Peter D. Panagos, MD, a Washington University neurologist & emergency medicine at Barnes-Jewish Hospital, provides an overview of stroke symptoms and how to respond.
My name is Peter Panagos and I’m an emergency physician at Barnes-Jewish Hospital and currently I’m associate professor of emergency medicine and neurology at the Washington University School of Medicine. I currently work in a very exciting environment, and a very chaotic environment, but there’s a lot of organization where I work. It may not seem it when you come in as a patient.
But I work in the emergency department of Barnes-Jewish Hospital. And the emergency department is a very unique place in a health care setting. It’s a place with specialized nurses and physicians of all different specialties and ancillary service that involves labs and x-rays and pharmacy that are there 24/7 and 365 to provide time critical care for the most severe and sickest patients in our community.
I think what everyone needs to understand or know for stroke is that it’s unlike a lot of other conditions, where the symptoms and signs may overlap many other illnesses that you may be familiar with. Dizziness is very common, but can be stroke symptoms. Headache is very common, but also can be the sign of a stroke.
But the classic signs of a stroke, things such as facial weakness, difficulties with speech, inability to move your arm or leg, that come on fairly quickly, are things that we want to recognize as stroke symptoms. When you do have these symptoms, we want people to know that they should call 911. Don’t call family members, don’t call friends. But call 911 because 911 and EMS is trained to recognize stroke symptoms and bring you to the right hospitals with the right treatment and time is of the essence.
What we like people to know is to recognize the signs and symptoms of stroke, which can be very, very heterogeneous, but they can also be very, very common symptoms, which we like to have people remember. I like to use the pneumonic, F.A.S.T., which is Face, Arm, Speech and Time.
Face meaning any facial asymmetry or weakness. Something doesn’t look normal, either by looking in the mirror or someone recognizes, that could be the sign of a stroke. As far as speech, if people have slurred speech, heavy speech, difficulty handling their words, that would certainly be something that we would want to know. Arm is part of the A, is part of F.A.S.T. If you have difficulty raising your arm, using your arm or a clumsy hand. And then time. Time is of the essence. We have a very narrow time window to treat stroke. Call 911. Don’t drive yourself in. Don’t call your primary care physician to ask what to do. So we like to say F.A.S.T. Fast, Arm, Speech, Time. Get into our hospital and we can run tests and do an evaluation to determine if you are having a stroke. And if you are, are you eligible for treatment, which may actually save your life and return you to your capabilities or your status before you had your symptoms.