As an award-winning stroke center certified by the Joint Commission, MarinHealth Medical Center has the expert team and advanced technologies to aggressively treat stroke. But the longer a stroke victim waits to go to the emergency room, the lower their chance of a satisfactory recovery. That’s why it’s so important to know and understand the warning signs of stroke.
In this podcast, Maureen Stull, RN, and Stroke Program Coordinator at MarinHealth Medical Center, explains the six components of BE FAST: Balance, Eyes, Face, Arm, Speech, and Time. So be informed, be vigilant, and if you think you or someone else might be having a stroke, BE FAST! Your quick response could save a life.
BE FAST – To Identify Stroke and Save a Life
Featured Speaker:
Maureen "Mo" Stull, RN
Maureen "Mo" Stull, RN is the Stroke Program Coordinator, MarinHealth Medical Center, Transcription:
BE FAST – To Identify Stroke and Save a Life
Bill Klaproth (Host): Stroke is an emergency and every moment counts, and right now Maureen Stull, a registered nurse and the Stroke Program Coordinator at Marin General Hospital, is going to share with us the B.E. F.A.S.T. acronym. Maureen, thank you for your time today. Before we get to the B.E. F.A.S.T. acronym, let me ask you this, why is time so critical when it comes to stroke?
Maureen Stull, RN (Guest): Well Bill, time is brain, and every minute that a stroke goes untreated, a person loses 30,000 brain cells. So every second, every minute counts.
Bill: So understanding stroke, the effects it can have on the brain, and recognizing the symptoms are so important. So that takes us right to the B.E. F.A.S.T. acronym that everyone should know and watch out for. So let's go through that, Maureen, and let's start with the B of the B.E. F.A.S.T. acronym, which is balance. Tell us about that.
Maureen: Okay, so the first thing to always remember is that usually these symptoms are very sudden, and usually they occur on one side of the body. So balance, the first acronym, the B is a little bit difficult because you're not going to really notice maybe that someone is leaning to one side more when they walk, or their walk is a staggering motion. But it's going to be a change from what you usually notice. It's a loss of coordination and it's a loss of balance.
Bill: Okay, so the B stands for balance, loss of balance, loss of coordination. So the E of B.E. F.A.S.T. is eyes. Tell us what we need to watch out for there.
Maureen: So again, it's going to be a sudden thing. It's not like gradually starting to need to use glasses to read, or anything like that. It's going to be where there's a sudden change in the vision, and usually it is either double vision type of a thing that doesn't go away when you blink your eyes, or the other thing that it can be is what we call the visual field cut, which is all of a sudden you cannot see out of the- you have no side vision, or you have no vision above midline so to speak, or below midline. Because when we look straight ahead, usually you see things in your periphery, and so a field cut as they call it, you lose that peripheral vision. It can be up, down, or to the side, and again it would be usually a sudden type of a thing.
Bill: Sudden vision loss and vision changes, watch out for that. So the F in B.E. F.A.S.T. equals face. Tell us about that, Maureen.
Maureen: So correct, it does equal face, and up until very recently, the F.A.S.T. portion of the acronym had been in place for quite a long time, and we've added the B.E. actually. So the face is the typical facial droop, uneven smile, sometimes people will actually not be able to control and have a little bit of drooling out of that side of their face. And a lot of times it's associated with speech, but the main thing is the face. When you're looking at someone, and it would be very obvious usually. And again, it's sudden, and it's not their normal. You're looking at them and all of a sudden they don't look right. So it's one side of the face drooping, and especially you can notice it usually with the mouth.
Bill: Face equals facial droop, uneven smile, and look at the mouth, very noticeable. So B.E. F.A.S.T., the A stands for arm. What is that, Maureen?
Maureen: So arm, again it's around your - what we all think of when we think of a stroke - it's going to be on one side, and it will be loss of coordination, numbness, weakness of that arm. You notice someone when they go to pick up their coffee cup, and they can't pick it up, or they drop, or they pick it up but they can barely get it up to their mouth. So things like that. You know, just big motor movements that they cannot do. But it can also be just as slight as feeling numb, wanting to shake your arm all the time to try to wake it up like it's asleep, like you slept on it wrong or something like that. Again, it's going to be sudden and it's going to either be usually the numbness or it will actually be weak.
Bill: So A equals arm which is arm numbness and arm weakness. That brings us to S for speech.
