The Face Arm Speech Test (FAST) can be used to screen a patient for evidence of a stroke. It is fast and simple, making it suitable for prehospital triage. The test was developed at the University of Newcastle upon Tyne.



(1) facial palsy

(2) arm weakness

(3) speech impairment


The patient is asked to show his or her teeth and to smile. A positive result is the presence of a new facial asymmetry, including an uneven grimace or smile. The side of a positive result is recorded.


Arm strength is tested by lifting both arms to set positions (90° if sitting, 45° if supine), then asking the patient to hold them both there for 5 seconds. A positive result is if either arm drifts down or falls rapidly before the 5 seconds is up. The side of a positive result is recorded.


Speech is tested by listening for a new disturbance in speech including slurring or difficulty in finding words for common objects. If the patient has poor vision, then place a common object in the patient's hand and ask him or her to name it.


In a stroke the facial palsy and arm weakness should affect the same side if both are present.

Positive Finding

Percent of Stroke Patients

arm weakness


speech disturbance


facial paresis


from Figure page 1357 Nor et al


Differential diagnosis of false positive results: seizures, intracranial infection, cerebral tumors, cardiovascular collapse and confusion.


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