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Updated: Jun 29, 2025

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Mnemonic utilization in stroke education: FAST and BEFAST adoption by certified comprehensive stroke centers
Christopher Hogge1, Larry B Goldstein2, Sushanth R Aroor3
1Walter Reed National Military Medical Center, Bethesda, MD, United States.
Introduction:
Symptom recognition and timely access to treatment are critical components of acute stroke care systems. Two mnemonics widely used in public educational campaigns for recognizing stroke symptoms include FAST (Face-Arm-Speech-Time) and BEFAST (Balance-Eyes-Face-Arm Speech-Time). The FAST mnemonic can miss up to 14% of strokes. BEFAST includes common posterior circulation stroke symptoms and has been implemented by several Comprehensive Stroke Centers (CSCs).
Methods:
We sought to analyze the pattern of public educational materials available on the websites of US CSCs. The Joint Commission (JC) quality check website compiles a list containing the names and locations of the country's 217 JC-certified CSCs, which was downloaded in August, 2022. Each CSC's website was searched for educational material containing FAST and BEFAST mnemonics for stroke symptom recognition.
Results:
The FAST mnemonic was listed by 35% of CSCs, the BEFAST by 58%, with 7% listing no specific mnemonic. The highest portion of CSCs using BEFAST was in western (65%) and southeastern (63%) states. The highest percentage of CSCs with no listed mnemonic were in the northeastern (14%) and southeastern (13%) states.
Conclusion:
Consistency is critical in shaping public health education related to stroke symptoms recognition. Our study suggests further effort is needed to unify the public messaging on stroke recognition.

