin." (AHA/Red Cross 2024, COR 2b, LOE C-EO).¹

In the UK. Call 999, then encourage and assist a person with cardiac sounding chest pain in "self-administering 300 mg of aspirin (ideally chewable or dissolvable) as soon as possible, whilst awaiting emergency assistance (but not to adults with a known aspirin allergy)." (RCUK 2025).²

• Dose: 300 mg (RCUK; NHS; St John; BHF). The British Red Cross: no more than 300 mg in one dose.²⁵⁷⁹⁸
• Who: "cardiac sounding" chest pain, which the ERC's 2025 wording put in place of its 2021 exclusion of pain of unclear or traumatic cause.²³ St John: not for anyone under 16.⁷
• If unsure: RCUK's page has no line for uncertainty. The ERC's evidence text makes an exception for "a potential contraindication such as aspirin allergy", and the NHS says the person you speak to at 999 will give you advice about what to do.³⁵

The two US figures aren't a slip: four 81 mg tablets make 324, and one US regular-strength tablet is 325.¹¹⁰ The ERC's European guideline gives a wider range, 150 to 500 mg of chewable aspirin, and RCUK's 300 mg sits inside it.³ Follow the figure for the country you are in, which is the one your call handler and your class use.

Every one of these puts the call first. Aspirin is what happens while you wait, never instead of the call and never before it.

How strong is it?

Lesson 4's grading key applies. COR 2b is the AHA's "may be considered" class, and the guideline's verb, "may encourage", matches it. ILCOR, whose review both countries build on, carries forward its 2019 recommendation for adults with nontraumatic chest pain: "we suggest the early administration of aspirin as a first aid intervention compared with late, in-hospital, administration of aspirin", a weak recommendation on very low certainty evidence.⁴

Read the comparison inside that sentence. The question ILCOR graded isn't aspirin or nothing. It's early aspirin against aspirin given later, in hospital. The AHA says aspirin at 162 to 324 mg improves survival in people having a heart attack, and the British Red Cross gives the plain-words reason: it helps thin the blood.¹⁸ What is weak is the evidence that giving it about two hours earlier, from a first aider, adds to that.

For: survival benefit, and no more complications in the studies. For caution: the studies are observational, the aspirin was given by professionals, and chest pain isn't always a heart attack. The AHA's supporting text weighs it in two sentences: harm from aspirin in nontraumatic chest pain is uncommon, but nobody has measured the risk in first aid, so where there is a possible reason not to use it, it's reasonable not to encourage it before EMS arrives.¹ RCUK's page gives no reasoning of its own. The ERC guideline it adapts starts from the same two facts, that harm is uncommon and that no study has measured the risk in first aid, and draws a firmer conclusion: "Therefore, we continue to recommend the early prehospital administration of 150–500 mg aspirin to those with cardiac chest pain, by first aid providers before the arrival of EMS, unless there is a potential contraindication such as aspirin allergy."³ The same evidence and exception, read more cautiously in the US, more firmly in Europe.

Who each sentence is for

Read the verbs, because they aren't all the same. The AHA says a first aider "may encourage" the person; RCUK's wording, which is also the ERC's concise guidance, is "Encourage and assist a person with cardiac sounding chest pain in self-administering", though the ERC's own assessment section says "administer 150–500 mg chewable aspirin".¹²³ The American Red Cross page says "assist them to take" it, and St John speaks to the helper most directly: "Give them one aspirin tablet (300mg) and ask them to chew it slowly."¹⁰⁷ The BHF speaks to the person with the symptoms; the NHS to both: take aspirin (300mg) if you have any, and "do not give aspirin to someone who has an aspirin allergy".⁹⁵

And one sentence from RCUK sits over all of it. Its first aid guideline sets a general principle for first aiders: "As a general principle, only use equipment and medications you have been trained to use." And its exception: "There are occasions when a first aider may be directed to use equipment by the emergency services that they may not have previously had in-depth training on."² RCUK's chest pain steps carry no training condition of their own, and RCUK doesn't say how the principle applies to helping someone take aspirin themselves, so this course won't say it for them. This course's suggestion is practical: in the UK you'll be on the phone to 999 before aspirin comes up, and the call handler is the person to ask. The AHA/Red Cross guideline has no such principle attached to aspirin: its general take-home message is to give care "within their skill and knowledge set", and its aspirin recommendation carries no training condition.¹

Who it is not for

• Anyone allergic to aspirin. The AHA, RCUK, the ERC, the NHS, St John and the BHF all say so; the British Red Cross page does not mention allergy.^1235798
• Anyone not alert enough to chew and swallow safely (AHA/Red Cross 2024's "alert adults"; the American Red Cross's awake, following commands, able to chew or swallow).¹¹⁰
• A suspected heart attack with no chest pain. The two guidelines' aspirin lines are written for chest pain, the AHA's for nontraumatic chest pain and RCUK's for cardiac sounding chest pain, so neither covers it.¹² The American Red Cross page and the NHS, St John, British Red Cross and BHF pages attach aspirin to a suspected heart attack without saying whether chest pain has to be there, and none of them speaks to this case.¹⁰⁵⁷⁸⁹ This course's suggestion is the same as for any doubt: ask the call handler.
• A suspected stroke. Its own section, below.

