The accuracy of the FAST stroke assessment in identifying stroke at initial ambulance call into a South African private emergency call centre

Abstract

Sub-Saharan Africa (sSA) is experiencing an epidemiological transition caused by a combination of lifestyle and dietary changes, urbanisation, and demographic as well as social transitions. [1,2] The incidence and burden of non-communicable diseases and risk factors for cardiovascular disease are on the rise in most low-and middle-income countries (LMICs), including South Africa (SA). [2,3] The incidence of cardiovascular disease (CVD) in sSA is increasing significantly, and between 1990 and 2013 mortality rates associated with CVD increased by 81%. [3] In 2013 the largest proportion of deaths associated with CVD in sSA was attributed to stroke. [3] Globally, LMICs carry a disproportionately high CVD and stroke burden. [2,4] Hypertension (a risk factor for stroke) has an extremely high incidence in SA, where it largely remains poorly managed due to low awareness and poor compliance to treatment. [5] According to the 2016 South African Demographic and Health Survey, [6] 46% and 44% of SA women and men, respectively, above 15 years of age suffer from hypertension. In addition, a large proportion of the SA population suffer other risk factors, including tobacco use, obesity, diabetes and physical inactivity. [6,7] Therefore, stroke is one of the leading causes of mortality and lasting morbidity in SA, [7] leading to an estimated 25 000 deaths per year. [8] With an increase in stroke prevalence it is imperative to improve care of those affected. Stroke is extremely time sensitive and time to definitive management directly correlates to patient outcome. [9] Delays in treatment and transport to adequate treatment centres negatively affect patient outcome and lasting morbidity. [10] In contrast, early recognition, diagnosis and transport to adequate treatment facilities have been linked to improved patient outcome. [11] Stroke leads to cerebral infarct, and time increases risk of infarct progression to healthy tissue. [12,13] Further insult and secondary neuronal injury (such as hypoxia) can accelerate the progression of the infarct. [14] The only definitive management strategies for ischaemic stroke are reperfusion

Nursing Care for Stroke Patients: Current Practice and Future Needs

“…Consistent with previous studies, the identification and consistent use of a standardized assessment was found to provide reliable and consistent data. A possible explanation for this similarity is that the FAST test is easy to use and is a highly recommended screening tool when a patient presents with the signs and symptoms of a stroke [ 24 ].…”

Sociodemographic Predictors of Knowledge and Practice of Stroke Preventive Strategies among Healthcare Workers in a Tertiary Hospital in Asaba, Delta State, Nigeria

“…Knowledge and practice of the emergency signs of stroke can save lives and increase the outcome for survivors; -"FAST" (facial drooping, arm weakness on one side, speech difficulty, timely intervention) (Crause, & Stassen, 2020). Stroke recognition assists any person in recognizing a stroke quickly and taking immediate action to transfer the patient to the nearest hospital (Václavík, et al, 2018).…”