Vaclavik et al reported the FAST-PLUS scale for prehospital assessment of a stroke patient. This can help to identify a patient with an intracranial large vessel occlusion. The authors are from multiple institutions in the Czech and Slovak Republics.

Patient selection: possible stroke prior to hospital arrival


The scale is a modification of the FAST test



(1) the FAST (facial palsy, any arm weakness, speech impairment)

(2) PLUS the presence of severe arm or leg weakness (NIHSS 3)


Criteria for a positive result - both of the following:

(1) at least one FAST component is present

(2) severe paresis of an arm and/or leg


A positive FAST-PLUS score is a sensitive test for stroke with a large vessel occlusion and a potential candidate for mechanical thrombectomy.



• The area under the ROC curve is 0.65.

• The sensitivity is 93% and specificity 47%.

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