FAST (stroke)


FAST is an acronym used as a mnemonic to help detect and enhance responsiveness to the needs of a person having a stroke. The acronym stands for Facial drooping, Arm weakness, Speech difficulties and Time to call emergency services.
The FAST acronym was developed in the UK in 1998 by a group of stroke physicians, ambulance personnel, and an emergency department physician and was designed to be an integral part of a training package for ambulance staff. The acronym was created to expedite administration of intravenous tissue plasminogen activator to patients within 3 hours of acute stroke symptom onset. The instruments at this time with most evidence of validity were the Cincinnati Prehospital Stroke Scale and the Los Angeles Prehospital Stroke Screen.
Studies using FAST have demonstrated variable diagnostic accuracy of strokes by paramedics and emergency medical technicians with positive predictive values between 64% and 77%.
Other acronyms such as BE-FAST has shown promise by capturing >95% of ischemic strokes, however adding coordination and diplopia assessment did not improve stroke detection in the prehospital setting.

Alternative versions

BE-FAST has shown promise and is currently being studied as an alternative method to the FAST acronym.
NEWFAST is an additional stroke identification tool available for use.
Copyrighted by Deborah Stabell Tran in 2017, as part of a DNP project, it was created to identify all types of strokes - anterior or posterior ischemic, and hemorrhagic strokes. It gives more definition to testing dizziness and balance, hallmark signs of posterior strokes. NEWFAST also addresses the sudden onset of a severe headache and vomiting that often accompany bleeds in the head.
NEW - means a NEW onset of symptoms.