BE FAST: A modified assessment tool to identify stroke

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‘Time is brain’. A patient with suspected stroke or ‘brain attack’ should therefore be shifted to hospital at the earliest and given a clot dissolving therapy. Jeffrey L. Saver reported in the journal Stroke that “every minute in which a large vessel ischemic stroke is untreated, the average patient loses 1.9 million neurons, 13.8 billion synapses, and 12 km (7 miles) of axonal fibers. And, each hour in which treatment fails to occur, the brain loses as many neurons as it does in almost 3.6 years of normal aging” (Stroke. 2006;36:263-6).

The American Stroke Association recommends the mnemonic FAST to recall the signs of stroke and quickly identify victims of stroke; “F” stands for Face drooping; “A” stands for arm weakness i.e. inability to raise arms high, “S” stands for Speech difficulty – slurring of speech and “T” stands for Time – time to call for emergency medical help.

A new research has devised a modified version of this simple prehospital stroke assessment tool, ‘BE FAST’ for early identification of patients with occlusion of large vessel, which was presented at the American Stroke Association’s International Stroke Conference 2017, which concludes in Houston, USA today (AHA News, February 22, 2017).

The acronym ‘BE FAST’ evaluates:

• Balance/coordination
• Eye deviation
• Facial weakness
• Arm/leg weakness
• Slurred speech/sensory deficits
• Time of onset

Researchers examined 455 ischemic stroke patient charts from July 2014 to June 2015, using information about patients’ symptoms and physical findings. The sensitivity i.e. positively recognizes a large vessel occlusion, for the ‘BE FAST’ score was found to be 83%.

Stroke is an emergency and getting timely help and treatment is extremely important. Hence, it is very important to act fast to identify these patients. Early treatment improves the chances of recovery.