A test that examines facial weakness, arm weakness and speech disturbance allows paramedics to quickly and accurately identify stroke

A test that examines facial weakness, arm weakness and speech disturbance allows paramedics to quickly and accurately identify stroke, researchers report in today’s rapid access issue of Stroke: Journal of the American Heart Association.

The study found that paramedics who used “Face Arm Speech Test” (FAST), were in close agreement with neurologists using the National Institute of Health Stroke Scale in early recognition of stroke. FAST was developed in 1998 as a stroke identification tool that examines facial weakness (F), arm weakness (A), and speech disturbance (S). The study is the largest and first non-experimental study in which paramedics’ assessments using FAST to diagnose strokes were compared with assessments by stroke physicians or neurologists.

“The main purpose of FAST is to rapidly recognize stroke to ensure that patients are fast-tracked to be imaged and assessed by an expert stroke team as soon as possible,” said Gary A. Ford, M.D., Acute Stroke Service, Freeman Hospital, Newcastle-upon-Tyne, in the United Kingdom. “Paramedics were accurate when compared to a ‘gold standard’ of diagnosis by a stroke physician in detecting facial weakness, arm weakness and speech disturbance.”

Rapid treatment of a stroke can reduce long-term deficits. However, symptoms of stroke can be vague and transient, making early identification difficult.

From August 2001 to July 2002, ambulance crews brought 278 suspected stroke cases to the acute stroke unit at University of Newcastle-upon-Tyne.  Of these, 217 (78 percent) were confirmed as stroke or transient ischemic attack (TIA).  A stroke neurologist examined cases an average of 18 hours after paramedic assessment.

Assessments by the neurologist and the paramedics were almost the same for all the areas measured. The most prevalent sign in confirmed acute stroke patients was arm weakness, which was present in 96 percent of patients.

For more information on stroke, visit the American Stroke Association web site: strokeassociation.org

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