Stroke Signs: Should FAST Change to BE-FAST?


Medical professionals have long recommended that people “act FAST” when it comes to spotting stroke symptoms. That means looking for:

F (face drooping)
A (arm weakness)
S (speech difficulty), and then following through with
T (time to call 911)


It’s a helpful mnemonic, but one University of Kentucky physician wondered how many stroke patients it really applied to. To find out, the neurology resident looked at all patients admitted for stroke at the University of Kentucky in 2014 to see how many cases were covered under FAST. He discovered that about 14 percent of patients did not have any symptoms related to face, arm or speech when they arrived.

Lutheran has been certified as a Primary Stroke Center by The Joint Commission for 10 years and is dedicated to providing the highest quality and fastest treatments to stroke patients. That’s why it’s important to call 911 immediately if you suspect a stroke.

Next, he took this group that did not have FAST symptoms and analyzed what they did present with. There were two major symptoms: problems with balance (42 percent) and sudden onset of visual problems (40 percent).

New Letters

Adding the B for “balance” and E for “eyes” to FAST—turning it into BE-FAST—reduces the number of people who aren’t covered under the mnemonic to 4.4 percent. The physician concluded that focusing education efforts on BE-FAST instead of FAST could help reduce the number of missed strokes, improving access time to treatments that may save a life.

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Preventing Stroke

  • Treat high blood pressure.

  • Don’t smoke, and avoid secondhand smoke.

  • Eat a diet low in added sugars and salt.
  • Control your blood sugar if you have diabetes.
  • Maintain a healthy weight.
  • Take your medications as prescribed.

Remember, the most important letter in both FAST and BE-FAST is the T—time is of the essence. The faster you act, the more likely you are to reduce damage to the brain. The treatments that work the best are only effective if the stroke is diagnosed within three hours. If you think you or someone you know might be experiencing a stroke, call 911 immediately.