Blurring of vision with malaise

Area of Science:

• Emergency Medicine
• Neurology
• Cardiology

Background:

• Ambulance services utilize screening tools like FAST (facial arm speech time) for initial patient assessment.
• Timely diagnosis and intervention are crucial for conditions like stroke, especially to meet thrombolysis windows.

Observation:

• A 56-year-old female presented with blurred vision and malaise, initially screened with the FAST tool.
• Further examination revealed visual field deficits and a pan-systolic murmur, suggesting potential septic emboli or infective endocarditis.

Findings:

• Rigorously obtained history and examination led to the suspected diagnosis.
• Blood tests and imaging supported the clinical suspicion, prompting tertiary center transfer.
• The case highlights the potential for enhanced ambulance screening.

Implications:

• Incorporating visual field assessment (V) into the FAST tool could improve patient selection for emergency departments.
• More comprehensive initial screening may facilitate timely treatment for time-sensitive conditions.
• This approach could optimize hospital resource allocation and patient flow.