Mnemonic video linked to faster 911 call response for stroke

Key takeaways:

• Likelihood of 911 call for stroke increased from 72% to 90% in FAST; 71% to 90% in BE-FAST.
• Ability to identify letters in mnemonics was higher immediately after video viewing vs. baseline.

An instructional video regarding two stroke-related mnemonics was linked to faster 911 call response for suspected stroke, according to a study presented at the International Stroke Conference.

“As clinicians, we know that FAST captures about 80% of all stroke,” Opeolu M. Adeoye, MD, MS, FAHA, chair of the department of emergency medicine at Washington University School of Medicine in St. Louis, said in a video. “However, we are more concerned about the 20% that are not captured, so the BE-FAST scale, which adds balance and eyes, was developed.”

Although prior research compared the sensitivity of stroke symptom awareness acronyms FAST (Face drooping, Arm weakness, Speech difficulty, and Time to call 911) to BE-FAST (which adds Balance loss, Eye changes to FAST), more detailed studies have not been undertaken. Adeoye and colleagues assessed whether the FAST or BE-FAST protocol was more efficiently recalled at 30 days post stroke and to determine which mnemonic was more likely to prompt a 911 call.

They conducted a randomized, parallel, two-group study that included responses to an online survey by English-speaking United States residents. Assessments were made at baseline (n = 1,900) and again 30 days later (n = 1,393) comparing the efficacy of each mnemonic’s protocol and each respondent’s understanding of the letters that comprise them via 1-minute educational videos.

Following immediate viewing of the educational video, the likelihood of calling 911 upon a suspected stroke increased for both groups: 72% to 90% in FAST and 71% to 90% in BE-FAST.

The results additionally showed that participants’ ability to identify what the letters F, A, and S in the mnemonic represent was significantly higher immediately after video viewing compared with baseline for both mnemonics (34% to 70% in FAST; 29% to 50% in BE-FAST), with FAST recording higher common letter recognition than BE-FAST immediately after the video (70% vs. 50%).

At 30 days, Adeoye and colleagues reported that likelihood of calling 911 underwent a slight decline in both groups but remained elevated compared with baseline. Conversely, participants in both groups saw a decline in letter recall abilities, but overall recall was higher than baseline assessments.

Data further showed that FAST had significantly higher common letter performance than BE-FAST after 30 days (50% vs. 40%).

“Historically, health care professionals want to provide the most comprehensive warning sign mnemonic to ensure no strokes are missed,” Adeoye said in a related release. “What this research shows is, from a public point of view, adding two extra letters made it more challenging to recall the stroke warning signs.”

Reference:

Stroke warning sign acronyms drive 911 calls, F.A.S.T. leads in symptom recall for public. https://newsroom.heart.org/news/stroke-warning-sign-acronyms-drive-911-calls-f-a-s-t-leads-in-symptom-recall-for-public?preview=2461&preview_mode=True. Published Jan. 30, 2025. Accessed Feb. 6, 2025.