Maureen: Yeah, speech. So going back to the face, usually it's going to be associated with a facial droop, uneven smile, that type of thing. But slurred speech, difficulty in speaking or understanding. So there's two kinds of different types; there's the person who doesn't understand what you're saying, so when they speak back to you it's garbled, or it's the person that totally understands what you're saying, but just can't get it back out to you. But the bottom line is it's going to be either jumbled speech, calling a piece of paper a tie, or it's going to be very slurred speech, or thick tongue. It doesn't have to be that major, it can be a thick tongue, that type of thing. And you get back into it can affect your swallow, so you may see somebody with the drooling again, not able to control your secretion, those kinds of things.
Bill: So speech, slurred speech, difficulty speaking or understanding. And that brings us to our last letter in B.E. F.A.S.T, T for time. Tell us about that, Maureen.
Maureen: Yes time, time, time is the most important thing. Again, like I said in the beginning, every second that a person has the symptoms of a stroke, they're losing brain cells. The more brain cells we lose, the less ability we have to maintain or regain our function that we had prior to the stroke event. Many people, they either try to minimize it thinking, "Oh it's nothing, it will go away," or "I'll call my doctor tomorrow, it's Sunday," when in reality any time a person questions if either they themselves are having any of these symptoms, or if we witness it in someone, we need to call 911. Let the paramedics, and the hospital, and the doctors and nurses, let them figure out if it was not a stroke or a stroke. If it's not a stroke, that's okay, you know? That's wonderful, actually. But if it is a stroke, you want them to be able to get to you really quickly, and provide you with some of the interventions that are available now that can break up the clot in your brain, or minimize the amount of loss that you have, disability. Stroke is the number one disability in our country, so if we can minimize that or reverse it, then that's a wonderful thing.
Bill: Maureen, we hear of people trying to drive themselves to the emergency department, or a loved one. That's really not a good idea, is it? The best way to do it is to call 911.
Maureen: Yes, call 911. Let them help you make the decision. Because the other thing is for people who do have an event like this, there's a trigger mechanism in the brain where enzymes and chemical reactions occur and everything because there's a loss of circulation to brain tissue. And sometimes people don't even realize that these things are occurring to them. It's the person who's living with them, or looking at them, or working with them, they're the ones that are recognizing that this person isn't right, something is wrong. So it's just so important that we teach as many people in the community, get the word out there, B.E. F.A.S.T. You see something that fits under this description, this acronym, just act on it. Call 911, it's okay. It's okay to call 911.
Bill: So B.E. F.A.S.T. Balance, eyes, face, arm, speech, time. Maureen, thank you so much for your time today and explaining that to us, we really appreciate it. For more information and health tips from Marin General Hospital, join Health Connection at www.MarinGeneral.org/healthconnection. That's www.MarinGeneral.org/healthconnection. This is The Healing Podcast brought to you by Marin General Hospital. I'm Bill Klaproth, thanks for listening.
BE FAST – To Identify Stroke and Save a Life
Bill Klaproth (Host): Stroke is an emergency and every moment counts, and right now Maureen Stull, a registered nurse and the Stroke Program Coordinator at Marin General Hospital, is going to share with us the B.E. F.A.S.T. acronym. Maureen, thank you for your time today. Before we get to the B.E. F.A.S.T. acronym, let me ask you this, why is time so critical when it comes to stroke?
Maureen Stull, RN (Guest): Well Bill, time is brain, and every minute that a stroke goes untreated, a person loses 30,000 brain cells. So every second, every minute counts.
Bill: So understanding stroke, the effects it can have on the brain, and recognizing the symptoms are so important. So that takes us right to the B.E. F.A.S.T. acronym that everyone should know and watch out for. So let's go through that, Maureen, and let's start with the B of the B.E. F.A.S.T. acronym, which is balance. Tell us about that.
Maureen: Okay, so the first thing to always remember is that usually these symptoms are very sudden, and usually they occur on one side of the body. So balance, the first acronym, the B is a little bit difficult because you're not going to really notice maybe that someone is leaning to one side more when they walk, or their walk is a staggering motion. But it's going to be a change from what you usually notice. It's a loss of coordination and it's a loss of balance.
Bill: Okay, so the B stands for balance, loss of balance, loss of coordination. So the E of B.E. F.A.S.T. is eyes. Tell us what we need to watch out for there.
Maureen: So again, it's going to be a sudden thing. It's not like gradually starting to need to use glasses to read, or anything like that. It's going to be where there's a sudden change in the vision, and usually it is either double vision type of a thing that doesn't go away when you blink your eyes, or the other thing that it can be is what we call the visual field cut, which is all of a sudden you cannot see out of the- you have no side vision, or you have no vision above midline so to speak, or below midline. Because when we look straight ahead, usually you see things in your periphery, and so a field cut as they call it, you lose that peripheral vision. It can be up, down, or to the side, and again it would be usually a sudden type of a thing.
