Neurological assessment with FAST to better detect posterior circulation stroke

Godley, Nicola ORCID logoORCID: (2023) Neurological assessment with FAST to better detect posterior circulation stroke. Journal of Paramedic Practice, 15 (7). pp. 272-279. Item availability may be restricted.

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Posterior circulation stroke (PCS) represents up to 25% of ischaemic strokes and affects more than 20 000 people annually within the UK. Prehospital clinical practice guidelines recommend the use of a validated stroke screening tool, such as the ‘Face, Arms, Speech, Time’ [FAST] tool for the assessment of all patients presenting with stroke symptoms. However, with PCS, patients may present with vestibular symptoms, which cannot be detected with ‘FAST’. Furthermore, over one-third of patients with PCS are delayed or misdiagnosed due to a lack of apparent ‘typical’ acute stroke symptoms. The ‘FAST’ tool is deemed to have high sensitivity and moderate specificity in the recognition of ischaemic stroke; yet there is evidence within the literature determining that the ‘FAST’ tool is not adequate for prehospital screening of PCS, leading to misdiagnosis, treatment delay, and severe life-limiting deficits or death. The aim of this literature search is to evaluate how the use of additional neurological assessment, alongside the validated ‘FAST’ tool, could be used within the prehospital setting for the improved paramedic detection of PCS.

Item Type: Article
Journal / Publication Title: Journal of Paramedic Practice
Publisher: MA Healthcare
ISSN: 2041-9457
Departments: Institute of Health > Centre for Excellence in Paramedic Practice
Depositing User: Anna Lupton
Date Deposited: 10 Jul 2023 09:33
Last Modified: 10 Jul 2023 10:30
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