What is the purpose of the Time component in BEFAST?

• A. Accurate Last Known Well time
• B. Time of injury
• C. Time since onset
• D. Time to hospital arrival

Answer: (A)

Time in BEFAST anchors the stroke onset to a specific moment. It records the last time the patient was known to be without symptoms (last known well). That timestamp is crucial because many stroke treatments, like clot-dusting therapy, depend on how long it has been since onset. Knowing the exact last known well time lets EMS and hospital teams calculate how long since symptoms began, determine eligibility for time-sensitive interventions, and streamline rapid imaging and transfer. If the patient woke up with symptoms, the onset time is considered the time they were last known normal, not when the symptoms were first noticed. Time to hospital arrival or time of injury aren’t used for establishing onset in BEFAST, since the key goal is to know the treatment window.