The stairs in Pittsburgh

A 58-year-old man carries two bags of groceries up the steep steps to his front door in Pittsburgh and stops at the top. He is grey and sweating, with a crushing pain behind his breastbone spreading into his left arm. His daughter is with him.

Danger. None beyond the steps themselves (lesson 2). She gets him to sit down where he is, with his back against the door, so that he is less likely to hurt himself if he collapses (British Red Cross).⁸

The call. 911 on speaker, first (AHA/Red Cross 2024, COR 1).¹ The address, then chest pain, sweating, pain into the arm. A neighbour is sent for the AED at the corner pharmacy, if it has one.¹⁰

Aspirin. He is alert, he can chew, he says he's not allergic, and no doctor has told him not to take it. Under the AHA/Red Cross guideline she may encourage him to chew and swallow 162 to 325 mg (COR 2b): from the Red Cross page, two to four 81 mg low-dose tablets or one 325 mg tablet.¹¹⁰ If he says "I'm not supposed to take that, I think, something about my stomach", she waits for EMS (COR 2b, LOE C-EO).¹

Watch. She stays beside him and watches his breathing and whether he answers her. If he stops responding and is not breathing normally, she starts CPR with the dispatcher coaching, and the neighbour's AED goes on the moment it arrives (lessons 2 to 5).

In Newcastle, the same man would get the same steps with 999, and encouragement and help to take 300 mg himself, ideally a chewable or dissolvable tablet (RCUK 2025).²

Recognising a stroke

The UK and the US guideline both teach one short check. The NHS: "The easiest way to remember these symptoms is the word FAST. This stands for: face, arms, speech and time to call 999."⁶ St John turns each letter into something you do:⁷

• Face. Look at their mouth and eyes: is one side drooping, is the smile uneven?
• Arms. Ask them to raise both arms. They may only manage one.
• Speech. Ask them a question, such as their name. Can they answer clearly, and understand you?
• Time. Call 999 or 112, and say you suspect a stroke.

The NHS lists other signs too: weakness or numbness down one side, blurred vision or loss of sight in one or both eyes, difficulty finding words, confusion and memory loss, dizziness or falling over, a severe headache, and feeling or being sick.⁶ The British Red Cross adds dribbling from the mouth and difficulty keeping balance.⁸

What the guidelines say:

• US: "If stroke is suspected, the EMS system should be activated immediately." (AHA/Red Cross 2024, COR 1, LOE B-NR). And the use of "a stroke recognition scale such as the Face, Arms, Speech, Time (FAST) or Cincinnati Prehospital Stroke Scale is recommended" (COR 1, LOE B-NR).¹
• UK: use a stroke assessment scale such as FAST to recognise it sooner, and call 999 (RCUK 2025).²

They agree. The Cincinnati scale checks the same three things as FAST, and the guideline's supporting text says a 2020 ILCOR review of 9 screening tools in 19 studies found FAST the only one intended for lay people.¹ ILCOR recommends that first aiders use a stroke scale (strong recommendation, low certainty evidence), and in a separate, weak recommendation names FAST among four suitable ones (ILCOR 2025, carrying its 2020 recommendations).⁴

Time, and why it still counts when the signs go away

Two instructions from opposite sides of the Atlantic say the same thing. The American Stroke Association: "Check the time so you'll know when the first symptoms appeared." And: "Call 911 even if the symptoms go away."¹² The NHS: call 999 if you've had signs of a stroke within the last 24 hours, even if they've now stopped, and don't drive yourself to A&E.⁶

Why call for something that is over? Because it may not be over. The ASA calls a transient ischaemic attack, a TIA, a warning stroke: the same symptoms, usually lasting from a few minutes up to 24 hours, which is why people dismiss them. It says TIAs come before about 15% of strokes, and that most of the later problems they're linked to happen within days or weeks.¹² The NHS says a TIA should be treated as urgent, because without immediate medical attention the person could be at risk of a full stroke.⁶ The time you note matters for another reason: the AHA's 2026 stroke message says knowing when symptoms first appeared can support treatment decisions.¹⁴

The ASA's figure for why minutes count is that an average of 1.9 million brain cells die every minute a stroke goes untreated ("nearly 2 million" in its 2026 release).¹²¹⁴ That is the ASA's estimate; this course hasn't read the study behind it.

