Achi news desk-
It comes as Scotland’s stroke rate hits an all-time high.
The European Standard Rate for stroke in Scotland in the year 2022-23 was 479.2 per 100,000 of the population, the highest since Public Health Scotland records began in 2013-14, when it was 398.0.
Almost 20,000 Scots have died from a stroke over five years to the end of 2022. There were 3874 deaths in the last full year.
Calls for action have come after the sudden death of Tony Bundy from Clackmannanshire in June last year, who suffered a stroke while shopping at a Costco store in Glasgow.
When his stroke started, his face, arms and speech were unaffected, meaning his FAST (Face, Arms, Speech, Time) test was negative.
The FAST test is used to assess a patient for the most common symptoms of a stroke.
However, the family of the 53-year-old man who is usually fit and healthy say that he “lost his balance, his eyes had trouble focusing, and he was throwing up”.
The family say that although they raised concerns that it could be a stroke, because his FAST test was negative, he was left in a corridor at Glasgow Royal A&E for over five hours before his fatal stroke struck.
The family are now calling for an update to the stroke public health awareness campaign.
They say that while the FAST campaign has undoubtedly saved lives, the overreliance on a public health campaign that doesn’t include all the symptoms has led to strokes, like Mr Bundy being “misdiagnosed and people dying premature”.
They called for a review of the FAST stroke campaign to ensure it covers all possible stroke symptoms including the inability to stand, cold sweats, eyes having trouble focusing, slow speech, nausea, and vomiting. They say the intention is to maximize knowledge among the public and the medical profession.
The family had previously been informed by the Scottish Government that there would be no update to the stroke public health awareness campaign.
Jean Minto, minister for public health and women’s health said in response to a family plea that the Scottish Government “does not currently intend to deviate from supporting the use of FAST”.
He accepted that the 2023 edition of the National Clinical Guideline for Stroke states that more research is needed to improve public awareness, and the appropriate steps for suspected stroke.
The same guideline states that “some people with stroke symptoms will not be identified by the FAST test and therefore a stroke may not be detected.”
But the minister added: “In terms of pre-hospital stroke recognition, the guideline also states that further evidence is needed before a recommendation could be made regarding the use of other screening tools that screen for stroke symptoms other than FAST.”
Now after Mr Bundy’s son James, a councilor in Falkirk, and his mother Selena met Mr Gray, it has been confirmed that a review will take place.
A Scottish Government spokesman said: “The Cabinet Secretary for NHS Recovery, Health and Social Care met the Bundy family to hear their experience and has asked the Chief Medical Officer’s adviser to carry out a review of education about stroke symptoms for clinical staff. ”
Mr Bundy, who said his father’s stroke could have been detected if the tests used to detect it were more widespread, welcomed the development.
“It is a step forward but this cannot be the end result,” he said.
“Increasing knowledge of stroke symptoms among medical staff is a welcome step. The more information is held, the more lives will be saved because people have access to rapid treatment.
“Yet the question I ask myself is this: Why won’t the public health campaign be updated to incorporate more stroke symptoms? Medical staff getting more information about stroke is not useful if stroke patients do not come to A&E.
“Let’s trust the people of Scotland with information that could save their lives.
“When people in Scotland, or their loved ones, suffer a stroke, we should all be in a position to know that the right response is ‘BE FAST’. [which includes being alert to balance and vision issues] and seek emergency treatment.”
An academic systematic review of evidence in 2021 found that the FAST test correctly detected 69-90% of strokes. However, the review noted that the FAST test missed up to 40% of posterior circulation strokes, such as the basilar artery ischemic stroke experienced by Mr Bundy.
Posterior stroke affects the blood flow at the back of the brain, and accounts for 20-25% of all acute strokes.
They can cause different symptoms than those assessed by the FAST test, including vertigo, vision problems, and nausea and vomiting.
The review noted that the less commonly used BE-FAST (Balance, Eyes, Face, Arms, Speech, Time) test identified more ischemic strokes than the FAST test, and noted that it may play an important role in diagnosing a stroke.
