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Cincinnati Stroke Scale vs. LA Stroke Scale vs NIH
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Transcript
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Cincinnati, LA and NIH Stroke Scales
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What are they?
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- All 3 scales are ways to assess if a patient is actively having a stroke
- Although different in some aspects, they look for similar features such as:
- Facial droop
- Arm weakness
- Slurred speech
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Cincinnati Stroke Scale
- Developed in 1997 at the University of Cincinnati hospital settings based on these 3 signs:
- Facial droop
- Arm drift
- Speech
- Patients with 1/3 of these signs have a 72% chance of ischemic stroke, while persons with 3/3 signs have a probability graters than 82%.
- Pros of this stroke scale:
- can be used quickly and efficiently by most people
- Easy to understand and score
- Cons of this stroke scale:
- Cannot identify posterior circulation strokes
LA Stroke Scale
- This screening tool is used by EMT's and paramedics. It is a longer screening tool
- Screening criteria include:
- Patient is >45 years of age
- Has no history of seizure/epilepsy
- Symptom duration is <24 hours
- Patient is not bedridden/wheelchair dependent at baseline
- Blood glucose is between 60-400 mg/dL.
- Pros of the LA Stroke Scale
- Can be performed rapidly and is mostly accurate
- Cons of LA Stroke Scale
- Is pretty extensive/lengthy for EMS to complete quickly
NIH Stroke Scale
- This scale is a 15-item neurological examination that can evaluate the level of brain damage caused by acute cerebral infarct.
- The criteria include:
- levels of consciousness, language, neglect
- visual-field loss, extraocular movement, motor strength
- ataxia, dysarthria, sensory loss
- Based on a scoring system (0-42 points), stroke severity is determined by:
- >25 = very severe
- 15-24 = severe
- 5-14 = Mild/Moderately severe
- 1-5 = Mild
- Pros of NIH stroke scale:
- Very reliable, rapid tool to asess effects of stroke
- Cons of NIH stroke scale:
- Cannot capture all stroke patients because it may be complicated by coma, intubation or aphasia.
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NIH Stroke Scale
Cincinnati Stroke Scale
LA Stroke Scale
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What do we use now?
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The Gold Standard
- Currently, the gold standard to evaluate stroke is the NIH stroke scale.
- It is considered the most sensitive and specific, and most encompassing of different types of strokes.
- Currently, this is the best and most effective choice.
Thank you!
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Sources
Sources
- https://www.heart.org/-/media/files/affiliates/gra/gra-qsi/2019-scbc-presentations/5--assessing-stroke--scores--scales-v2.pdf?la=en
- https://www.stroke.nih.gov/documents/NIH_Stroke_Scale_508C.pdf
- https://physio-pedia.com/Stroke:_Assessment#sts=Cincinnati%20Pre-Hospital%20Stroke%20Scale%20(CPSS)
- https://www.physio-pedia.com/NIH_Stroke_Scale
- http://www.strokecenter.org/wp-content/uploads/2011/08/LAPSS.pdf
- https://www.stroke.org/-/media/stroke-files/ems-resources/ems-stroke-assessment-guide-ucm_454087.pdf?la=en
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