To FAST or Not to FAST?

Abstract

See related article, pages 2864–2868. In this issue of Stroke , Kleindorfer and colleagues1 report on a chart review comparing the traditional 5 “sudden” warning signs of stroke and the FAST system. FAST is based on the Cincinnati Prehospital Stroke Scale (CPSS) and focuses on 3 symptoms: facial droop (F), arm drift (A) and speech problems (S), with “T” for “time” rounding out the acronym. As Kleindorfer and colleagues point out, the standard list of 5 warning signs was created by a committee (the Brain Attack Coalition). Although it may be neurologically sound, Kleindorfer et al suspect it does not represent best practices when talking to the general public. But what does make for effective public education messaging? If we look at the world of advertising, there appears to be 3 underlying principles for getting messages out to people—and ensuring they are remembered. They are: (1) consistency, (2) simplicity, and (3) repetition. Looking at public-oriented websites of some of the major English-language stroke organizations suggests that common messaging on the warning signs of stroke follows national boundaries. The American Stroke Association (ASA),2 National Stroke Association (NSA)3 and National Institute of Neurological Disorders and Stroke (NINDS)4 all list the same 5 warning signs. The Heart and Stroke Foundation of Canada lists five,5 as does the Stroke …