Nirali Vora, MD
Fothergill RT, Williams J, Edwards MJ, Russell IT, and Gompertz P. Does Use of the Recognition Of Stroke In the Emergency Room StrokeAssessment Tool Enhance Stroke Recognition by Ambulance Clinicians? Stroke. 2013
The burden to accurately predict stroke increasingly falls upon the paramedics who first respond and decide if a patient needs to be re-routed to a specialty (certified) stroke center. The traditional and widely used FAST score is easy, with its acronym prompts — deficit in Face, Arm, or Speech? However, FAST was criticized for missing 38% of posterior fossa strokes.
|ROSIER score > or = 1 suggests stroke/TIA|
the pre-hospital or emergency setting.
What do you, the ER, or your paramedics use to recognize stroke/TIA? In this study, a regression analysis identified the best predictors of stroke as face or arm weakness, or (absence of) seizure activity. Maybe the FAST + a question about seizure activity would improve sensitivity of stroke identification.