While you wait

• Nothing to eat or drink. St John's reason: it may be hard for them to swallow.⁷
• Keep them comfortable and supported, and reassure them (St John; the British Red Cross).⁷⁸
• Watch. If they stop responding: breathing normally, lesson 7; not breathing normally, lesson 2.
• Know what can look like a stroke. The AHA/Red Cross guideline says low blood sugar is a common stroke mimic, and that it is reasonable for a first aider with the knowledge and equipment to check blood glucose, if it does not delay the call (COR 2a, LOE C-EO).¹ Lesson 14 teaches low blood sugar. For now, tell the call handler if the person has diabetes.

Children. The guideline says adult scales such as FAST are not validated in children and should not be the only check (COR 3: No Benefit, LOE C-EO), though its take-home message says FAST may be used alongside other signs; it found no children's tool validated for first aid. A child's stroke can show up as numbness or weakness in one part of the body, unsteadiness, or trouble with speech or vision. Or as a sudden or severe headache, a change in alertness or sudden vomiting; because headache and vomiting come with many childhood illnesses, the guideline says to think of stroke when they come with other neurological signs (COR 2a, LOE C-EO). Or as a seizure, especially under 1 year. If you suspect a stroke in a child, call (AHA/Red Cross 2024, COR 1, LOE B-NR).¹

No aspirin for a stroke

No guideline this course read recommends aspirin for a suspected stroke, in either country. Every aspirin recommendation above is written for chest pain.¹²³ None of the stroke sections, US or UK, mentions aspirin at all.¹²³ There is no single sentence that says "never give aspirin for a stroke"; the rule comes from where the aspirin sentences stop.

And there is a reason not to stretch them. A stroke can be a bleed, and the NHS names hospital tests, including scans, as what shows which type someone has had.⁶ The British Red Cross's reason for aspirin in a heart attack is that it helps thin the blood.⁸ The AHA names bleeding risk as one reason someone may not be able to take aspirin even for chest pain.¹ None of the texts read here spells out what aspirin does to a bleed in the brain, so this course does not either. It's enough that nobody at the scene can know which kind of stroke it is, and that no guideline asks you to guess.

So this course's rule, drawn from those texts: if someone has chest pain and stroke signs together, the stroke signs win. Tell the call handler both, and give no aspirin unless the call handler tells you to.

FAST or BE-FAST

In the US, you may have seen a longer version. It's a real disagreement, handled differently on each side of the Atlantic, and nobody in it is being careless.

In January 2025 the ASA wrote that it "currently utilizes the F.A.S.T. acronym".¹³ By May 2026 its Stroke Month message was "Learn B.E. F.A.S.T. to spot a stroke."¹⁴ This course didn't find the announcement of the change or the ASA's stated reasons for it, so it dates the change to between those two releases. The ERC lists BE-FAST, FAST and the Cincinnati scale as suitable, and says neither ILCOR's review nor its update "could find evidence supporting the use of one scale over another".³

The case for BE-FAST. FAST can miss strokes in the back of the brain, which the ASA says can show up as imbalance, vertigo (in the ASA's words, a "sensation like the room is spinning") or double vision.¹² The ASA's January 2025 release put the argument as the hospitals that had switched saw it: adding balance and vision should catch more of these posterior strokes, which it said make up about 20% of ischaemic strokes and tend to be more disabling.¹³ The evidence behind it is a 2017 study by Aroor and colleagues at one US stroke centre. Of 736 patients admitted with an ischaemic stroke in 2014, 14.1% had none of the FAST symptoms when they arrived. Adding gait imbalance or leg weakness and visual symptoms cut the proportion missed to 4.4%.¹⁵

The case for FAST. A shorter message may be remembered better. The ASA's own randomised online study, with 1,900 people (1,393 of them asked again a month later), tested exactly that.

Aroor's study is retrospective, from one centre, and its authors are careful about what it shows. They say a revision of public education "may be warranted" only "if validated in a prospective study".¹⁵ The ASA's study measured what people said they would do and what they remembered, not what happened to anyone having a stroke.¹³

Sleep lesson 1 gave you the two measures that sort this out. Everyone in Aroor's study had had a stroke, so it measured sensitivity and nothing else. It couldn't measure specificity, how often the extra letters fire for someone who is not having a stroke, and this course read no study that counts those false alarms. The ERC names the demands a first aid stroke check has to meet: easy to understand, learn and remember, quick to do, and highly sensitive.³ FAST and BE-FAST trade one of those against another. What would settle it is a prospective study that also counts the false alarms. Until then, learn the one your country teaches. In the US, the ASA's message is to call 911 for any of its signs.¹⁴

A word on oxygen

You may see oxygen on a first aid course, and the two countries differ on it.

