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Face, Arms, Speech Test

Olli S Mattila, Tuukka Puolakka, Juhani Ritvonen, Saana Pihlasviita, Heini Harve, Ari Alanen, Gerli Sibolt, Sami Curtze, Daniel Strbian, Mikko Pystynen, Turgut Tatlisumak, Markku Kuisma, Perttu J Lindsberg
BACKGROUND: Accurate identification of acute stroke by Emergency Medical Dispatchers (EMD) is essential for timely and purposeful deployment of Emergency Medical Services (EMS), and a prerequisite for operating mobile stroke units. However, precision of EMD stroke recognition is currently modest. AIMS: We sought to identify targets for improving dispatcher stroke identification. METHODS: Dispatch codes and EMS patient records were cross-linked to investigate factors associated with an incorrect dispatch code in a prospective observational cohort of 625 patients with a final diagnosis of acute stroke or transient ischemic attack (TIA), transported to our stroke center as candidates for recanalization therapies...
February 13, 2019: International Journal of Stroke: Official Journal of the International Stroke Society
Philip M Bath, Polly Scutt, Jason P Appleton, Mark Dixon, Lisa J Woodhouse, Joanna M Wardlaw, Nikola Sprigg
BACKGROUND: High blood pressure is common in acute stroke and associated with a worse functional outcome. Glyceryl trinitrate, a nitric oxide donor, lowers blood pressure in acute stroke and may improve outcome. AIMS: Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) tested the feasibility of performing a UK multicenter ambulance-based stroke trial, and the safety and efficacy of glyceryl trinitrate when administered by paramedics before hospital admission...
November 26, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Frederik Geisler, Syed F Ali, Martin Ebinger, Alexander Kunz, Michal Rozanski, Carolin Waldschmidt, Joachim E Weber, Matthias Wendt, Benjamin Winter, Lee H Schwamm, Heinrich J Audebert
Background Patients with a sudden onset of focal neurological deficits consistent with stroke, who turn out to have alternative conditions, have been labeled stroke mimics. Aims We assessed a recently validated telemedicine-based stroke mimic score (TeleStroke mimic score; TM-score) and individual patient characteristics with regard to its discriminative value between cerebrovascular disease and stroke mimic patients in the in-person, pre-hospital setting. Methods We evaluated patients cared for in a mobile stroke unit in Berlin, Germany...
October 10, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Michaela V Bonfert, Katharina Badura, Julia Gerstl, Ingo Borggraefe, Florian Heinen, Sebastian Schroeder, Martin Olivieri, Raphael Weinberger, Mirjam N Landgraf, Katharina Vill, Moritz Tacke, Steffen Berweck, Karl Reiter, Florian Hoffmann, Thomas Nicolai, Lucia Gerstl
Objective: Acute childhood stroke is an emergency requiring a high level of awareness among first-line healthcare providers. This survey serves as an indicator of the awareness of, the interest in, and knowledge of childhood stroke of German pediatricians. Methods: Thousand six hundred and ninety-seven physicians of pediatric in- and outpatient facilities in Bavaria, Germany, were invited via email to an online-survey about childhood stroke. Results: The overall participation rate was 14%. Forty-six percent of participants considered a diagnosis of childhood stroke at least once during the past year, and 47% provide care for patients who have suffered childhood stroke...
2018: Frontiers in Pediatrics
Aditya Maddali, Farook Abdul Razack, Srihari Cattamanchi, Trichur V Ramakrishnan
Background: Early recognition of Stroke is one of the key concepts in the "Chain of Survival" as described by the American Heart Association/American Stroke Association Stroke guidelines. The most commonly used tools for prehospital assessment of stroke are "The Cincinnati Prehospital Stroke Scale," (CPSS) the "Face, Arm, Speech Test," and "The Los Angeles Prehospital Stroke Screen." The former two are used to identify stroke using physical findings while the latter is used to rule out other causes of altered consciousness...
April 2018: Journal of Emergencies, Trauma, and Shock
Jing Zhao, Maryellen F Eckenhoff, Wei-Zen Sun, Renyu Liu
BACKGROUND AND PURPOSE: To improve stroke awareness and reduce life-threatening prehospital delays worldwide, a universal stroke educational program is needed. To meet this unmet need, we developed a universal program without language barriers and tested its acceptance in Taiwan, where Chinese is the native language. METHODS: Stroke 112 was developed using the universal emergency phone number, 112. The numbers imply an emergency and correspond to the 3 stroke recognition signs used in FAST (Face, Arm, Speech, and Time): 1 uneven face (crooked mouth); 1 weak arm (arm weakness); 2 incoherent lips (slurred speech)...
