To FAST or Not to FAST: SHOUT-FAST!
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.
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.
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.
Hodgson C, Lindsay P, Rubini F. Can mass media influence emergency department visits for stroke? Stroke. 2007; 38: 2115–2122.
Hodgson CS. To FAST or not to FAST? Stroke. 2007; 38: 2631–2632.