Brissette Vincent, Rioux Bastien, Choisi Thérésa, Poppe Alexandre Y
Department of Medicine (Neurology), Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada.
CJEM. 2023 May;25(5):403-410. doi: 10.1007/s43678-023-00482-6. Epub 2023 Apr 3.
Face, arm, speech, time (FAST) public awareness campaigns improve stroke recognition in the general population. Whether this translates into improved emergency medical services (EMS) activation remains unclear. We assessed the association of five consecutive FAST campaigns with EMS calls for suspected strokes in a large urban area of Quebec, Canada.
We conducted an observational study to assess data collected between June 2015 and December 2019 by the public EMS agency covering the cities of Laval and Montreal (Quebec, Canada). Five FAST campaigns were held over this period (mean duration: 9 weeks). We compared daily EMS calls before and after all FAST campaigns (2015 vs 2019) with t tests and Mann-Whitney U tests. We used single-group, univariate interrupted time series to measure changes in daily EMS calls for suspected strokes following each FAST campaign (stroke categories: any, symptom onset < 5 h, Cincinnati Prehospital Stroke Scale [CPSS] 3/3). Calls for headache served as negative control.
After five FAST campaigns, mean daily EMS calls increased by 28% (p < 0.001) for any suspected stroke and by 61% (p < 0.001) for stroke with symptom onset < 5 h, compared to 10.1% for headache (p = 0.012). Significant increases in daily EMS calls were observed after three campaigns (highest OR = 1.26; 95% CI 1.11, 1.43; p < 0.001). There were no significant changes in calls after individual campaigns for suspected stroke with symptom onset < 5 h, or suspected stroke with CPSS 3/3.
We observed an inconsistent impact of individual FAST campaigns on EMS calls for any suspected stroke, and did not observe significant EMS call changes after individual campaigns for acute (< 5 h) and severe (CPSS 3/3) strokes. These results may help stakeholders identify potential benefits and limitations of public awareness campaigns using the FAST acronym.
脸、臂、言语、时间（FAST）公众意识宣传活动提高了普通人群对中风的识别能力。这是否能转化为改善紧急医疗服务（EMS）的启动尚不清楚。我们评估了加拿大魁北克一个大城市地区连续开展的五次FAST宣传活动与因疑似中风拨打EMS电话之间的关联。
我们进行了一项观察性研究，以评估2015年6月至2019年12月期间由覆盖拉瓦尔和蒙特利尔市（加拿大魁北克）的公共EMS机构收集的数据。在此期间举办了五次FAST宣传活动（平均持续时间：9周）。我们使用t检验和曼-惠特尼U检验比较了所有FAST宣传活动前后（2015年与2019年）的每日EMS呼叫量。我们使用单组单变量中断时间序列来测量每次FAST宣传活动后因疑似中风的每日EMS呼叫量的变化（中风类别：任何中风、症状发作<5小时、辛辛那提院前中风量表[CPSS]3/3）。因头痛拨打的电话作为阴性对照。
在五次FAST宣传活动后，与因头痛拨打的电话增加10.1%（p = 0.012）相比，因任何疑似中风拨打的每日EMS呼叫量增加了28%（p < 0.001），因症状发作<5小时的中风拨打的每日EMS呼叫量增加了61%（p < 0.001）。在三次宣传活动后观察到每日EMS呼叫量显著增加（最高比值比=1.26；95%置信区间1.11，1.43；p < 0.001）。对于症状发作<5小时的疑似中风或CPSS 3/3的疑似中风，在每次宣传活动后呼叫量没有显著变化。
我们观察到个别FAST宣传活动对因任何疑似中风拨打的EMS电话的影响不一致，并且在针对急性（<5小时）和严重（CPSS 3/3）中风的个别宣传活动后，未观察到EMS呼叫量的显著变化。这些结果可能有助于利益相关者识别使用FAST首字母缩写的公众意识宣传活动的潜在益处和局限性。
