BE-FAST
Suspected stroke
CCMS-MED-SOP-001 §8
Church is a classic 'we didn't want to interrupt the sermon' delay. Do not add to it. Activate EMS immediately if stroke is suspected.
Call 911 now. Do not debate this.
Give location, problem, and send a runner to meet EMS at the watched entry.
- 1
911 now. Write last known well as a clock time, not 'a few minutes ago.' Stay with the patient.
- 2
BE-FAST: Balance, Eyes, Face (smile/teeth), Arms (pronator drift), Speech, Time.
- 3
Glucose fingerstick if it does not delay EMS. A low sugar can mimic stroke; a normal sugar does not exclude it.
- 4
Comfortable head position. Do not force flat if vomiting. Nothing by mouth.
- 5
Protect the airway if consciousness drops. Recovery position if breathing and vomiting risk.
Do not
- Do not give aspirin for suspected stroke. You cannot tell bleed from clot in the sanctuary.
- Do not give ibuprofen or anything else 'for the headache.'
- Sudden worst headache of life, with or without vomiting — think hemorrhage.
- Children: uncommon but real. Sudden focal weakness, new seizure with focal findings, severe headache + vomiting + neuro change — do not call it a virus in the hallway.
- Mimics: hypoglycemia, Todd's paralysis, migraine, intoxication, conversion. Check glucose. Still call 911 if FAST is positive.
This field guide does not replace 911, a medical director, or licensed clinical judgment. It does not authorize anyone to practice beyond license and current training.
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