July 2018: Stroke; a Journal of Cerebral Circulation
Alexander C Flint, Shiv G Bhandari, Sean P Cullen, Adhikari V Reddy, Daniel P Hsu, Vivek A Rao, Minal Patel, Jasmeen Pombra, Nancy J Edwards, Sheila L Chan
BACKGROUND AND PURPOSE: Large artery occlusion (LAO) in ischemic stroke requires recognition and triage to an endovascular stroke treatment center. Noninvasive LAO detection is needed to improve triage. METHODS: Prospective study to test whether noninvasive cerebral oximetry can detect anterior circulation LAO in acute stroke. Interhemispheric ΔBrSO2 in LAO was compared with controls. RESULTS: In LAO stroke, mean interhemispheric ΔBrSO2 was -8...
February 2018: Stroke; a Journal of Cerebral Circulation
A Nordanstig, K Asplund, B Norrving, N Wahlgren, P Wester, L Rosengren
BACKGROUND: Time delay from stroke onset to arrival in hospital is an important obstacle to widespread reperfusion therapy. To increase knowledge about stroke, and potentially decrease this delay, a 27-month national public information campaign was carried out in Sweden. AIMS: To assess the effects of a national stroke campaign in Sweden. METHODS: The variables used to measure campaign effects were knowledge of the AKUT test [a Swedish equivalent of the FAST (Face-Arm-Speech-Time)] test and intent to call 112 (emergency telephone number) ...
October 2017: Acta Neurologica Scandinavica
Jan F Scheitz, Azmil H Abdul-Rahim, Rachael L MacIsaac, Charith Cooray, Heidi Sucharew, Dawn Kleindorfer, Pooja Khatri, Joseph P Broderick, Heinrich J Audebert, Niaz Ahmed, Nils Wahlgren, Matthias Endres, Christian H Nolte, Kennedy R Lees
BACKGROUND AND PURPOSE: The National Institutes of Health Stroke Scale (NIHSS) correlates with presence of large anterior vessel occlusion (LAVO). However, the application of the full NIHSS in the prehospital setting to select patients eligible for treatment with thrombectomy is limited. Therefore, we aimed to evaluate the prognostic value of simple clinical selection strategies. METHODS: Data from the Safe Implementation of Thrombolysis in Stroke International Stroke Thrombolysis Registry (January 2012-May 2014) were analyzed retrospectively...
February 2017: Stroke; a Journal of Cerebral Circulation
A Feeney, T Barry, D Hayden, L Higgins, E Kavanagh, P MacMahon, M O'Reilly, S P Teeling, P J Kelly, S Murphy
Ischaemic stroke clinical outcomes are improved by earlier treatment with intravenous thrombolysis. An existing pathway at the Mater University Hospital for assessment of suspected acute stroke in the Emergency Department was updated, aiming to shorten door-to-needle time. This study examines the final clinical diagnosis of Dublin Fire Brigade Ambulance Paramedic identified Face-Arm-Speech-Test (FAST) positive patients presenting to the Emergency Department over a 7 month period. A retrospective analysis was carried out of 177 consecutive FAST positive patients presenting between March and November 2014...
April 11, 2016: Irish Medical Journal
J P Sheppard, A Lindenmeyer, R M Mellor, S Greenfield, J Mant, T Quinn, A Rosser, D Sandler, D Sims, M Ward, R J McManus
BACKGROUND: Thrombolysis can significantly reduce the burden of stroke but the time window for safe and effective treatment is short. In patients travelling to hospital via ambulance, the sending of a 'prealert' message can significantly improve the timeliness of treatment. OBJECTIVE: Examine the prevalence of hospital prealerting, the extent to which prealert protocols are followed and what factors influence emergency medical services (EMS) staff's decision to send a prealert...
July 2016: Emergency Medicine Journal: EMJ
Z Sun, Y Yue, C C H Leung, M T V Chan, A W Gelb
Perioperative stroke is a devastating complication that carries high mortality and functional disability. Unfortunately, residual anaesthesia and analgesia may obscure important warning signs and may lead to a delay in the assessment and treatment of major stroke after surgery. The purpose of this review is to examine the utility of existing stroke scales, for the recognition of perioperative stroke in the general surgical population. A total of 21 stroke scales have been described in the literature. Diagnostic performance was reported in 17 scales...
March 2016: British Journal of Anaesthesia
Matthew Rudd, Deborah Buck, Gary A Ford, Christopher I Price
BACKGROUND: We undertook a systematic review of all published stroke identification instruments to describe their performance characteristics when used prospectively in any clinical setting. METHODS: A search strategy was applied to Medline and Embase for material published prior to 10 August 2015. Two authors independently screened titles, and abstracts as necessary. Data including clinical setting, reported sensitivity, specificity, positive predictive value, negative predictive value were extracted independently by two reviewers...
