Stroke/Assessment Tools

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Assessment Tools

F.A.S.T.

Early, quick assessment of stroke symptoms can be easily achieved using the F A S T tool. This tool uses an acronym to help anyone, lay person or medical personnel, remember the assessment process:

FAST Acronym

(Medical personnel would use the "time" portion of this assessment to determine if the persons last known 'normal' is within guidelines (3 hours) for administering thrombolytics). In addition to the above quick assessment items, further assessment should include:

  • Sudden onset numbness or weakness of:
    • unilateral (one side) face
    • unilateral (one side) arm
    • unilateral (one side) leg
  • Sudden onset confusion
  • Sudden onset difficulty speaking or understanding what is said
  • Sudden onset difficulty walking
  • Sudden onset loss of balance or coordination
  • Sudden SEVERE headache with unknown cause

Symptoms of stroke are mimicked by other disease processes, such as Bells Palsy, vertigo, and even urinary tract infections, and therefore the most useful diagnostic tool is a computed tomography (CT) scan of the head.

Computed Tomography (CT)

The CT scan is a front line definitive tool used to diagnose a stroke. It is an imperative tool used for all patients presenting with stroke symptoms and The Joint Commission requires that "80% of acute stroke patients must have a diagnostic brain image completed and results reported within 45 minutes of the being ordered." These requirements are easily met at most hospitals with a CT scanner.

CT imaging has four essential issues to address: 1) presence of hemorrhage 2) presence of intravascular thrombus that can respond to treatment 3) presence and size of a core irreversibly infarcted tissue 4) presence of hypoperfused tissue at risk for subsequent infarction, unless perfusion restored.

REMEMBER: TIME IS BRAIN!

  • In the CT picture (left), the large darkened portion of brain matter (noticeable on the left side of this picture) is the area of 'stroke', or infarction of brain tissue that has been affected.



More Assessment Tools

The links below offer easy access to several standard tools currently used across the nation for assessing stroke patients.

NIHSS Assessment Tool

GLASCOW Coma Scale

Brain Attack Coalition - Stroke Scales

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