# FAST-ED scale (Lima) FAST-ED Status: LIVE Price: $0.005 USDC `GET /api/calc/fast_ed` HTML: https://magentlab.com/docs/fast-ed Markdown: https://magentlab.com/docs/fast-ed.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum Lima 2016 Field Assessment Stroke Triage for Emergency Destination (FAST-ED) points from caller-assigned facial palsy, arm weakness, speech, eye deviation, and neglect, and return whether the total suggests large-vessel occlusion (score ≥4) plus the published LVO-rate band. ## When to use When an agent has caller-assigned Lima 2016 FAST-ED field items and needs the published 0-9 total, score ≥4 LVO flag, and 0_to_1 / 2_to_3 / gte_4 band, not a stroke diagnosis, transfer order, or NIHSS total. ## When not to use - Not a medical device. magent does not examine the patient. Facial palsy, arm weakness, speech, eye deviation, and neglect are caller-assigned Lima 2016 FAST-ED integers (Table 1). - Not a stroke diagnosis and not a transfer or thrombolysis order. - This is the published FAST-ED field scale, not NIHSS. magent does not compute NIHSS. - Time from last known well is documented for decision making (0 points) and is not a scoring parameter. - lvo_suggested is true iff score ≥ 4 (this paper's abstract threshold). fast_ed_band is the published LVO-rate grouping only (0-1 <15%, 2-3 ~30%, ≥4 ~60%+). Sensitivity, PPV, and a patient-level LVO probability are not returned. ## Formula ``` FAST-ED = facial_palsy (0 normal or minor, 1 partial or complete) + arm_weakness (0 no drift, 1 drift or some effort against gravity, 2 no effort against gravity or no movement) + speech (0 absent, 1 mild to moderate, 2 severe, global aphasia, or mute) + eye_deviation (0 absent, 1 partial, 2 forced) + neglect (0 absent, 1 extinction to bilateral stimulation in only one sensory modality, 2 does not recognize own hand or orients only to one side); Lima 2016 Table 1; Time documented for decision making (0 points, not scored); max 9; lvo_suggested if score ≥ 4; fast_ed_band 0_to_1 (score 0–1, <15% LVO), 2_to_3 (score 2–3, ~30%), gte_4 (score ≥4, ~60%+) ``` ## Citation [Field Assessment Stroke Triage for Emergency Destination: A Simple and Accurate Prehospital Scale to Detect Large Vessel Occlusion Strokes](https://doi.org/10.1161/STROKEAHA.116.013301) Lima FO, Silva GS, Furie KL, et al. Stroke. 2016;47(8):1997-2002 DOI: [10.1161/STROKEAHA.116.013301](https://doi.org/10.1161/STROKEAHA.116.013301) ## Worked example ### All items 0 Given: `arm_weakness=0, eye_deviation=0, facial_palsy=0, neglect=0, speech=0` 1. facial_palsy 0 + arm_weakness 0 + speech 0 + eye_deviation 0 + neglect 0 2. Score = 0 (max 9); lvo_suggested false (cutoff is ≥4); fast_ed_band 0_to_1 ### All items at published maximum Given: `arm_weakness=2, eye_deviation=2, facial_palsy=1, neglect=2, speech=2` 1. facial_palsy 1 + arm_weakness 2 + speech 2 + eye_deviation 2 + neglect 2 2. Score = 9 (max 9); lvo_suggested true; fast_ed_band gte_4 ## Also searched as - FAST-ED - FAST ED scale - Field Assessment Stroke Triage - Lima FAST-ED - Field Assessment Stroke Triage for Emergency Destination - prehospital LVO scale - FAST-ED stroke scale - FASTED ## Parameters - `facial_palsy` (integer, required): Caller-assigned Lima 2016 FAST-ED facial palsy (integer 0-1): 0 normal or minor, 1 partial or complete. magent does not examine the patient. - `arm_weakness` (integer, required): Caller-assigned Lima 2016 FAST-ED arm weakness (integer 0-2): 0 no drift, 1 drift or some effort against gravity, 2 no effort against gravity or no movement. magent does not examine the patient. - `speech` (integer, required): Caller-assigned Lima 2016 FAST-ED speech changes (integer 0-2): 0 absent, 1 mild to moderate, 2 severe, global aphasia, or mute. magent does not examine the patient. - `eye_deviation` (integer, required): Caller-assigned Lima 2016 FAST-ED eye deviation (integer 0-2): 0 absent, 1 partial, 2 forced. magent