JFRD explains what helped save Ebron prosecutor's life

F.A.S.T. is an easy mnemonic to remember and identify common stroke symptoms


JACKSONVILLE, Fla. – According to Lt. Mark Rowley of the Jacksonville Fire and Rescue Department (JFRD), the following factors helped make the difference in saving Assistant State Attorney Richard Mantei’s life.

What helped make the difference for Richard Mantei?

  • As of Dec. 18, 2015 at 3:00 p.m., JFRD responded to 1,271, 911 calls for strokes this year alone. That is nearly four (4) persons each day in Duval County.
  • Mantei's 911 call came immediately after his onset of symptoms – a quick recognition by the HIT Center staff.
  • JFRD had a 4-minute en route time to the HIT Center (responded from Fire Station 54 off south Philips Hwy near I-295)
  • JFRD Paramedics limited their scene time to nine minutes. Paramedics moved quickly and did not waste time. TIME is BRAIN!
  • JFRD was at Baptist South ER within six (6) minutes of leaving the HIT Center.
  • Due to the JFRD Rescue Paramedic calling a "Stroke Alert" on the radio – dispatchers provided Early Notification to Baptist South ER allowing them to ready their CT and Stroke Team.
  • Mantei did not have to wait in the Emergency Room. He was transported directly from the Rescue unit to the CT scan while still on the ambulance stretcher/gurney.

Stroke Facts:

According to the American Stroke Association, nearly 800,000 people in the U.S. experience a stroke. That's one stroke every 40 seconds

Stroke Symptoms:

F.A.S.T. is an easy mnemonic to remember and identify the most common symptoms of a stroke. It is also very similar to the Cincinnati Pre-hospital Stroke Scale that our Firefighter/Paramedics use in the field for assessing potential stroke patients.

F: Face – Ask the person to smile. Does one side of the face droop?

A: Arms – Ask the person to raise both arms. Does one arm drift downward?

S: Speech – Ask the person to repeat a simple phrase. Is their speech slurred or strange?

T: Time – If you observe any of these signs, note the time and call 9-1-1 immediately.

The "You can't teach an old dog new tricks" phrase was used.

Stroke Mimics:

The caller stated both "seizure" and "stroke". Our JFRD 9-1-1 Communications Officer completed the call using the seizure dispatch protocol. The reason I bring this to your attention is that there are many conditions that can mimic a stroke and vice versa; strokes may mimic other conditions which may delay proper identification.  In Mr. Mantei's case, it was not until our trained Firefighters and Paramedics arrived at his side and assessed him, that it was determined he was suffering from a stroke. H.E.M.I. is another mnemonic used to remember the stroke mimics:

H: Hypoglycemia and hyperglycemia.  (Sugar too low or too high)
E: Epilepsy (Seizures)
M: Multiple sclerosis (and hemiplegic migraine)
I: Intracranial tumors (or infections, such as meningitis, encephalitis and abscesses)


Human brains have approximately 100 billion neurons.  The neurons receive and send out information, the synapses are the connection through which information flows (sort of like an IT Server) and the myelinated fibers are the high speed rail by which information and instructions are sent throughout the body. 

A study by the National Institute of Health reveals that the brain suffering from an ischemic stroke ages 3.6 years for each hour without treatment, as compared with the normal rate of neuron loss due to brain aging. This is due to the millions of neurons, billions of synapses and miles of fibers that are destroyed without adequate brain perfusion. TIME literally is BRAIN.

Source: National Institute of Health, PubMed.gov, PMID: 16339467

From American Stroke Association:


F.A.S.T. is an easy way to remember the sudden signs of stroke. When you can spot the signs, you'll know that you need to call 9-1-1 for help right away. F.A.S.T. is:

Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?

Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

Speech Difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly?

Time to call 9-1-1 – If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you'll know when the first symptoms appeared.

Beyond F.A.S.T. – Other Symptoms You Should Know

  • Sudden NUMBNESS or weakness of face, arm, or leg, especially on one side of the body

  • Sudden CONFUSION , trouble speaking or understanding speech
  • Sudden TROUBLE SEEING in one or both eyes
  • Sudden TROUBLE WALKING , dizziness, loss of balance or coordination
  • Sudden SEVERE HEADACHE with no known cause


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