Key Points
Î The chain of events favoring good functional outcome from an acute
ischemic stroke begins with the recognition of stroke when it occurs.
Î Data show that the public's knowledge of stroke warning signs remains
poor.
Î In one study, fewer than half of 9-1-1 calls for stroke events were made
within one hour of symptom onset, and fewer than half of those callers
thought stroke was the cause of their symptoms.
Î Many studies have demonstrated that intense and ongoing public
education about the signs and symptoms of stroke improves stroke
recognition.
Î The California Acute Stroke Pilot Registry (CASPR) reported that the
expected overall rate of fibrinolytic treatment within 3 hours could be
increased from 4.3% to 28.6% if all patients arrived early after onset.
Î Public education campaigns feature one of two stroke recognition
tools:
• The 5 "Suddens"
▶ Sudden weakness
▶ Sudden speech difficulty
▶ Sudden visual loss
▶ Sudden dizziness
▶ Sudden, severe headache
• FAST (Face, Arm, Speech, Time)
▶ One or more of face weakness, arm weakness, and speech difficulty symptoms
are present in 88% of all strokes and transient ischemic attacks (TIAs).
