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(Stroke. 2008;39:e22-a.)
© 2008 American Heart Association, Inc.

Letters to the Editor

To FAST or Not to FAST: SHOUT-FAST!

Alberto Chiti, MD; Elisa Giorli, MD Giovanni Orlandi, MD

Department of Neuroscience, Clinic of Neurology, Pisa, Italy

To the Editor:

We read with great interest the article by Kleindorfer et al¹ evaluating the effectiveness of FAST and "SUDDENS" message to identify stroke. We agree that FAST may be easier for the lay public to remember, but we have great concern on its lower sensitivity. To our advice, the "SUDDENS" message represents the minimum essential core to deliver to people, and a great effort is worth being made to produce both simple and complete advice and to implement widespread stroke information campaigns. In fact, this kind of intervention has proved effective to improve people’s knowledge of all the "SUDDENS" and to increase the number of emergency department presentations for stroke/transient ischemic attacks.^2,3 As for the issue of simplicity, FAST could be modified into SHOUT-FAST (Figure) in order to highlight "S"evere "H"eadache, "O"cular symptoms, "U"nbalance "T"rouble, which are not evident in FAST and are suggestive for subarachnoid hemorrage and vertebrobasilar stroke. Even if this acronym is longer than FAST, it’s consistent and quite simple,⁴ and we think it may be appealing and feasible. Further resarch on this issue is advisable.

View larger version (34K): [in this window] [in a new window]   Figure. SHOUT-FAST message higlights some symptoms (headache, ocular symptoms and unbalance trouble), which are not evident in FAST; face-arm-speech-time message is maintained, too.

Acknowledgments

Disclosures

None.

References

1. Kleindorfer DO, Miller R, Moomaw CJ, Alwell K, Broderick JP, Khoury J, Woo D, Flaherty ML, Zakaria T, Kissela BM. Designing a message for public education regarding stroke: does FAST capture enough stroke? Stroke. 2007; 38: 2864–2868.[Abstract/Free Full Text]

2. Chiti A, Fanucchi S, Sonnoli C, Barni S, Orlandi G. Stroke symptoms and the decision to call for an ambulance: turn on people’s minds! Stroke. 2007; 38: e58–e59.[Free Full Text]

3. Hodgson C, Lindsay P, Rubini F. Can mass media influence emergency department visits for stroke? Stroke. 2007; 38: 2115–2122.[Abstract/Free Full Text]

4. Hodgson CS. To FAST or not to FAST? Stroke. 2007; 38: 2631–2632.[Free Full Text]

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Stroke 2008 39: e42. [Extract] [Full Text] [PDF]

Response to Letters by Chiti et al and You et al

Dawn O. Kleindorfer
Stroke 2008 39: e43. [Extract] [Full Text] [PDF]

This Article Extract Full Text (PDF) All Versions of this Article: 39/2/e22-a    most recent STROKEAHA.107.508424v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chiti, A. Articles by Orlandi, G. Search for Related Content PubMed PubMed Citation Articles by Chiti, A. Articles by Orlandi, G. Pubmed/NCBI databases Medline Plus Health Information Emergency Medical Services Stroke Related Collections Related Articles