• A recent systematic review evaluated the diagnostic accuracy of 19 prehospital stroke scales.
• Arm motor strength is the most frequently evaluated item by the scales (15/19), followed by gaze (13/19) and language (13/19).
• Only 4 scales (RACE, LAMS, VAN, sNIHSS-EMS) were performed by paramedics in their original studies.
• The NIHSS, LAMS, and VAN appear to have better results in predicting large vessel occlusion.
• The presence of hemineglect, a sign of cortical involvement, improved the accuracy of the scale.

Additional Information

• There is growing evidence for mechanical thrombectomy in acute ischemic stroke patients with large vessel occlusion.
• Identification of potential eligible patients begin in the prehospital setting in order for preferential transport of these patients to comprehensive stroke centers.
• Selected prehospital stroke scales:
  • RACE = Rapid Arterial Occlusion Evaluation Scale
  • LAMS = Los Angeles Motor Scale
  • VAN = Stroke Vision, Aphasia, Neglect Assessment
  • NIHSS = National Institute of Health Stroke Scale

References

• Vidale S, Agostini E. Prehospital stroke scales and large vessel occlusion: A systematic review. Acta Neurol Scand. 2018 Feb 11. [Epub ahead of print]

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