The Cincinnati Prehospital Stroke Scale (CPSS) can help emergency medical response personnel identify possible stroke patients before arrival at the hospital. This can aid in the prompt initiation of tissue plasminogen activator therapy, which must be given within 3 hours of symptom onset to be effective.
Parameters:
(1) facial droop: The patient smiles or shows teeth.
(2) arm drift: The patient closes her/his eyes and extends both arms straight out for 10 seconds.
(3) speech: The patient repeats a phrase such as "The sky is blue in Cincinnati."
Parameter
Finding
Assessment
facial droop
both sides of face move equally
normal
one side of face does not move as well as the other
abnormal
arm drift
both arms move the same, or both arms do not move at all
normal
one arm does not move, or one arm drifts down compared to the other
abnormal
speech
correct words spoken without slurring of words
normal
slurs words, says wrong words, or unable to speak
abnormal
Interpretation:
• The presence of one or more abnormal findings may indicate that the patient is having a stroke, and appropriate diagnostic tests started as promptly as possible.
• In the test population used, the sensitivity of at least one abnormal finding for a stroke was 66% for all strokes and 88% for anterior circulation strokes. The specificity was 87%.
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