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Registrar: ‘Hello, am I speaking with the consultant neurologist on-call?’
Consultant: ‘Regrettably! Yes that’s me. What is it?’
R: ‘Hi this is Dr Richter, medical reg. on call. Sorry to disturb you so late, but we’ve got a FAST1 positive in A&E.’
C: ‘A what?’
R: ‘A FAST-positive patient.’
C: ‘I assume that’s worse than a FAST-negative patient then. Go on.’
R: ‘Well the NIHSS2 is 24 but her GCS3 4 is 12 currently. Before we got the CT, I was worried about a subarachnoid, because her Hunt & Hess5 was 4.’
R: ‘But thankfully the CT showed no bleed, but the ASPECTS6 was 6.’
C: ‘Six, did you say? That doesn’t sound too bad. At least it’s not 10 or something.’
R: ‘Actually 10 is a normal score. You really don’t want an ASPECTS lower than 6.’
C: ‘I see. So what are you recommending to do?’
R: ‘Well, time is brain, Professor, and I think it would be good to keep our door-to-needle stats …
Contributors The author is the sole contributor to the text. Mr Aongus Collins (collaborator) provided the figure.
Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned. Externally peer reviewed by Charles Warlow, Edinburgh, UK.
Collaborators Aongus Collins.