In a suspected stroke, language should never be the step that slows you down. Spanish-speaking patients and families may know a different acronym than the one on your unit's poster, and you may not have an interpreter on the line in the first seconds. This guide covers the Spanish stroke acronym RÁPIDO, shows how to run a BE-FAST style screen in plain Spanish, and gives you questions for family and bystanders.
Follow your facility's stroke protocol first. Use this as a communication aid, and call for an interpreter at the same time you start the screen.
What RÁPIDO stands for
RÁPIDO is a Spanish-language stroke acronym. According to American Heart Association News (September 2023), researchers at UTHealth Houston released data on it in 2021 and then worked with the American Stroke Association to refine it. The Spanish expansion in that article is below; the English column is our own rendering.
| Letter | Spanish | English |
|---|---|---|
| R | Rostro caído | Face drooping |
| Á | Alteración del equilibrio | Change in balance |
| P | Pérdida de la fuerza en el brazo o una pierna | Loss of strength in an arm or leg |
| I | Impedimento visual repentino | Sudden vision problem |
| D | Dificultad para hablar | Difficulty speaking |
| O | Obtén ayuda y llama al 911 | Get help and call 911 |
Many families will have seen RÁPIDO in public health messages. Others will know no acronym at all, so do not assume recognition. The official "O" line uses the informal "Obtén"; when you give the instruction yourself, use the formal "Busque ayuda y llame al 911."
BE-FAST screening phrases in Spanish
BE-FAST stands for Balance, Eyes, Face, Arms, Speech, Time. These are plain-language prompts for each element, written in the formal "usted."
| Element | English | Spanish |
|---|---|---|
| Balance | Do you feel dizzy or off balance? | ¿Se siente mareado/a o sin equilibrio? |
| Eyes | Have you lost vision suddenly? Do you see double or blurry? | ¿Perdió la vista de repente? ¿Ve doble o borroso? |
| Face | Smile for me. Show me your teeth. | Sonría, por favor. Muéstreme los dientes. |
| Arms | Lift both arms and hold them up. | Levante los dos brazos y manténgalos arriba. |
| Arms (symptom) | Do you feel weakness or numbness in an arm or leg? | ¿Siente debilidad o adormecimiento en un brazo o una pierna? |
| Speech | Are you having trouble speaking or understanding? | ¿Tiene dificultad para hablar o para entender? |
| Speech (test) | Repeat after me: "Today is a sunny day." | Repita después de mí: "Hoy es un día soleado." |
| Time | When did the symptoms start? | ¿A qué hora empezaron los síntomas? |
| Time | When was the last time you felt completely normal? | ¿Cuándo fue la última vez que se sintió completamente normal? |
Two practical notes. First, "last known well" is the most important time question, so ask it even if the patient gives a start time. Second, if your protocol specifies a particular sentence for the speech test, use that sentence's validated Spanish version. The example above is a simple sentence, not a standardized test item.
Questions for family and bystanders
The patient may not be able to answer. Family often can.
| English | Spanish |
|---|---|
| What happened? How did it start? | ¿Qué pasó? ¿Cómo empezó? |
| When did you last see him/her normal? | ¿A qué hora fue la última vez que lo/la vio normal? |
| Does he/she take blood thinners? Which ones? | ¿Toma anticoagulantes, medicinas para adelgazar la sangre? ¿Cuáles? |
| Does he/she have any medication allergies? | ¿Tiene alergia a algún medicamento? |
| Did he/she fall or hit the head? | ¿Se cayó o se golpeó la cabeza? |
| Is there a family member we can call? | ¿Hay algún familiar a quien podamos llamar? |
What to say while you work
Short reassurance keeps people calm and cooperative.
| English | Spanish |
|---|---|
| We are here to help you. | Estamos aquí para ayudarle. |
| We need to act quickly because time matters. | Necesitamos actuar rápido porque el tiempo es importante. |
| I am calling an interpreter so we can talk clearly. | Voy a llamar a un intérprete para que podamos hablar con claridad. |
| Tell me right away if anything gets worse. | Dígame de inmediato si algo empeora. |
Stroke words patients and families use
Lay terms for stroke vary by region, and the clinical term is rarely what a family says.
- Derrame cerebral: very common in lay speech in Mexico and Central America. Strictly it suggests bleeding, but families often use it for any stroke.
- Embolia: also common in lay speech in some regions.
- Ataque cerebral: widely understood and used in some public health materials.
- ACV (accidente cerebrovascular): the clinical term in much of Latin America.
- Ictus: common in Spain, rarely heard from Latin American patients.
If a family says "le dio un derrame," treat it as a possible stroke and ask when it started. Do not correct the term; confirm the symptoms.
Carry the stroke check where you can see it
The bedside badge card set includes a BE-FAST stroke check card in Spanish with English underneath, alongside pain, triage, and emergency cards, designed by a family medicine physician & certified medical interpreter. The Medical Spanish Kit adds a pocket guide and flashcards for learning the phrases before you need them. If you are an EMT, the same kit covers emergency scene phrases. To build the phrases into a routine, see the medical Spanish study plan.
When to use a qualified interpreter
Use a phrase list to start the screen. Use a qualified medical interpreter, by phone or video if needed, for history, consent, treatment decisions, and any explanation of results. If the patient is in an emergency and no interpreter is yet available, follow your facility's language access policy and bring one in as soon as possible.
Related guides
- For the pain scale and descriptors: Pain assessment in Spanish for nurses
- For prehospital scene and assessment phrases: Spanish for EMTs
- For the full triage question sequence: ER triage Spanish phrases
These phrases support routine and emergency communication and do not replace a qualified medical interpreter in clinical care. This article is general education, not medical advice or a clinical protocol.