This morning approx. 03:45 we get a call for a fall. Pt wife states he lost balance and fell. We get there an assess the man and find out he has no head neck or back pain. Also no evidence of him hitting his head. We sit him on the toilet and as we're assisting him to the toilet I notice he is slightly weak on his L side. He has Hx of CHF, TIA, pacemaker. BP 97/63 HR 72. Continued to stay slightly hypotensive. As he finished on the toilet I noticed that he is has noticeable L sided weakness. It has progressed. He states slightly lightheaded pointing to R side of head. He couldn't say much more. Wife says no deficit from prev TIA and he normally walks and swims. I call ALS and they take him for possible stroke but no stroke alert since the wife couldn't confirm an onset time. What do you think? Stroke alert or no?