FAST-PLUS Scale of Vaclavik et al for Prehospital Assessment of a Stroke Patient

Patient selection: possible stroke prior to hospital arrival

The scale is a modification of the FAST test

Components:

(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.

Performance:

• The area under the ROC curve is 0.65.

• The sensitivity is 93% and specificity 47%.