Field Assessment Stroke Triage for Emergency Destination (FAST-ED)
Identifies large vessel occlusion stroke (LVOS) in the pre-hospital setting.
Advice
- Use as part of a protocolized pathway alongside a brief mimics screen (e.g., seizure with Todd’s paralysis, hypoglycemia, migraine, intoxication).
- Results may be used to expedite in-hospital stroke team activation and imaging, especially for potential endovascular candidates.
- Continue to monitor and reassess neurological status during transport and after arrival, as stroke symptoms may evolve.
Management
Score ≥4:
- Indicates high LVOS probability.
- Prioritize direct transport to a thrombectomy-capable or comprehensive stroke center if within reasonable transport time and per local protocol.
Score <4:
- Indicates lower LVOS probability.
- Transport to the nearest appropriate stroke center for further evaluation and management may be appropriate.
Critical Actions
Posterior circulation strokes (e.g., vertigo, ataxia, dysmetria) may score low; do not use this tool to “rule out” stroke when the history and examination are concerning.