Recognize stroke and act fast (FAST and beyond)

Recognize stroke and act fast (FAST and beyond)

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FAST is a powerful starting point, but not every stroke announces itself with face, arm, or speech changes. This lesson teaches B.E. F.A.S.T., last-known-well, and what to do when symptoms are subtle or temporary

Why this matters

The correct response to possible stroke is not to diagnose it perfectly. It is to recognize enough danger to call for urgent help

B.E. F.A.S.T

Balance means sudden loss of balance, dizziness, or trouble walking. Eyes means sudden vision change. Face means drooping or numbness. Arms means weakness, numbness, or drifting down. Speech means slurring, strange words, or trouble understanding. Time means call emergency services now

Any one sudden sign is enough. Do not wait for all signs to appear

Last-known-well

Last-known-well is the last time the person was completely at their normal baseline. It is not the time symptoms were discovered unless someone saw the person normal just before that

This time helps clinicians decide which treatments and tests are possible. Write it down and tell emergency responders

Subtle and temporary symptoms count

Strokes in the back of the brain can show dizziness, imbalance, double vision, vomiting, or severe coordination trouble. TIAs can resolve before help arrives. Both patterns still need urgent evaluation

Do not drive yourself. Call emergency services when available because responders can start stroke routing and prenotification

Watch and connect

How to Recognize and Respond to a Stroke | First Aid Tips - Use this video to rehearse the recognition-to-action sequence.

In practice

A grandmother wakes from a nap with slurred speech. The family last saw her normal at noon before the nap, not at 2 p.m. when they found her. They call emergency services and report noon as last-known-well

★ Key takeaways

  • B.E. F.A.S.T. adds balance and eye symptoms to FAST
  • Any sudden warning sign is enough to call emergency services
  • Last-known-well means last normal baseline, not time found

Lesson quiz

Check this lesson

Answer these lesson-specific questions before continuing. They focus on the decisions, scenarios, and safety points covered above.

0 of 3 answered

Question 1

1. A person is found at 4 p.m. with speech trouble after sleeping. They were last seen normal at 1 p.m. What is last-known-well?

Question 2

2. Which sudden symptoms fit B.E. F.A.S.T.? Select all that apply.

Select all that apply

Question 3

3. What should you do if stroke-like symptoms disappear after ten minutes?

Complete every question, then submit once to see all correct and incorrect answers.

References

  1. American Stroke Association logo
    Tier 1American Stroke Association2024
    Stroke Symptoms (F.A.S.T. / B.E. F.A.S.T.)
  2. American Stroke Association logo
    Tier 1American Stroke Association2024
    TIA (Transient Ischemic Attack)
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