Learn to “BEFAST” for National Stroke Awareness Month

May is National Stroke Awareness Month, a month in which to raise awareness about stroke risk factors and lessen the occurrence of stroke in the United States. It’s quite likely that you know someone who has suffered from a stroke in their life or know someone who may, so you could benefit from learning about the signs and symptoms to protect those you love.

In the United States, strokes are very common, as someone has a stroke every 40 seconds, and someone dies from a stroke every 3 ½ minutes. More than 795,000 people in the United States have a stroke every year. Raising awareness and identifying the signs can help you know what to do if you witness someone potentially having a stroke.

The Stroke System of Care Task Force recommends using the acronym BEFAST to identify signs and symptoms of a stroke. In addition to the existing FAST acronym, the “BE” in BEFAST adds additional stroke symptoms and helps to identify strokes that occur in the posterior portion of the brain. Twenty percent of ischemic strokes involve the posterior circulation (Louis).

Take the time to review and learn the signs:

B is for Balance

Is the person experiencing trouble walking, dizziness, loss of balance or coordination?

E is for Eyes

Does the person have any sudden double vision or trouble seeing out of one or both eyes?

F is for Face

Does the person have any sudden drooping or numbness on one side of the face?

A is for Arm

Is the person having any sudden numbness or weakness of the arm, especially on one side of the body?

S is for Speech

Is the person experiencing sudden confusion, trouble speaking or understanding? Face drooping, arm weakness and speech difficulty are the most common stroke symptoms.

T is for Time

If the person is experiencing any of these symptoms, it is time to activate your local emergency response and call 911, rather than going by personal vehicle to the hospital. This allows health care professionals to provide the most efficient stroke care. It is also time to document when the person was last seen normal or their last known well time.

The saying “time is brain” means the longer the brain goes without oxygen, the greater likelihood of death or disability. The best treatment for stroke begins with the quick identification of stroke symptoms and rapid activation of Emergency Medical Services (EMS).

Though not identified in the BEFAST assessment, sudden severe headache with no known cause is also a stroke symptom.

Rapid evaluation of stroke begins with community education to better recognize the signs and symptoms of stroke, an organized system of care by first responders and the emergency department, prompt evaluation by the stroke team, and the timely administration of reperfusion including intravenous thrombolysis and endovascular thrombectomy (EVT).


-Dr. Michelle Lin, Neurologist, Mayo Clinic

Visit the websites below for more information about stroke:




Lin MP. Time matters greatly in acute stroke care. Neurol Neurochir Pol. 2020;54(2):104-105. doi: 10.5603/PJNNS.2020.0037. PMID: 32352152.

Louis CR. Posterior circulation cerebrovascular syndromes. UpToDate.

https://www.uptodate.com/contents/posterior-circulation-cerebrovascular-syndromes. Accessed May 11, 2022.

Stroke facts. Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/facts.htm. Published April 5, 2022. Accessed May 11, 2022.