In the US, the guideline says "It is not beneficial to administer oxygen over room air in the first aid setting for adults experiencing acute stroke." (AHA/Red Cross 2024, COR 3: No Benefit, LOE B-R), and grades the usefulness of oxygen from a first aider for breathlessness as unknown (COR 2b, LOE C-LD).¹

In the UK, RCUK says to give oxygen in a stroke only if you're trained in its use and the person shows signs of low oxygen, such as blue tinges to the skin and lips (RCUK 2025).²

Neither asks an untrained bystander to give it, and this course doesn't teach it (lesson 1 said so).

Two emergencies, one call

It's a Sunday in Darlington. A 62-year-old woman with type 2 diabetes has felt breathless and sick since lunch, with a sore jaw she puts down to a bad tooth and the sickness to "indigestion". Her husband has been making tea. Just after two o'clock, she tries to tell him something and the words come out wrong, jumbled, for about two minutes. Then they come right. She laughs it off.

He says: "It's passed. Shall I give her an aspirin? She's had them before, she's fine with them."

The call. 999, now, on speaker, for two reasons that each would be enough. Breathlessness, sickness and jaw pain are on the heart attack lists, and the AHA/Red Cross guideline names people with diabetes among those who may have other symptoms, jaw pain, breathlessness and nausea among them.¹ And jumbled speech is a stroke sign, which the NHS says means 999 even if it has stopped.⁶ "It's passed" is the TIA story, and the ASA's answer is to call anyway.¹²

What he tells the call handler. Where they are. That she is awake and talking. The symptoms and roughly when each began: breathless, sick and a sore jaw since about one o'clock; speech jumbled for two minutes at about ten past two, now normal. That she has type 2 diabetes, because low blood sugar can look like a stroke.¹ Her medicines and allergies.

While they wait. She sits comfortably, with nothing to eat or drink (St John).⁷ He watches her breathing and whether she answers him. If she stops responding and is not breathing normally, it's CPR with the call handler talking him through it (lesson 2).

What people get wrong

"It's just indigestion." The NHS lists "feeling like you have indigestion" as a heart attack symptom.⁵

"Wait and see if it passes." Chest pain can go and come back (AHA), and a stroke's signs can stop and still mean 999 (NHS) or 911 (ASA).¹¹⁶¹²

"It's quicker to drive them." About 1 in 300 chest-pain patients who came by car in one study arrested on the way, and the guideline wants EMS to take them (AHA/Red Cross 2024, COR 1).¹

"No crushing chest pain, no heart attack." Women, people with diabetes and older people may have other symptoms (AHA/Red Cross 2024), and some people have no chest pain at all (American Red Cross).¹¹⁰

"Aspirin for any chest pain, or for a stroke." For chest pain that sounds like the heart, in an alert adult who can take it, under your country's dose. No guideline recommends it for a suspected stroke, and a stroke can be a bleed.¹²³⁶

"FAST catches every stroke." In one centre's records it missed 14.1% of ischaemic strokes, and BE-FAST 4.4%.¹⁵ Neither list is complete, which is why the NHS also lists signs on neither, such as a severe headache (the British Red Cross says a sudden severe headache).⁶⁸

"BE-FAST has been shown to be better." Not yet. Aroor's study counted no false alarms, and in the ASA's own study fewer of those taught BE-FAST could say what F, A and S stood for.¹⁵¹³

Practice

Where to learn more with your hands

A page can carry recognition and decisions. What it can't give you is the moment the person collapses and it becomes lesson 2's CPR, which a class practises with a manikin; lesson 16 lists where to find one. The heart attack and stroke videos have not been watched against the guidance, so none is embedded; the NHS stroke symptoms page shows the UK check in full, and the ASA's page, linked above, the US one.

Connections

Strength and Fitness's warning signs came back here as someone else's emergency. Lesson 1's give-a-job tactic sends one person for the AED; lesson 2's recognition decides when a heart attack has become an arrest; lesson 4's grading key read aspirin's COR 2b and ILCOR's weak recommendation; Sleep lesson 1's sensitivity and specificity sorted out FAST and BE-FAST.