does not examine the patient. - `neglect` (integer, required): Caller-assigned Lima 2016 FAST-ED denial/neglect (integer 0-2): 0 absent, 1 extinction to bilateral stimulation in only one sensory modality, 2 does not recognize own hand or orients only to one side. magent does not examine the patient. ## Bulk (POST) POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/fast_ed` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "arm_weakness": "0", "eye_deviation": "0", "facial_palsy": "0", "neglect": "0", "speech": "0" }, { "arm_weakness": "0", "eye_deviation": "0", "facial_palsy": "0", "neglect": "0", "speech": "0" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/fast-ed Example 200: ```json { "count": 2, "path": "/api/calc/fast_ed", "items": [ { "components": [ { "value": 0, "factor": "facial_palsy", "points": 0, "present": false }, { "value": 0, "factor": "arm_weakness", "points": 0, "present": false }, { "value": 0, "factor": "speech", "points": 0, "present": false }, { "value": 0, "factor": "eye_deviation", "points": 0, "present": false }, { "value": 0, "factor": "neglect", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Lima FO, Silva GS, Furie KL, et al.", "doi": "10.1161/STROKEAHA.116.013301", "id": "lima-2016", "pmid": "27364531", "source": "Stroke. 2016;47(8):1997-2002", "title": "Field Assessment Stroke Triage for Emergency Destination: A Simple and Accurate Prehospital Scale to Detect Large Vessel Occlusion Strokes" }, "formula": "fast_ed", "formula_expression": "FAST-ED = facial_palsy (0 normal or minor, 1 partial or complete) + arm_weakness (0 no drift, 1 drift or some effort against gravity, 2 no effort against gravity or no movement) + speech (0 absent, 1 mild to moderate, 2 severe, global aphasia, or mute) + eye_deviation (0 absent, 1 partial, 2 forced) + neglect (0 absent, 1 extinction to bilateral stimulation in only one sensory modality, 2 does not recognize own hand or orients only to one side); Lima 2016 Table 1; Time documented for decision making (0 points, not scored); max 9; lvo_suggested if score ≥ 4; fast_ed_band 0_to_1 (score 0–1, <15% LVO), 2_to_3 (score 2–3, ~30%), gte_4 (score ≥4, ~60%+)", "max_score": 9, "score": 0, "arm_weakness": 0, "eye_deviation": 0, "facial_palsy": 0, "fast_ed_band": "0_to_1", "lvo_suggested": false, "neglect": 0, "speech": 0 }, { "components": [ { "value": 0, "factor": "facial_palsy", "points": 0, "present": false }, { "value": 0, "factor": "arm_weakness", "points": 0, "present": false }, { "value": 0, "factor": "speech", "points": 0, "present": false }, { "value": 0, "factor": "eye_deviation", "points": 0, "present": false }, { "value": 0, "factor": "neglect", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Lima FO, Silva GS, Furie KL, et al.", "doi": "10.1161/STROKEAHA.116.013301", "id": "lima-2016", "pmid": "27364531", "source": "Stroke. 2016;47(8):1997-2002", "title": "Field Assessment Stroke Triage for Emergency Destination: A Simple and Accurate Prehospital Scale to Detect Large Vessel Occlusion Strokes" }, "formula": "fast_ed", "formula_expression": "FAST-ED = facial_palsy (0 normal or minor, 1 partial or complete) + arm_weakness (0 no drift, 1 drift or some effort against gravity, 2 no effort against gravity or no movement) + speech (0 absent, 1 mild to moderate, 2 severe, global aphasia, or mute) + eye_deviation (0 absent, 1 partial, 2 forced) + neglect (0 absent, 1 extinction to bilateral stimulation in only one sensory modality, 2 does not recognize own hand or orients only to one side); Lima 2016 Table 1; Time documented for decision making (0 points, not scored); max 9; lvo_suggested if score ≥ 4; fast_ed_band 0_to_1 (score 0–1, <15% LVO), 2_to_3 (score 2–3, ~30%), gte_4 (score ≥4, ~60%+)", "max_score": 9, "score": 0, "arm_weakness": 0, "eye_deviation": 0, "facial_palsy": 0, "fast_ed_band": "0_to_1", "lvo_suggested": false, "neglect": 0, "speech": 0 } ] } ``` ## Response