“FAST” is a well-known acronym used as a mnemonic device to help people detect and enhance responsiveness to the needs of a person having a stroke. The acronym stands for Facial drooping, Arm weakness, Speech difficulties and Time to call emergency services.
While “FAST” has been in place for a long time and is widely used across the country, there has not been a corresponding mnemonic for Spanish-speaking populations, creating a public education gap. Thanks to the work of Ascension Seton stroke outreach coordinator Maricela (Marcie) Wilson, there is a new mnemonic for reducing stroke recognition disparities in Spanish-speaking communities, “AHORA.”
According to Marcie, it was important that the translated tool demonstrate the same desirable characteristics of the “FAST” in that each letter of the mnemonic represents common signs and symptoms of stroke and the mnemonic spells a word that inspires action. After many iterations, the “AHORA” tool was born.
“AHORA”, meaning "NOW" in Spanish, contains all of the elements of “FAST” and adds the symptom of a terrible headache unlike past headaches. Sudden, severe headache is an important predictor of hemorrhagic stroke, a particularly debilitating type of stroke experienced more frequently among Hispanic populations. The acronym stands for Andar (walking), Hablar (speech), Ojos (eyes), Rostro (face and head), and Ambos Brazos o Piernas (both arms and legs).
Public educational campaigns lead to increased community awareness of warning signs for stroke and the need to activate emergency services. As the familiar adage goes: during a stroke, time lost is brain lost. EMS clinicians have a meaningful influence on helping patients reach timely care, often serving as the first medical contact for patients experiencing stroke. While rapid EMS assessment and immediate transport to a stroke center are important, studies have found that the biggest delay in receiving life-saving care is the time it takes patients or bystanders to recognize stroke symptoms and decide to seek medical care. Community education and outreach can work to reduce these delays.
"As part of my responsibilities as a community educator for Ascension, much of my time was spent in the Hispanic communities and Hispanic patients who had suffered strokes. I realized the language barriers were creating a problem with the traditional acronyms, and I decided to develop a Hispanic version," says Marcie. "It is very gratifying that other organizations have recognized that AHORA will fill a need in the healthcare field. I very much appreciate the support Ascension has shown as the program gets rolled out to a wider audience."
Maricela was awarded the 2021 Innovation Award by the Lone Star Stroke Consortium for her work to address stroke recognition disparities in Spanish-speaking communities. Today, EMS programs from around the country have begun adoption of the program.