Lesson 13 is anaphylaxis and asthma, where you again help someone use their own medicine. Lesson 14 teaches the low blood sugar that can look like a stroke. Medical Literacy, later on the Core, can use the FAST and BE-FAST study as a worked case of reading a mnemonic's sensitivity.

Go deeper

• Hewett Brumberg and colleagues, 2024 AHA and American Red Cross Guidelines for First Aid, Circulation, free, sections 6.2 to 6.4. The chest pain supporting text lays out the aspirin evidence and its gap. Read in full from an archived copy.
• Resuscitation Council UK, 2025 Resuscitation Guidelines: First aid, the "Chest pain" and "Stroke" sections: a few lines each, and the UK text for both. Read in full.
• American Heart Association newsroom, Stroke warning sign acronyms drive 911 calls, F.A.S.T. leads in symptom recall for public, 30 January 2025. The ASA's own randomised study of FAST against BE-FAST, with its caveats. Read in full.
• Aroor, Singh and Goldstein, BE-FAST: Reducing the proportion of strokes missed using the FAST mnemonic, Stroke, 2017. The study behind BE-FAST; its short abstract states its own limit, and only the abstract was read here.

Sources

1. E. K. Hewett Brumberg, M. J. Douma and colleagues, "2024 American Heart Association and American Red Cross Guidelines for First Aid", Circulation 150, 2024, e519 to e579. **Read level: full, direct, from the Internet Archive capture 20260329073336**, for all prose, with sections 5.3 and 6.2 to 6.4 and the take-home messages re-read on 2026-09-25. The tables for stroke in adults and children, chest pain, oxygen and presyncope were read from the publisher's table images (archived for the first four; live for presyncope, 2026-09-25).
2. Resuscitation Council UK, 2025 Resuscitation Guidelines: First aid, 27 October 2025 . Read level: full, direct; the key points, "Expectations of a first aid provider", "Chest pain" and "Stroke" sections re-read on 2026-09-25.
3. T. Djärv, J. Rogers, F. Semeraro and colleagues, "European Resuscitation Council Guidelines 2025 First Aid", Resuscitation 215 (suppl 1), 2025, 110752 . Read level: full, direct, on the publisher's page; the chest pain and stroke concise guidance and evidence text checked there on 2026-09-25. The 2021 ERC first aid guideline's aspirin section was read on the publisher's page for the change in wording.
4. T. Djärv, M. J. Douma and colleagues for the ILCOR First Aid Task Force, "2025 International Consensus on First Aid Science With Treatment Recommendations", Circulation 152, 2025. **Read level: full, direct, from the accepted manuscript on ilcor.org**; the aspirin and stroke recommendations checked against the typeset text at ahajournals.org.
5. NHS, Heart attack, last reviewed 31 March 2026. **Read level: full, direct**; re-read on 2026-09-25.
6. NHS, Symptoms of a stroke and Diagnosing a stroke, last reviewed 12 September 2024 . Read level: both full, direct, read on 2026-09-25.
7. St John Ambulance, Heart attack and Stroke, clinically reviewed 28 April 2025. **Read level: full, direct**; both re-read on 2026-09-25.
8. British Red Cross, First aid for a heart attack and First aid for a stroke, undated . Read level: full, direct; both re-read on 2026-09-25.
9. British Heart Foundation, Heart attack. **Read level: full, direct**; re-read on 2026-09-25.
10. American Red Cross, Heart attack. **Read level: full, from the Internet Archive capture 20260414033047**; the live site showed a maintenance page on 2026-09-25, so it was re-read from the same capture.
11. American Heart Association, Warning signs of a heart attack, last reviewed 12 December 2024 . Read from the Internet Archive capture 20260921133040, the warning-signs and women's sections in full, on 2026-09-25.
12. American Stroke Association, Stroke symptoms. **Read level: full, from the Internet Archive capture 20260919053155**; re-read on 2026-09-25.
13. American Heart Association newsroom, Stroke warning sign acronyms drive 911 calls, F.A.S.T. leads in symptom recall for public, 30 January 2025 . Read level: full, direct; re-read on 2026-09-25. It reports an unpublished conference abstract (International Stroke Conference 2025, WMP31), which this course did not read.
14. American Heart Association newsroom, Knowing stroke signs can save a life when every minute counts, 1 May 2026 . Read level: full, direct; re-read on 2026-09-25.
15. S. Aroor, R. Singh and L. B. Goldstein, "BE-FAST (Balance, Eyes, Face, Arm, Speech, Time): Reducing the Proportion of Strokes Missed Using the FAST Mnemonic", Stroke 48, 2017, 479 to 481 . Read level: abstract only (PubMed 28082668), re-read on 2026-09-25.