How to spot a stroke? BE FASTER

When it comes to medical emergencies, few conditions are as time-sensitive as a stroke. The ability to recognize stroke symptoms quickly can make the difference between a full recovery and long-term disability—or even death.

Stroke remains one of the leading causes of death in the Philippines. According to the Stroke Society of the Philippines, it is the second leading cause of death and the leading cause of disability. Studies also show that stroke-related deaths are higher in lower-middle-income countries like the Philippines, where there are inadequate acute stroke-ready hospitals and poor community stroke awareness, among others.^[1] This data highlights a growing need for comprehensive and empathetic neurological care in the country.

To address this urgent need, The Medical City (TMC), with its network of hospitals and clinics nationwide, introduces an updated and more robust guideline for stroke identification: BE FASTER. This initiative builds on the well-known "FAST" (Face, Arms, Speech, Time) protocol, emphasizing the critical importance of swift action. Over the years, the acronym has evolved to “BE FAST” with the inclusion of balance and eyesight changes. Now, TMC’s BE FASTER goes a step further by ensuring patients get rapid identification and treatment and the ongoing care and recovery support they need.

Understanding BE FASTER: TMC’s Standard for Stroke Identification

TMC’s BE FASTER protocol helps identify the critical signs of a stroke and highlights the need for immediate medical attention and guided recovery. BE FASTER stands for:

• Balance: Is the person experiencing sudden loss of balance or coordination?
• Eyes: Is there a sudden loss of vision or blurry eyesight?
• Face: Ask the person to smile. Does one side of the face droop?
• Arms: Can the person raise both arms? Is one arm drifting downward?
• Speech: Is their speech slurred or strange? Can they repeat a simple sentence correctly?
• Time: If the person shows any of these signs, time is critical—call for emergency help immediately.
• Emergency Room: Ensure the patient is taken to a stroke-ready hospital like TMC, where expert care can be given instantly.
• Recovery: Stroke care doesn’t end in the ER. Ensure that the hospital can also guide the patient into recovery. TMC tailors rehabilitation plans for each patient.

Dr. Artemio A. Roxas Jr., a neurologist and the Director of TMC Ortigas’ Stroke Unit, emphasized that stroke patients should be rushed immediately to a stroke-ready hospital that can provide them with the immediate care that their condition requires within 4.5 hours.

“Stroke is an emergency, and time is brain. Patients coming in with signs and symptoms of acute stroke in the hospital should be seen immediately by the brain attack team,” Dr. Roxas Jr. said.

TMC Ortigas is equipped with a brain attack team composed of a neurologist, a neurology resident on duty, a stroke nurse certified to administer the National Institute of Health Stroke Scale (NIHSS), and, if necessary, an interventional neurosurgeon. The team will take a brief but detailed history, a complete neurological examination, and administer the NIHSS.

“There are now drugs that can remove blood clots from the brain and provide better outcomes compared to if this were not given. So, it is important that the patient should be in the hospital,” he added.

Mechanical Thrombectomy: A Life-saving Procedure for Stroke Patients

Time is a critical factor in stroke care, which is why BE FASTER emphasizes the need for rapid intervention. In cases where initial clot-dissolving medications cannot be administered in time, TMC offers a life-saving procedure known as mechanical thrombectomy (MT). This minimally invasive procedure involves removing blood clots from blocked arteries in the brain, restoring blood flow, and significantly improving outcomes for stroke patients.

TMC Ortigas is one of the few hospitals that is capable of performing MT. Recently, the hospital earned a 5-star rating for the said procedure. This recognition was given by the Society of Vascular and Interventional Neurology (SVIN) as part of their Mission Thrombectomy 2020+ campaign, which aims to recognize institutions that demonstrate outstanding performance in delivering timely and effective Mechanical Thrombectomy procedures to stroke patients.

TMC’s network of hospitals and clinics nationwide is equipped with expert neurologists, neurosurgeons, and psychiatrists who provide comprehensive neurological and mental health services that can guide patients through every step of their brain health journey, from prevention to time-critical management and recovery.

Media Requests

For media requests or to interview a TMC Stroke Specialist, visit https://www.themedicalcity.com/media-requests or email media@themedicalcity.com.

[1] Collantes, Maria Epifanio; Navarro, Jose; Belen, Allan; Gan, Robert. Stroke systems of care in the Philippines: Addressing gaps and developing strategies (2022).