The face arm speech test: does it encourage rapid recognition of important stroke warning symptoms?

Emerg Med J. 2013 Jun;30(6):467-71. doi: 10.1136/emermed-2012-201471. Epub 2012 Jul 4.


Objectives: To assess public knowledge of stroke and transient ischaemic attack symptoms, and awareness of the content of a recent national health campaign.

Design: Interviewer-administered questionnaire.

Setting: Leicester, UK.

Participants: 1300 members of a mixed urban/rural, multiethnic population that was sampled in public areas, places of work and schools.

Main outcome measures: Knowledge of the terms 'stroke', 'stroke risk factors' and the 'FAST campaign'. Awareness of stroke symptoms, and ability to distinguish from non-stroke symptoms.

Results: 70% of the public surveyed were aware of the FAST campaign, with highest penetration in the female, older and white population. Overall, high levels of awareness of FAST symptoms (facial weakness 89%, arm weakness 83%, speech problems 91%) as warning signs of stroke were observed, though significantly lower levels were reported in the black and minority ethnic population. However, poor recognition of other important signs, including leg weakness (57%) and visual loss (44%) were seen, and significantly more men were likely to report non-specific symptoms as being associated with stroke.

Conclusions: The survey has confirmed the effectiveness of the recent FAST campaign in raising public awareness of stroke and stroke warning signs, though poorest penetration was seen in the black and minority ethnic population. However, important stroke symptoms, including leg weakness and visual loss, were poorly recognised. This may lead to delays in presentation, specialist assessment and secondary prevention, and such stroke warning signs should be included in future public health campaigns.

Keywords: FAST; aged; neurology; nursing home care; primary care; stroke; symptom awareness; thrombolysis; transient ischaemic attack.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Awareness*
  • Child
  • Ethnicity / psychology
  • Ethnicity / statistics & numerical data
  • Female
  • Health Education
  • Health Knowledge, Attitudes, Practice*
  • Hospital Rapid Response Team
  • Humans
  • Male
  • Middle Aged
  • Minority Groups / psychology
  • Minority Groups / statistics & numerical data
  • Patient Education as Topic
  • Risk Factors
  • Stroke / diagnosis*
  • Stroke / psychology*
  • Surveys and Questionnaires
  • Sweden
  • Time Factors
  • United Kingdom
  • Young Adult