Facial Palsy

Have the patient show teeth or smile.

NORMAL: Both sides of the face move equally.

ABNORMAL: One side of the face does not move as well as the other side.

Arm Weakness

Have the patient close their eyes and hold both arms out for 10 seconds.

NORMAL: Both arms move the same or not at all.

ABNORMAL: One arm does not move or drifts down compared to the other.

Speech Changes

Have the patient say "You can't teach an old dog new tricks".

NORMAL: Patient uses correct words.

ABNORMAL: Patient slurs words, uses the wrong words or is unable to speak.

Eye Deviation

Observe range of motion of eyes and look for head turning to one side.

NORMAL: Reflex present; Head rotated to the right, eyes move to the left.

ABNORMAL: Reflex absent; Head rotated to the right, eyes follow.

Denial / Neglect

When showing the patient the weak arm, ask "Who's arm is this?" or "Can you move your arm?".

NORMAL: The patient can see and feel on both sides and recognize own extremity.

ABNORMAL: Patient cannot feel or see on one side or does not recognize own arm.

FAST-ED Results

FAST-ED Score

0 points

Likelihood of LVOS

< 15%

Consider

• A FAST-ED greater than or equal to 4 is considered high probability for an LVO, and should be taken to the closest comprehensive stroke center.
• Get the Time Last Known Well.
• Get the best contact name & number for a witness.
• Get a blood sugar.
• Don't delay transport for ALS.
• Call a Stroke Alert, if appropriate.