A stroke is a medical emergency, often described as a “brain attack,” occurring when blood flow to an area of the brain is interrupted or reduced. Without the oxygen and nutrients supplied by the blood, brain cells begin to die within minutes, potentially leading to long-term disability or death. Recognizing the sudden onset of symptoms is important because receiving quick treatment significantly improves the patient’s outcome. The ability to identify these warning signs immediately is the first step in minimizing damage to the brain.
The Essential Stroke Mnemonic
The most current tool used to help the public quickly identify a stroke is the mnemonic “BE FAST.” This acronym expands upon earlier methods and provides a simple, structured way for a non-medical person to check for symptoms. The letters of BE FAST serve as a memory aid for the six most common warning signs and the necessary response. This framework is designed to eliminate hesitation and standardize the initial assessment during a time-sensitive medical event.
Recognizing the Signs
The first two letters, B and E, address symptoms often associated with posterior circulation strokes (strokes occurring in the back of the brain). The ‘B’ stands for Balance, referring to a sudden loss of coordination or unexpected dizziness. The ‘E’ is for Eyes, which involves sudden changes in vision, such as blurriness, double vision, or loss of sight in one or both eyes. These symptoms are often sudden in their onset, unlike typical balance or vision issues.
The next three letters represent the symptoms that were part of the original F.A.S.T. acronym. ‘F’ is for Face, where one side may droop or feel numb; ask the person to smile to check if the smile is uneven or lopsided. The ‘A’ is for Arm, indicating weakness or numbness in one arm. Test this by asking the person to raise both arms; if one arm drifts downward involuntarily, it is a sign of concern.
The ‘S’ stands for Speech, which manifests as slurred speech, difficulty speaking, or trouble understanding others. Asking the person to repeat a simple sentence, such as “The sky is blue,” helps assess if their speech is slurred or incorrect. These three signs (Face, Arm, and Speech) are highly predictive of a stroke if one or more are present. While these are the most common indicators, any sudden onset of these symptoms should be treated as an emergency.
Taking Immediate Action
The final letter, ‘T,’ stands for Time, reminding you to call emergency services immediately once symptoms are recognized. Do not attempt to drive the person to the hospital yourself, as ambulance personnel can begin lifesaving treatment sooner. When speaking with the dispatcher, state clearly that you suspect a stroke and provide the exact time the symptoms were first noticed.
Providing the time of onset is important because stroke treatment options, such as administering clot-busting medications like tissue plasminogen activator (tPA), are highly time-dependent. Medical professionals use the phrase “Time is Brain,” noting that an estimated 1.9 million neurons die every minute blood flow is cut off. For patients with an ischemic stroke, the window for administering tPA is often within four and a half hours of symptom onset.