Fast test

Synonyms

Face- Arm- Speech Test;

Definition

The FAST- test is a simple neurological preclinical examination to identify patients with an apoplexy at an early stage (Nor 2004 / Kraft 2020). The test can be performed by both experienced and lay persons (Mader 2020).

The sensitivity is 84.7% (Saver 2021).

FAST- Test:

1. Face (drooping eyelids, asymmetry, facial paresis [Leo 2022]):

2. A Arm (affected arm cannot be held up).

3. S Speech (aphasia, dysarthria)

4. T Time (onset of symptomatology) (Leo 2022).

There is also the extended FAST test, the so-called BE-FAST test. This includes the following additional tests:

5. B Balance (balance, gait insecurity, foot lift weakness)

6. E Eyes (double vision, blurring, visual disturbances)

(Saver 2021)

Positive FAST- Test:

At least 1 criterion must be true for the test to be considered positive (Herold 2022).

If the FAST test is positive, the patient should be transferred to a stroke unit immediately (Herold 2022).

Negative FAST- Test:

If the short test is negative, at least 4 other factors should be checked:

- Gaze paresis:

Check eye movement to the right and left.

- Visual disturbance:

Visual fields of right and left eyes should be checked separately.

- Leg paresis:

In recumbency, an attempt to hold both legs forward should be made with eyes closed.

- Hemihypesthesia:

Touch sensation should be checked separately on each side on the face, arms and legs (Herold 2022).

In addition to the FAST test, 2 other tests are also used, particularly in the Anglo-Saxon world:

- Cincinnati Prehospital Stroke Scale (CPSS)

- Los Angeles Prehospital Stroke Screen (LAPSS)

(Saver 2021)

Apoplexy is one of the most common diseases in Germany and represents one of the leading causes of morbidity and mortality worldwide (Neumann- Haefelin 2021).

- Face:

- Stick out tongue

- Smile

- Frown

- Trace fingers in front of face (Kohfahl 2022)

- Facial paresis: Laughter and grimacing restricted

- Arm paresis: When holding out an object with eyes closed, one arm drops; handshake weakened on one side;

- Speech: Have a sentence repeated, name object held out (Herold 2022).

Since apoplexy requires rapid diagnosis and treatment, the practice team should be trained in the FAST test and perform it independently during a telephone call as soon as there is a suspicion of apoplexy (Mader 2020).

It is also recommended to train patients with an increased risk of apoplexy, such as arterial hypertension, history of cardiovascular disease, smoking, etc., regarding the test (Mader 2020).

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