STROKE SCREENING TOOLS:

BE FAST and FAST-ED

START HERE Is the patient having a stroke?

Check
if yes ANY POSITIVE BE FAST FINDINGS? Score
(Circle)
Balance Are their symptoms indicative of a large vessel stroke?
Perform bilateral index finger-to-nose test and bilateral heel-to-shin test
Does the patient have sudden loss of balance or coordination, trouble B
walking or dizziness? Ask if the patient is on any anticoagulant medications, such as:
Coumadin/Warfarin Xarelto/Rivaroxaban
Eyes Pradaxa/Dabigatran Savaysa/Edoxaban Time anticoagulant
Assess 4 quadrants of visual field by having patient locate your index finger. Eliquis/Apixaban Heparin/Enoxaparin last taken:
Does the patient have trouble seeing out of one or both eyes or sudden E
Any other anticoagulants? (please list):
double vision?

Face
Facial Palsy (ask the patient to show their teeth or smile) Score:
Ask the patient to smile or show their teeth.
Does the patient's face look uneven, have sudden drooping or numbness F F Both sides of the face move equally or not at all 0
One side of the face droops or is clearly asymmetric 1
on one side?

Arm Weakness (with eyes closed, ask patient to hold arms out with
Arms
their palms up and hold them there for 10 seconds) Score:
Ask the patient to raise and extend both arms with their palms up.
Both arms remain up for > seconds or slowly move down equally 0
Does one arm drift downward?
Does the patient have sudden numbness or weakness of the arm on one
A A Patient can raise arms but one arm drifts down in < 10 seconds 1
One or both arms fall rapidly, can't be lifted, or no movement occurs 2
side of the body?
at all

Speech Changes
Expressive Aphasia - ask the patient to name 3 common items Score:
Speech Names 2 to 3 items correctly 0
Ask the patient to say, "You can't teach an old dog new tricks". S S Names 0 to 1 item correctly 1
Does the patient have slurred speech, trouble speaking, understanding or Receptive Aphasia - ask the patient to perform a simple command
seem confused? (Example: "show me two fingers")
Normal - patient can follow the simple command 0
Unable to follow the simple command 1

Time Time
What time did the symptoms start?
What time was the patient last known well (last appear normal)?
____:____
____:____
T T What time did the symptoms start?
What time was the patient last known well (last appear normal)?
____:____
____:____

Glucose level = ___________ Eye Deviation Score:

No deviation; eyes move equally to both sides 0
If these criteria are met, the patient qualifies for a stroke alert: E Patient has clear difficulty when looking to one side (left or right) 1
Patient received one or more check marks ( ); and Eyes are deviated to one side and do not move to the other side 2
Glucose is over 80 mg/dl; and
Last known well time is under 4.5 hours Denial/Neglect
Denial - show the patient their affected arm and ask, "Do you feel
BEFORE you request a stroke alert, obtain a FAST-ED score to see if weakness in this arm?" Score:
the patient is having symptoms indicative of a large-vessel occlusion. Patient recognizes the weakness in their weak arm 0
If glucose is < 80, treat and then reassess BE FAST D Patient does NOT recognize the weakness in their weak arm 1
Neglect - show the patient their affected arm and ask, "Whose arm is
If last known well is > 4.5 hours, obtain a FAST-ED score to see if
this?"
they qualify for other treatment
Patient recognizes their weak arm 0
Patient does NOT recognize their weak arm 1

TOTAL FAST-ED SCORE

Remember:
Minimize scene time as must as possible. When to call a STROKE ALERT:
Severe headache with no known cause may be a sign of a hemorrhagic If any symptoms from BE FAST and within 4.5 hours = call a stroke alert regardless
stroke. Continue your assessment but be sure to report the headache to the of FAST-ED score
receiving hospital. If FAST-ED score of 1 - 3 and within 4.5 hours = call a stroke alert
If FAST-ED score > 4 and within 24 hours = call stroke alert and discuss with stroke-
It is important to rule out seizure activity with the onset of symptoms.
ready hospital if the patient should be taken to a thrombectomy capable stroke center.
If symptoms on BE FAST or FAST-ED score of 1 - 3 and outside of 4.5 hours =
discuss with receiving facility
If score > 4 and outside of 24 hours = Discuss with receiving facility

IMPORTANT PATIENT DEMOGRAPHICS

Patient Name: ______________________________________________________________________________________________
Patient DOB: _______________________________________

Emergency Contact Name: ____________________________________________________________________________ Emergency Contact Phone: ___________________________

Medical History: _____________________________________________________________________________________________________________________________________________

Allergies: ___________________________________________________________________________________________________________________________________________________

Medications: _________________________________________________________________________________________________________________________________________________

Is this patient on blood thinners? Yes No Incident Date: ______________________________________