Bill: Sudden vision loss and vision changes, watch out for that. So the F in B.E. F.A.S.T. equals face. Tell us about that, Maureen.
Maureen: So correct, it does equal face, and up until very recently, the F.A.S.T. portion of the acronym had been in place for quite a long time, and we've added the B.E. actually. So the face is the typical facial droop, uneven smile, sometimes people will actually not be able to control and have a little bit of drooling out of that side of their face. And a lot of times it's associated with speech, but the main thing is the face. When you're looking at someone, and it would be very obvious usually. And again, it's sudden, and it's not their normal. You're looking at them and all of a sudden they don't look right. So it's one side of the face drooping, and especially you can notice it usually with the mouth.
Bill: Face equals facial droop, uneven smile, and look at the mouth, very noticeable. So B.E. F.A.S.T., the A stands for arm. What is that, Maureen?
Maureen: So arm, again it's around your - what we all think of when we think of a stroke - it's going to be on one side, and it will be loss of coordination, numbness, weakness of that arm. You notice someone when they go to pick up their coffee cup, and they can't pick it up, or they drop, or they pick it up but they can barely get it up to their mouth. So things like that. You know, just big motor movements that they cannot do. But it can also be just as slight as feeling numb, wanting to shake your arm all the time to try to wake it up like it's asleep, like you slept on it wrong or something like that. Again, it's going to be sudden and it's going to either be usually the numbness or it will actually be weak.
Bill: So A equals arm which is arm numbness and arm weakness. That brings us to S for speech.
Maureen: Yeah, speech. So going back to the face, usually it's going to be associated with a facial droop, uneven smile, that type of thing. But slurred speech, difficulty in speaking or understanding. So there's two kinds of different types; there's the person who doesn't understand what you're saying, so when they speak back to you it's garbled, or it's the person that totally understands what you're saying, but just can't get it back out to you. But the bottom line is it's going to be either jumbled speech, calling a piece of paper a tie, or it's going to be very slurred speech, or thick tongue. It doesn't have to be that major, it can be a thick tongue, that type of thing. And you get back into it can affect your swallow, so you may see somebody with the drooling again, not able to control your secretion, those kinds of things.
Bill: So speech, slurred speech, difficulty speaking or understanding. And that brings us to our last letter in B.E. F.A.S.T, T for time. Tell us about that, Maureen.
Maureen: Yes time, time, time is the most important thing. Again, like I said in the beginning, every second that a person has the symptoms of a stroke, they're losing brain cells. The more brain cells we lose, the less ability we have to maintain or regain our function that we had prior to the stroke event. Many people, they either try to minimize it thinking, "Oh it's nothing, it will go away," or "I'll call my doctor tomorrow, it's Sunday," when in reality any time a person questions if either they themselves are having any of these symptoms, or if we witness it in someone, we need to call 911. Let the paramedics, and the hospital, and the doctors and nurses, let them figure out if it was not a stroke or a stroke. If it's not a stroke, that's okay, you know? That's wonderful, actually. But if it is a stroke, you want them to be able to get to you really quickly, and provide you with some of the interventions that are available now that can break up the clot in your brain, or minimize the amount of loss that you have, disability. Stroke is the number one disability in our country, so if we can minimize that or reverse it, then that's a wonderful thing.
Bill: Maureen, we hear of people trying to drive themselves to the emergency department, or a loved one. That's really not a good idea, is it? The best way to do it is to call 911.
Maureen: Yes, call 911. Let them help you make the decision. Because the other thing is for people who do have an event like this, there's a trigger mechanism in the brain where enzymes and chemical reactions occur and everything because there's a loss of circulation to brain tissue. And sometimes people don't even realize that these things are occurring to them. It's the person who's living with them, or looking at them, or working with them, they're the ones that are recognizing that this person isn't right, something is wrong. So it's just so important that we teach as many people in the community, get the word out there, B.E. F.A.S.T. You see something that fits under this description, this acronym, just act on it. Call 911, it's okay. It's okay to call 911.
Bill: So B.E. F.A.S.T. Balance, eyes, face, arm, speech, time. Maureen, thank you so much for your time today and explaining that to us, we really appreciate it. For more information and health tips from Marin General Hospital, join Health Connection at www.MarinGeneral.org/healthconnection. That's www.MarinGeneral.org/healthconnection. This is The Healing Podcast brought to you by Marin General Hospital. I'm Bill Klaproth, thanks for listening.