The “FAST” education and awareness campaign alerts people to the warning signs of stroke. If the Face is drooping, an Arm is limp or Speech is slurred, Time is of the essence and 9-1-1 should be dialed immediately.
While this campaign has helped reduce prehospital delays and emergency medical service (EMS) response times in English-speaking countries, something gets lost in translation when it’s applied to other languages.
“It is difficult for non-English speaking people to remember ‘FAST’ and the related meaning of each Roman character, which generally does not translate well into other languages without the loss of the concept of ‘fast action,’” a group of researchers wrote in Stroke, where they published an idea for an alternative, number-based campaign called Stroke 112.
Stroke 112 takes the same symptoms highlighted in FAST and gives them numerical designations: 1 uneven face (crooked mouth), 1 weak arm and 2 incoherent lips (slurred speech). It also has the benefit of 1-1-2 being the 9-1-1 equivalent in more than 70 countries and regions, according to lead author Jing Zhao, MD, PhD, and colleagues. And in some other nations where 112 isn’t the primary emergency number, dialing those digits may result in a call being rerouted to emergency services.
“It is important to note that 112 can be dialed free of charge even when the cell phone is locked or without an active service contract,” the authors wrote. “In addition, the location of the caller can be detected by the operator immediately if the caller’s phone has a global positioning system function, a critical feature that could avoid significant delay in locating the patient, especially when a patient has speech problems because of stroke or the caller does not speak the local language.”
Zhao et al. studied the acceptance of the Stroke 112 program in Taiwan, where the native language is Chinese. An initial survey of 465 survey respondents revealed that 54.6 percent thought Stroke 112 was easier to remember than the Chinese translation of FAST.
After the official launch of the Stroke 112 awareness campaign in Taiwan, even more people preferred the new tool. Another survey of 610 individuals found 66.4 percent felt Stroke 112 was easier to remember, a sentiment shared by three-quarters of neurologists (out of 55 total) who attended the campaign’s introductory lecture.
“It is striking that as high as 74.5 percent of neurologists who responded to the survey … believed that Stroke 112 was easier to remember despite the fact that FAST has been used in Taiwan as an educational tool for less than eight years,” the authors wrote. “The actual clinical impact of Stroke 112 still needs to be investigated in the future.”
Zhao and colleagues acknowledged their study may be limited by a small sample size. In addition, even if people are aware of these educational campaigns, they may not always call emergency services as directed.
“A well-designed clinical trial is needed to investigate whether Stroke 112 can improve the response rate to quickly call the EMS,” the researchers wrote.
According to a press release, Zhao and his team are working with international experts to implement Stroke 112 worldwide, as the numerical reminders of symptoms can be applied to any language.
Daniel joined TriMed’s Chicago editorial team in 2017 as a Cardiovascular Business writer. He previously worked as a writer for daily newspapers in North Dakota and Indiana.