November 2016: Emergency Medicine Journal: EMJ
Annika Berglund, Mia von Euler, Karin Schenck-Gustafsson, Maaret Castrén, Katarina Bohm
OBJECTIVES: To evaluate symptoms presented by the caller during emergency calls regarding stroke, and to assess if symptoms in the Face-Arm-Speech-Time Test (FAST) are related to identification of stroke. SETTING: Emergency calls to the Emergency Medical Communication Center (EMCC) concerning patients discharged with stroke diagnosis in a large teaching hospital in Stockholm, Sweden, in January-June 2011. PARTICIPANTS: The emergency calls of 179 patients who arrived at hospital by ambulance, and who were discharged with a stroke diagnosis and consented to participate were included in the study...
April 28, 2015: BMJ Open
Frank J Wolters, Nicola L M Paul, Linxin Li, Peter M Rothwell
BACKGROUND: Urgent assessment is essential after stroke. Several countries have had public education campaigns, based on the FAST (Face-Arm-Speech-Time) test to reduce delays in seeking attention. However, the impact of these campaigns on patient behavior is uncertain. METHODS: We prospectively determined patient behavior after incident major stroke (NIHSS > 3) in a UK population based study (Oxford Vascular Study) before (2002-2008) and after (2009-2013) introduction of the FAST TV-campaign and assessed any sustained impact of campaign continuation...
October 2015: International Journal of Stroke: Official Journal of the International Stroke Society
Jan C Purrucker, Christian Hametner, Andreas Engelbrecht, Thomas Bruckner, Erik Popp, Sven Poli
OBJECTIVE: First, to determine the sensitivity and specificity of six stroke recognition scores in a single cohort to improve interscore comparability. Second, to test four stroke severity scores repurposed to recognise stroke in parallel. METHODS: Of 9154 emergency runs, 689 consecutive cases of preclinically 'suspected central nervous system disorder' admitted to the emergency room (ER) of the Heidelberg University Hospital were included in the validation cohort...
September 2015: Journal of Neurology, Neurosurgery, and Psychiatry
Jonathan S Litt, Maria Glymour, Penny Hauser-Cram, Thomas Hehir, Marie C McCormick
OBJECTIVES: To evaluate the effect of an intensive early intervention on special service use at school-age. STUDY DESIGN: The Infant Health and Development Program was a randomized controlled trial of an intervention for low birth weight (<2500 g) infants ages 0-3 years. We used multivariate logistic regression to test the association between intervention and risk of special education, remedial reading and math, and speech therapy at age 8 years. We also compared rates of service use between study arms among those with learning disabilities (LDs)...
February 2015: Journal of Pediatrics
Stephan U Dombrowski, Martin White, Joan E Mackintosh, Paul Gellert, Vera Araujo-Soares, Richard G Thomson, Helen Rodgers, Gary A Ford, Falko F Sniehotta
BACKGROUND: The stroke awareness raising campaign 'Act FAST' (Face, Arms, Speech: Time to call Emergency Medical Services) has been rolled out in multiple waves in England, but impact on stroke recognition and response remains unclear. PURPOSE: The purpose of this study was to test whether providing knowledge of the FAST acronym through a standard Act FAST campaign leaflet increases accurate recognition and response in stroke-based scenario measures. METHODS: This is a population-based, cross-sectional survey of adults in Newcastle upon Tyne, UK, sampled using the electoral register, with individuals randomized to receive a questionnaire and Act FAST leaflet (n = 2500) or a questionnaire only (n = 2500) in 2012...
April 2015: International Journal of Stroke: Official Journal of the International Stroke Society
Ethan S Brandler, Mohit Sharma, Richard H Sinert, Steven R Levine
OBJECTIVE: To identify and compare the operating characteristics of existing prehospital stroke scales to predict true strokes in the hospital. METHODS: We searched MEDLINE, EMBASE, and CINAHL databases for articles that evaluated the performance of prehospital stroke scales. Quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. We abstracted the operating characteristics of published prehospital stroke scales and compared them statistically and graphically...
June 17, 2014: Neurology
Annika Berglund, Leif Svensson, Nils Wahlgren, Mia von Euler
BACKGROUND: Prehospital identification of acute stroke increases the possibility of early treatment and good outcome. To increase identification of stroke, the Face Arm Speech Time (FAST) test was introduced in the Emergency Medical Communication Center (EMCC). This substudy aims to evaluate the implementation of the FAST test in the EMCC and the ambulance service. METHODS: The study was conducted in the region of Stockholm, Sweden during 6 months. The study population consisted of all calls to the EMCC concerning patients presenting at least one FAST symptom or a history/finding making the EMCC or ambulance personnel to suspect stroke within 6 h...
2014: Cerebrovascular Diseases
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