In a stroke, brain cells die every minute without blood flow. The nurse's job is to spot it fast and get the patient treated fast.
BE FAST
- Balance: sudden loss of balance or dizziness
- Eyes: sudden vision loss or double vision
- Face: one side droops
- Arm: one arm drifts down or is weak
- Speech: slurred or confused speech
- Time: note the time and call a stroke alert
Two types
| Ischemic (about 87%) | Hemorrhagic |
|---|---|
| A clot blocks an artery | A blood vessel bursts |
| May get tPA or clot removal | No tPA. Control BP and bleeding |
First actions
- Find out when the patient was last known well.
- Call a stroke alert.
- Check blood glucose. Low sugar can look like a stroke.
- Get a CT scan without contrast right away to rule out bleeding.
- Keep the patient NPO until a swallow screen is passed.
tPA
- Usually given within 4.5 hours of when the patient was last known well.
- BP must be under 185/110 before tPA and kept under 180/105 after.
- Frequent neuro checks. Report a new headache or worsening neuro signs right away, because they can mean bleeding.
Left vs. right brain stroke
| Left brain | Right brain |
|---|---|
| Weakness on the right side | Weakness on the left side |
| Trouble speaking or understanding (aphasia) | Ignores the left side (neglect) |
| Slow and cautious | Impulsive, poor judgment, safety risk |
Practice this in Priority Care
Catch the stroke and act fast on a busy shift.
Play Priority CareFree account to start. Every game free for 14 days.
Quick answers
What does BE FAST stand for?
Balance, Eyes, Face, Arm, Speech, and Time.
What is the time window for tPA in stroke?
tPA is usually given within 4.5 hours of when the patient was last known well, after a CT scan rules out bleeding.
Evidence & Clinical Sources
- American Stroke Association
- Hinkle & Cheever, Brunner & Suddarth's Textbook of Medical-Surgical Nursing, Wolters Kluwer
Reviewed against current guidelines and drug labels. Always follow your program, a current drug reference, and facility policy. Our sources policy
For learning only. Lab ranges and policies vary. Always follow your nursing program, a current drug reference, and your facility's policies.