Abstract

CRAUSE, K  and  STASSEN, W. The accuracy of the FAST stroke assessment in identifying stroke at initial ambulance call into a South African private emergency call centre. South. Afr. j. crit. care (Online) [online]. 2020, vol.36, n.1, pp.35-39. ISSN 2078-676X.  http://dx.doi.org/10.7196/sajcc.2020.v36i1.399.

BACKGROUND: Stroke is a potentially life-threatening, time-dependent event, and one of the leading causes of mortality and lasting morbidity in South Africa (SA). It is of vital importance that Emergency Medical Services (EMS) call-takers accurately recognise stroke symptoms and prioritise time as well as adequate care. EMS call-takers are the first link in stroke care and improving call-taker recognition of stroke signs and symptoms can drastically improve patient outcome. The Newcastle Face Arm Speech Time (FAST) test is a mnemonic aimed at improving diagnostic accuracy of strokeOBJECTIVE: To assess the use of the FAST test at a call-taker level to raise early suspicion of stroke and appropriately allocate resources to increase awareness of time and decrease delays on sceneMETHODS: A retrospective diagnostic study to determine the accuracy of the FAST mnemonic at identifying stroke when applied at EMS call-taker level. The outcome of the FAST assessment was compared with EMS stroke diagnosis for cases of a private SA EMS over a three-month period (N=146RESULTS: Using FAST, call-takers were able to identify stroke with a sensitivity of 87.5% and a specificity of 17.4% (positive predictive value 34%, negative predictive value 74%). This yielded an overall accuracy of 40.41%CONCLUSION: FAST is a useful screening tool for identifying stroke at call-taker level. FAST has acceptable sensitivity when used as a screening tool; however, specificity and diagnostic effectiveness are lacking. Further studies should be considered to determine call-taker as well as general public knowledge of stroke risk factors and presentation

Keywords : stroke; emergency medical services; Emergency Medical Dispatch.

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