What to Do While Awaiting Help for a Vertebrobasilar Stroke?

If you suspect someone is having a stroke, your immediate priority is to call emergency services (such as 911) and keep the person safe while waiting for the ambulance ^[1]. You do not need to diagnose a vertebrobasilar stroke yourself—any sudden neurological symptoms, such as severe spinning dizziness (vertigo), loss of balance, double vision, slurred speech, or weakness, are a medical emergency ^[2]. Even if symptoms improve, you must still call for help, as they could indicate a “warning stroke” called a transient ischemic attack (TIA).

Do This Now: Immediate Checklist

1. Call emergency services immediately and explicitly say you suspect a stroke ^[3]. Do not drive to the hospital yourself ^[4].
2. Assess responsiveness and breathing. If the person is unresponsive and not breathing normally, follow the emergency dispatcher’s instructions immediately (which may include starting CPR). If they are breathing but unconscious or vomiting, gently roll them onto their side (the recovery position) to keep their airway clear, provided it is safe to do so ^[5].
3. Determine the “Last Known Well” time. Write down the exact time symptoms started or the last time the person was completely normal ^[6].
4. Keep the person safe. Have them sit or lie down to prevent falls ^[2]. Do not let them walk unassisted, but allow them to move if necessary to protect their airway or follow emergency instructions.
5. Give nothing by mouth. Do not give food, drink, or any medications (including aspirin) unless specifically instructed by the dispatcher or a medical professional ^[7][8].
6. Unlock the front door so paramedics can enter quickly.

If You Are Alone
If you are experiencing symptoms yourself and are alone, call emergency services immediately and keep your phone on speaker ^[1]. Unlock your front door, then sit or lie down in a safe place to prevent a fall ^[2]. Do not delay your call to look for medical records or medications; you can provide that information to the paramedics once they arrive.

Why Calling Emergency Services is Crucial

Do not wait to see if symptoms disappear, and do not drive the patient to the emergency room yourself ^[9][10]. Arriving by ambulance rather than your own transport can speed up evaluation and allow the hospital to prepare ^[4]. Emergency medical services (EMS) can often begin assessment and alert the hospital in advance, which may speed triage and preparation upon arrival ^[11]. If an ambulance is delayed, follow the dispatcher’s instructions rather than taking matters into your own hands.

Critical Safety Steps While Waiting

Determine the “Last Known Well” Time
Write down the exact time the symptoms started. If you didn’t see the symptoms begin, note the last time the person was completely normal or symptom-free ^[6]. This specific time helps the stroke team determine which urgent treatments—such as clot-busting drugs (thrombolysis) or emergency procedures to restore blood flow—may be possible ^[6].

Prevent Falls and Position Safely
Strokes in the back of the brain (the posterior circulation or vertebrobasilar system) commonly cause severe spinning dizziness, loss of balance, or sudden weakness ^[2]. To prevent serious falls or head injuries, have the person sit or lie down immediately ^[2]. Do not let them walk unassisted. If they are vomiting or unconscious but breathing normally, help them into a side-lying recovery position to prevent choking ^[5].

Give Nothing by Mouth (Including Aspirin)
Strokes can suddenly impair the muscles used for swallowing, causing dysphagia (difficulty swallowing). Giving food, water, or medication by mouth poses a severe risk of choking or fluid entering the lungs, which can cause pneumonia ^[7][12]. Wait until assessed by EMS and hospital clinicians before allowing anything by mouth.

Crucially, do not give aspirin, extra blood thinners (anticoagulants), or extra blood pressure medication ^[13]. It is impossible to know without a brain scan whether the stroke is caused by a blood clot (ischemic stroke) or bleeding in the brain (hemorrhagic stroke) ^[8]. Giving aspirin or blood thinners to someone having a bleeding stroke can make the bleeding significantly worse ^[8][13].

Gather Medical Information Safely

Without delaying the call to 911 or leaving the patient unattended for long, quickly gather essential health information ^[14]. Providing this directly to paramedics helps doctors make rapid treatment decisions ^[14]:

• Medications: Write down drug names, doses, and the time of the last dose (especially for blood thinners or anti-platelet drugs) ^[14]. Bring the medication bottles if possible.
• Medical History: Note existing conditions, recent surgeries, and known drug allergies ^[14].
• Emergency Contacts: Have the name and number of the primary contact ready.