Acute Stroke Essentials: BE FAST and Prepared

Presented by Kristen Keech and Jessica Asiello

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Stroke remains a leading cause of disability and death, requiring acute care clinicians to act swiftly and skillfully across a complex clinical continuum. This course equips acute care practitioners with the foundational knowledge needed to identify, differentiate, and respond to various stroke types during the critical early phase of care. Participants will explore neuroanatomy, stroke syndromes, acute medical management protocols, and the dual lens of prevention and recovery. With a focus on interdisciplinary collaboration and clinical reasoning, the course prepares therapists to recognize early signs using the BE FAST framework, interpret imaging and severity scales, and understand medical interventions that impact therapy timing and discharge planning. Designed for providers in acute hospital settings, this course supports confident, evidence-informed decision-making to optimize functional outcomes and reduce secondary complications.

Learning Objectives

Differentiate between anterior and posterior circulation strokes and their typical clinical presentations
Clarify ischemic from hemorrhagic strokes based on clinical signs and imaging findings
Recall acute medical management protocols for stroke, including thrombolysis (tPA), thrombectomy, and blood pressure control
Identify common acute stroke complications and the importance of monitoring and urgent interventions
Outline the dual lens approach of stroke care, integrating prevention strategies to reduce recurrent stroke risk with rehabilitation efforts aimed at functional recovery

Meet your instructors

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Kristen Keech

Dr. Kristen Keech is an occupational therapist passionate about advancing care and advocating for survivors of brain injury. She holds a Master of Science in Occupational Therapy from the University of New Hampshire and a Doctorate in Occupational Therapy from the MGH Institute of Health Professions. She is recognized as a…

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Jessica Asiello

Jessica Asiello is an assistant professor in the Department of Occupational Therapy in the School of Health and Rehabilitation Sciences at the MGH Institute for Health Professions in Boston, Massachusetts. She primarily teaches in the online postprofessional OTD program. Her clinical practice is in acute care at…

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Chapters & learning objectives

1. Neuroanatomy and Functional Implications

This chapter reviews key neuroanatomical structures and their functional relevance to stroke, highlighting how lesion location influences clinical presentation and therapy needs. Participants will learn to differentiate anterior and posterior circulation strokes, understand the impact of laterality, and connect neuroanatomy to assessment, education, and intervention strategies in acute care.

2. Ischemic vs Hemorrhagic Stroke: Clinical and Medical Differences

This chapter provides a deep dive into ischemic and hemorrhagic stroke types, including vascular territories, common syndromes, and subtypes, such as cortical, subcortical, and brainstem strokes. Clinicians will develop skills to anticipate functional deficits, recognize stroke patterns, and appreciate how stroke type influences prognosis, complications, and therapy priorities.

3. Acute Medical Management and Therapy Implications

Focusing on the first hours to days post stroke, this chapter reviews emergent interventions including thrombolysis, mechanical thrombectomy, and blood pressure management. Participants will explore therapy considerations related to stability, intracranial pressure, and procedural recovery while learning to use tools like the NIH Stroke Scale to support safe clinical decisions.

4. Dual Lens: Prevention vs Recovery Frameworks

In the final chapter, clinicians are introduced to the dual approach of stroke care: prevention of recurrence and rehabilitation for functional recovery. The content emphasizes modifiable and nonmodifiable risk factors, the impact of social determinants of health, and the importance of early, neuroplasticity-based interventions. Therapists will gain tools to promote safety, independence, and long-term participation.