The widely used acronym FAST has found to be the best tool for helping bystanders recognize stroke symptoms, despite efforts to expand it to BE-FAST.
The study showed that adding Balance and Eye changes (BE) to FAST — Face drooping, Arm weakness, Speech difficulty, and Time to call 911 — did not significantly increase the likelihood of bystanders immediately calling emergency services when a stroke is suspected. Indeed, the study showed FAST performed significantly better than BE-FAST in terms of recalling key face, arm, and speech symptoms.
FAST, which has been used in the stroke community for over 20 years, captures only about 80% of all strokes, which has led stroke neurologists to start using BE-FAST, which in theory allows the capture of posterior circulation, or back of the brain, strokes that are believed to be missed by FAST. Because BE-FAST includes more symptoms, it was presumed it would be better at triggering emergency action by the general public.
The study included a sample of US residents who completed a survey on their awareness of stroke symptoms. They were then randomly assigned to view a 1-minute educational video depicting FAST or a 1-minute video on BE-FAST. After viewing the video, the likelihood of calling 911 if a stroke was suspected increased in both groups (72% to 90% in FAST and 71% to 90% in BE-FAST), with no difference therefore found between the groups.
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