Paramedics Accurately Assess Stroke Symptoms

By assessing speech disturbance and weakness in the face and arms, paramedics can quickly and accurately identify patients likely to be having a stroke, British investigators report.

By assessing speech disturbance and weakness in the face and arms, paramedics can quickly and accurately identify patients likely to be having a stroke, British investigators report. “The main purpose of the FAST (Face Arm Speech Test) is to rapidly recognize stroke to ensure that patients are fast-tracked to be imaged and assessed by an expert stroke team as soon as possible,” senior investigator Dr. Gary A. Ford said in a press statement. But until now, there have been no studies comparing paramedics’ findings with those of neurologists in routine clinical situations, Ford and his associates note in their article in the online issue of Stroke: Journal of the American Heart Association. The team, based at Royal Bournemouth and Christchurch Hospital in Dorset, therefore compared findings between paramedics and stroke physicians regarding 278 suspected stroke patients transported by ambulance. Stroke was confirmed in 189 patients. The paramedics reported arm weakness in 96 percent of patients with stroke, facial weakness in 68 percent, and speech problems in 79 percent. When a neurologist examined the same patients several hours later, they nearly always agreed with the arm weakness finding, usually agreed with the speech disturbance finding, and often agreed with the facial weakness finding. Moreover, it’s likely that the rates of agreement would have been even higher if the neurologists had seen the patients at the same time as the paramedics instead of a day or so later, the authors note. They believe that “the FAST assessment may be sufficiently reliable to use as a stroke diagnostic instrument for prehospital diagnosis, including the potential involvement of ambulance paramedics in drug administration in” trial settings. (SOURCE: Stroke, April 29th online issue, 2004: Reuters Health news: April 2004)