Befast acronym
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BEFAST Acronym in Stroke Recognition: A Comprehensive Overview
Introduction to Stroke Symptom Recognition
Recognizing stroke symptoms quickly is crucial for timely treatment and improved outcomes. Two primary mnemonics used in public education for stroke symptom recognition are FAST (Face-Arm-Speech-Time) and BEFAST (Balance-Eyes-Face-Arm-Speech-Time). While FAST is widely endorsed, it can miss up to 14% of strokes, particularly those involving the posterior circulation. BEFAST aims to address this gap by including additional symptoms related to balance and vision .
Utilization of FAST and BEFAST in Public Education
Adoption by Comprehensive Stroke Centers
A study analyzing the educational materials of US Comprehensive Stroke Centers (CSCs) found that 58% of CSCs listed BEFAST, while 35% listed FAST, and 7% did not list any mnemonic. The adoption of BEFAST was highest in the western (65%) and southeastern (63%) states, indicating a regional preference for the more inclusive mnemonic . This suggests a trend towards broader symptom recognition in public health education.
Social Media Campaigns for Stroke Awareness
The #BEFASTChallenge, a social media campaign launched by Mission Thrombectomy 2020+, utilized dance videos to promote the BEFAST acronym. This campaign demonstrated the feasibility of using social media to reach a large audience at a low cost, with significant engagement metrics including 13,821 video views and numerous interactions across platforms like Facebook, Twitter, and Instagram. This innovative approach highlights the potential of social media in enhancing public awareness of stroke symptoms.
Comparative Effectiveness of FAST and BEFAST
Diagnostic Accuracy in Acute Stroke
A systematic review and meta-analysis comparing FAST and BEFAST in acute ischemic stroke patients revealed that BEFAST has a higher diagnostic value. The sensitivity of BEFAST was 0.68, and its specificity was 0.85, compared to FAST's sensitivity of 0.77 and specificity of 0.60. The area under the ROC curve was 0.86 for BEFAST and 0.76 for FAST, indicating better overall performance for BEFAST in stroke detection.
Prehospital Stroke Detection
In a prospective study of emergency response activations, the BEFAST scale did not significantly outperform the FAST scale in prehospital settings. Both scales had similar accuracy for stroke identification, with BEFAST showing a positive predictive value (PPV) of 0.49 and a negative predictive value (NPV) of 0.93, compared to FAST's PPV of 0.53 and NPV of 0.86. This suggests that while BEFAST includes additional symptoms, its practical advantage in prehospital settings may be limited.
Integration into Clinical Practice
The BEFAST mnemonic is gaining popularity for its comprehensive approach to stroke symptom recognition. Integrating BEFAST into nursing practice and public education can potentially improve the early detection of strokes that might be missed by FAST alone. This integration is crucial for enhancing the overall effectiveness of stroke care systems.
Conclusion
The BEFAST acronym offers a more inclusive approach to stroke symptom recognition by incorporating balance and vision symptoms, which are often associated with posterior circulation strokes. While its adoption is increasing among Comprehensive Stroke Centers and through innovative social media campaigns, its practical advantage over FAST in prehospital settings remains a topic of ongoing research. Consistent public health messaging and further studies are needed to fully realize the potential benefits of BEFAST in improving stroke outcomes.
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