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Inspect the airway for obvious obstruction. If an obstruction is visible within the airway, use a finger sweep or suction to remove it. Are we anywhere near to a breakthrough? So far, research has produced modest yields. Gerontologists speak prophetically of potential, but most warn a significant human development remains somewhere far off in the distance – almost in sight but not quite. Richard Hodes, the director of the National Institute of Aging, a US government agency, told me that, though research in animals has led to “dramatic increases in lifespan”, some of them multi-fold, “There has been far less quantitative effect as those models have moved towards mammalian species.” The biologist Laura Deming, who in 2011 established the Longevity Fund, a venture capital firm that supports “high-potential longevity companies”, told me that startups continue to successfully root out biological markers of ageing – inefficient cells, mitochondrial decline – but that, in humans, “We really don’t know right now what will work and what won’t.”

In the context of a stroke, a patient’s consciousness level may be reduced if the stroke is large or affects the brainstem. There are several conditions which can mimic a stroke. When assessing a suspected stroke patient, it is important to consider these differentials.Until the end of time: James Strole, 70, founder of the Coalition for Radical Life Extension in Arizona, with some of the many pills and supplements he takes daily Acting FAST will give the person having a stroke the best chance of survival and recovery. Always call 999 straight away.

For patients who do not fit the criteria for acute management (thrombolysis/thrombectomy), general medical management involves: All critically unwell patients should have continuous monitoring equipment attached for accurate observations. Further interventions will depend on the clinical context and may be required to manage stroke mimics. CPR

Repeat administration of fluid boluses up to four times (e.g. 2000ml or 1000ml in patients at increased risk of fluid overload), reassessing the patient each time. The next team of doctors on shift should be made aware of any patient in their department who has recently deteriorated. A TACS (total anterior circulation stroke) is caused by an infarct affecting the areas of the brain supplied by the middle and anterior cerebral arteries, and it causes: