BE-FAST (Balance, Eyes, Face, Arm, Speech, Time)

Aroor, Sushanth; Singh, Rajpreet; Goldstein, Larry B.

doi:10.1161/strokeaha.116.015169

Cited by 142 publications

(87 citation statements)

References 10 publications

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“…The FAST tool has some limitations in detecting an acute stroke. In the study by Aroor et al (17), 104 out of 736 (14.1%) patients diagnosed with acute stroke did not have any symptoms of FAST. The BE-FAST test (B for Balance and E for Eye) could be used considering the fact that most of these patients had an imbalance and visual impairment.…”

Section: Limitationsmentioning

confidence: 90%

“…The BE-FAST test (B for Balance and E for Eye) could be used considering the fact that most of these patients had an imbalance and visual impairment. Thus, using BE-FAST, 4.4% of patients did not have BE-FAST symptoms (17). Therefore, we can add more symptoms to FAST, but it requires staff training and increases the number of healthy people who receive health care.…”

Section: Limitationsmentioning

confidence: 99%

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Accuracy of Stroke Diagnosis Using FAST (Face, Arm, Speech, Time) Tool by Emergency Medical Service Dispatchers and Technicians and its Impact on Transport Time

et al. 2019

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Objectives: This study aimed to determine the accuracy of the Face-Arm-Speech-Time (FAST) screening tool used by emergency medical dispatchers (EMDs) and emergency medical technicians (EMTs) for the diagnosis of acute stroke and its effect on the patient's transfer time from the scene to the hospital. Methods: This study was conducted retrospectively during a one-year period. Via census sampling, we recruited all patients over 18-years-old diagnosed with acute stroke whether by EMDs or by EMTs. Pre-hospital operation forms and hospital records were used for data gathering. Final diagnoses were finally determined according to the patients' brain magnetic resonance imaging (MRI). Results: Totally, 1,280 patients with a mean age of 64.1 ± 17.8 years were studied, of whom, 730 were men (57%). Accordingly, 1,016 probable cases of stroke (79.4%) were reported by EMDs, while only 543 cases (42.4%) were reported as suspected cases of stroke by EMTs at the scene of the incident. Ultimately, stroke was confirmed in 519 (40.5%) cases. Accordingly, the Area under the curves (AUCs) for EMDs and EMTs were 0.50 (0.48 to 0.53) and 0.74 (0.71 to 0.76), respectively. Transport time (TT) was shorter if the initial diagnosis of stroke was made by EMTs. The TT was marginally significant and patients with stroke diagnoses were transported to the hospital faster than others (17.3 ± 11.5 vs. 18.5 ± 11.9 min; P = 0.065). Conclusions: The use of FAST by EMTs for detecting probable acute stroke has acceptable sensitivity and specificity; but when it is used by EMDs, it has higher sensitivity and very low specificity. The diagnosis of stroke by EMTs may lead to faster transport to the hospital.

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Section: Limitationsmentioning

confidence: 90%

Section: Limitationsmentioning

confidence: 99%

Accuracy of Stroke Diagnosis Using FAST (Face, Arm, Speech, Time) Tool by Emergency Medical Service Dispatchers and Technicians and its Impact on Transport Time

et al. 2019

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“…The mnemonic “FAST” is crucial for public concern of stroke. The mnemonic “FAST” is useful for identifying stroke signs that refer to Face drooping, Arm weakness, Speech, and Time to call 9-1-1, where it was found that it could identify 88% of carotid artery distribution strokes [ 5 , 6 ]. In this era, errors in texts in chat applications should be considered as a stroke sign.…”

Section: Discussionmentioning

confidence: 99%

Garbled and Incoherent Text Messages Are a Sign of Acute Ischemic Stroke: A New Sign of Aphasia in the Era of Chat Applications

Kobkitsuksakul¹,

Sirilert²,

Boongird³

2020

Neurointervention

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We report a 68-year-old female was diagnosed acute ischemic stroke with an interesting clinical presentation. She was unable to send the messages in chat application normally and accurately. Neurological examination revealed global aphasia without weakness. Computed tomography angiography (CTA) showed the occlusion of the inferior branch of the left M2 of middle cerebral artery (MCA) but showed a good collateral score. Intravenous fibrinolysis and mechanical thrombectomy were not indicated. The patient showed spontaneous clinical improvement and almost fully recovered by the day of hospital discharge. Currently, chat applications have been widely adopted for communication and have replaced direct or telephone conversations in daily life. Dystextia and dystypia may serve as modern sign of aphasia on text conversation.

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“…In the current study, the tutors and neurologists placed more emphasis on the items of carotid bruit auscultation, pronator drift, and the National Institute of Health Stroke Scale. This suggests that AIS screening and stroke severity evaluation should be highlighted in the core curriculum for neurology clerks [ 26 ]. In addition, the epidemiological trend in the aging society raises the importance of degenerative diseases including dementia and movement disorders in medical education.…”

Section: Discussionmentioning

confidence: 99%

Core neurological examination items for neurology clerks: A modified Delphi study with a grass-roots approach

Liu¹,

Hsu²,

Hsiao³

et al. 2018

PLoS ONE

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BackgroundWith the evolution of treatments for neurological diseases, the contents of core neurological examinations (NEs) for medical students may need to be modified. We aimed to establish a consensus on the core NE items for neurology clerks and compare viewpoints between different groups of panelists.MethodsFirst, a pilot group proposed the core contents of NEs for neurology clerks. The proposed core NE items were then subject to a modified web-based Delphi process using the online software “SurveyMonkey”. A total of 30 panelists from different backgrounds (tutors or learners, neurologists or non-neurologists, community hospitals or medical centers, and different academic positions) participated in the modified Delphi process. Each panelist was asked to agree or disagree on the inclusion of each item using a 9-point Likert scale and was encouraged to provide feedback. We also compared viewpoints between different groups of panelists using the Mann-Whitney U test.ResultsEighty-three items were used for the first round of the Delphi process. Of them, 18 without consensus of being a core NE item for the neurology clerks in the first round and another 14 items suggested by the panelists were further discussed in the second round. Finally, 75 items with different grades were included in the recommended NE items for neurology clerks.ConclusionsOur findings provide a reference regarding the core NE items for milestone development for neurology clerkships. We hope that prioritizing the NE items in this order can help medical students to learn NE more efficiently.

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BE-FAST (Balance, Eyes, Face, Arm, Speech, Time)

Cited by 142 publications

References 10 publications

Accuracy of Stroke Diagnosis Using FAST (Face, Arm, Speech, Time) Tool by Emergency Medical Service Dispatchers and Technicians and its Impact on Transport Time

Accuracy of Stroke Diagnosis Using FAST (Face, Arm, Speech, Time) Tool by Emergency Medical Service Dispatchers and Technicians and its Impact on Transport Time

Garbled and Incoherent Text Messages Are a Sign of Acute Ischemic Stroke: A New Sign of Aphasia in the Era of Chat Applications

Core neurological examination items for neurology clerks: A modified Delphi study with a grass-roots approach

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