Prehospital Recognition of Stroke: Performance of Fast and Be-Fast Scales and Impact on Access to Reperfusion

Objective: to analyze the performance of FAST and BE-FAST scales in prehospital stroke recognition and their repercussions on access to reperfusion therapy. Method: an integrative review was conducted in PubMed/MEDLINE, LILACS, SciELO and the Virtual Health Library, including studies published from 2021 to July 2026. Results: twenty-eight studies were synthesized. FAST showed high operational feasibility but lower sensitivity for posterior circulation events and mild deficits. BE-FAST expanded the detection of balance and visual abnormalities, potentially reducing false negatives, although with lower specificity. Clinical benefit depended on combining the scale with clinical reasoning, last-known-well documentation, capillary glucose testing, prenotification and transport to the appropriate stroke center. Conclusion: BE-FAST can complement FAST but does not replace structured neurological assessment, continuing education and regional management of the stroke pathway.