fields - `formula` (string): fast_ed - `formula_expression` (string): Exact expression used - `score` (integer): FAST-ED scale points 0-9 - `max_score` (integer): 9 - `lvo_suggested` (boolean): true iff score ≥ 4 (Lima 2016 abstract threshold). Not a stroke diagnosis or transfer order. Sensitivity and PPV are not returned. - `fast_ed_band` (string): Published Lima 2016 LVO-rate grouping: 0_to_1 (score 0-1, <15% LVO), 2_to_3 (score 2-3, ~30%), gte_4 (score ≥4, ~60%+). Cohort rates, not a patient-level probability. - `facial_palsy` (integer): Caller-assigned facial palsy 0 or 1 - `arm_weakness` (integer): Caller-assigned arm weakness 0, 1, or 2 - `speech` (integer): Caller-assigned speech 0, 1, or 2 - `eye_deviation` (integer): Caller-assigned eye deviation 0, 1, or 2 - `neglect` (integer): Caller-assigned neglect 0, 1, or 2 - `components` (array): Per-item Lima 2016 Table 1 points - `citation` (object): Lima et al. Stroke 2016 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 0, "factor": "facial_palsy", "points": 0, "present": false }, { "value": 0, "factor": "arm_weakness", "points": 0, "present": false }, { "value": 0, "factor": "speech", "points": 0, "present": false }, { "value": 0, "factor": "eye_deviation", "points": 0, "present": false }, { "value": 0, "factor": "neglect", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Lima FO, Silva GS, Furie KL, et al.", "doi": "10.1161/STROKEAHA.116.013301", "id": "lima-2016", "pmid": "27364531", "source": "Stroke. 2016;47(8):1997-2002", "title": "Field Assessment Stroke Triage for Emergency Destination: A Simple and Accurate Prehospital Scale to Detect Large Vessel Occlusion Strokes" }, "formula": "fast_ed", "formula_expression": "FAST-ED = facial_palsy (0 normal or minor, 1 partial or complete) + arm_weakness (0 no drift, 1 drift or some effort against gravity, 2 no effort against gravity or no movement) + speech (0 absent, 1 mild to moderate, 2 severe, global aphasia, or mute) + eye_deviation (0 absent, 1 partial, 2 forced) + neglect (0 absent, 1 extinction to bilateral stimulation in only one sensory modality, 2 does not recognize own hand or orients only to one side); Lima 2016 Table 1; Time documented for decision making (0 points, not scored); max 9; lvo_suggested if score ≥ 4; fast_ed_band 0_to_1 (score 0–1, <15% LVO), 2_to_3 (score 2–3, ~30%), gte_4 (score ≥4, ~60%+)", "max_score": 9, "score": 0, "arm_weakness": 0, "eye_deviation": 0, "facial_palsy": 0, "fast_ed_band": "0_to_1", "lvo_suggested": false, "neglect": 0, "speech": 0 } ``` ## Errors - HTTP 400 `invalid_fast_ed`: facial_palsy must be 0-1; arm_weakness, speech, eye_deviation, and neglect must each be 0-2 (Lima 2016 FAST-ED). Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [RACE scale](https://magentlab.com/docs/race) — Sum Pérez de la Ossa 2014 Rapid Arterial oCclusion Evaluation (RACE) scale points from caller-assigned facial palsy, arm motor, leg motor, head and gaze deviation, and cortical signs (aphasia if right hemiparesis, agnosia if left) and return whether the total suggests large arterial occlusion (score ≥5). - [CP-SSS](https://magentlab.com/docs/cpsss) — Sum Katz 2015 Cincinnati Prehospital Stroke Severity Scale (CP-SSS) points from caller-assigned conjugate gaze deviation, abnormal level of consciousness, and arm weakness, and return whether the total suggests severe stroke (score ≥2). - [LAMS](https://magentlab.com/docs/lams) — Sum Llanes 2004 LAMS points from caller-assigned facial droop, arm drift, and grip (LAPSS motor items). - [ROSIER](https://magentlab.com/docs/rosier) — Sum the seven Nor 2005 ROSIER items from caller-assigned flags and return whether the score is greater than 0 (stroke more likely). ## Payment Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/docs/mcp ## Guarantees - HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON. - exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.