Now you try to assess four patients using the FAST test. Watch the videos and answer each of the questions superimposed on the video.
The videos below are provided by kind permission: Mark Garside – Northumbria Healthcare; Chris Price – Newcastle University.
Patient 1
Duration: 34 seconds
Patient 2
Duration: 28 seconds
Patient 3
Duration: 47 seconds
Patient 4
Duration: 33 seconds
Patient 1
Face
Q1. Is there an unequal smile or grimace? (Yes/No) – Yes – Correct, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is much less obvious on his left side.
No – Wrong, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is much less obvious on his left side.
Q2. Which side is weaker? (Left/Right/Neither) – Left – Correct, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is less obvious on his left side.
Right/Neither – Wrong, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is less obvious on his left side.
Arms
Q3. Does one arm drift down, or fall rapidly? (Yes/No) – No – Correct, although there is slight difference in the positioning of his left hand which might be a subtle sign that something is wrong.
Yes – Wrong, the arm does not move down although there is slight difference in the positioning of his left hand which might be a subtle sign that something is wrong.
Q4. Which arm is affected? (Left/Right/Neither) Neither – Correct, there was no drift down although there is slight difference in the positioning of his left hand which might be a subtle sign that something is wrong.
Left – Wrong, there was no drift down although there is slight difference in the positioning of his left hand which might be a subtle sign that something is wrong.
Right – Wrong, he maintains the position of the right arm normally.
Speech
Q5. Is the patients speech normal? (Yes/No) – No – Correct he has slight difficulty making the words clear, this is subtle. Yes – wrong, he has slight difficulty make the words clear, this is subtle.
Q6. What is wrong with the speech (Slurred/Word finding difficulty/Neither) – Slurred – Correct, very slightly.
Word finding difficulty – Wrong , he was quite fluent,
Neither – Wrong, he has slight difficulty making the words clear, this is subtle.
Q7. Does patient 1 have a Positive FAST test (Yes/No) – Yes – Correct, he has an unequal smile and slight speech problems – however even with one of these the test is positive.
No – Wrong, he has an unequal smile and slight speech problems – however even with one of these the test is positive.
Patient 2
Face
Q1. Is there an unequal smile or grimace? (Yes/No) – No – Correct, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is similar on both sides and the mouth moves symmetrically.
Yes – Wrong, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is similar on both sides and the mouth moves symmetrically.
Q2. Which side is weaker? (Left/Right/Neither) – Neither– Correct, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is similar on both sides and the mouth moves symmetrically.
Left/Right – Wrong, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is similar on both sides and the mouth moves symmetrically.
Arms
Q3. Does one arm drift down, or fall rapidly? (Yes/No) – Yes – Correct, he is clearly having problems lifting his left arm and keeping it in position.
No – Wrong, he is clearly having problems lifting his left arm and keeping it in position.
Q4. Which arm is affected? (Left/Right/Neither) – Left – Correct he is clearly having problems lifting his left arm and keeping it in position.
Right/Neither – Wrong, he is clearly having problems lifting his left arm and keeping it in position.
Speech
Q5. Is the patients speech normal? (Yes/No) – Yes – Correct, although quiet his speech is clear, not slurred and he has no word finding difficulty.
No – Wrong, although quiet his speech is clear, not slurred and he has no word finding difficulty.
Q6. What is wrong with the speech? (Slurred/Word finding difficulty/Neither) – Neither – Correct, although quiet his speech is clear, not slurred and he has no word finding difficulty.
Slurred/Word finding difficulty – Wrong, although quiet his speech is clear, not slurred and he has no word finding difficulty.
Q7. Does patient 2 have a Positive FAST test (Yes/No) – Yes – Correct, he has drift of his left arm.
No – Wrong, he has drift of his left arm.
Patient 3
Face
Q1. Is there an unequal smile or grimace (Yes/No) No – Correct, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is similar on both sides and the mouth moves symmetrically.
Yes – Wrong, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is similar on both sides and the mouth moves symmetrically.
Q2. Which side is weaker? (Left/Right/Neither) – Neither – Correct, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is similar on both sides and the mouth moves symmetrically.
Left/Right – Wrong, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is similar on both sides and the mouth moves symmetrically.
Arms
Q3. Does one arm drift down, or fall rapidly? (Yes/No) – Yes – Correct, he is clearly having problems keeping his right arm in position – it drifts down.
No – Wrong, he is clearly having problems keeping his right arm in position – it drifts down.
Q4. Which arm is affected? (Left/Right/Neither) – Right – Correct, he is clearly having problems keeping his right arm in position – it drifts down.
Left/Neither – Wrong, he is clearly having problems keeping his right arm in position – it drifts down.
Speech
Q5. Is the patients speech normal? (Yes/No) – No – Correct he is having problems saying the words, more likely a word finding difficulty than just slurring.
Yes – Wrong, he is having problems saying the words, more likely a word finding difficulty than just slurring.
Q6. What is wrong with the speech? (Slurred/Word finding difficulty/Neither) – Word finding difficulty – Correct, he is having problems saying the words, more likely a word finding difficulty than just slurring.
Slurred/Neither – Wrong, he is having problems saying the words, more likely a word finding difficulty than just slurring.
Does patient 4 have a Positive FAST test (Yes/No) Yes – Correct, he has drift of his right arm and speech problems.
No – Wrong, he has drift of his right arm and speech problems.
Patient 4
Face
Q1. Is there an unequal smile or grimace (Yes/No) – Yes – Correct, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is much less obvious on his right side.
No – Wrong, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is much less obvious on his right side.
Q2. Which side is weaker? (Left/Right/Neither) – Right – Correct, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is less obvious on his right side indicating a weakness on his right side.
Left/Neither – Wrong, when he smiles the nasolabial fold (crease between the edge of the mouth and nostril) is less obvious on his right side.
Arms
Q3. Does one arm drift down, or fall rapidly? (Yes/No) – Yes – Correct, he is unable to move his right arm, but the left is normal.
No – Wrong, he is unable to move his right arm, but the left is normal.
Q4. Which arm is affected? (Left/Right/Neither) – Right – Correct, he is unable to move his right arm, but the left is normal.
Left/Neither – Wrong, he is unable to move his right arm, but the left is normal.
Speech
Q5. Is the patients speech normal (Yes/No) – No – Correct, he is unable to say any words clearly.
Yes – Wrong, he is unable to say any words clearly.
Q6. What is wrong with the speech? (Slurred/Word finding difficulty/Neither) – Slurred/Word finding difficulty – Correct, he is unable to say any words clearly – this could be due to severe slurring (dysarthria) and/or word finding difficulty due to a language problem.
Neither – Wrong this could be due to severe slurring (dysarthria) and/or a word finding difficulty due to a language problem.
Q7. Does patient 5 have a Positive FAST test? (Yes/No) – Yes – Correct, he has an unequal smile, weak right arm and abnormal speech- however even with one of these the test is positive .
No – Wrong, he has an unequal smile, weak right arm and abnormal speech- however even with one of these the test is positive.
