A stumble and fall on the trail could have numerous causes including, more likely of course in older hikers, a stroke. Remember an individual can fall, rise up, seem fine (without a closer check), and collapse later. For years the first three letters of STRoke have served as a reminder of ways to check the patient for indications of stroke.
S: ask the patient to Smile.
T: ask the patient to Talk, to repeat a simple sentence such as "It's a sunny day today."
R: ask the patient to Raise both arms.
A fourth indicator of stroke should now be added to your checklist. Ask the patient to stick out his or her tongue. If the tongue goes to one side or the other, instead of straight out, if the tongue looks "crooked," you have another sign that a stroke has occurred. If any one of the four subtle indicators is present, the patient should be kept at rest and help should be summoned ASAP. The sooner the patient arrives at a hospital, the greater the chance of survival!