Directed Use of the Cincinnati Prehospital Stroke Scale by Laypersons

  title={Directed Use of the Cincinnati Prehospital Stroke Scale by Laypersons},
  author={Amy S. Hurwitz and Jane H. Brice and Barbara A. Overby and Kelly R. Evenson},
  journal={Prehospital Emergency Care},
  pages={292 - 296}
Background. The Cincinnati Prehospital Stroke Scale (CPSS) is a three-item examination that has been effective in the identification of stroke victims by health care professionals. However, assessment of the patient earlier in the chain of care, specifically by a 9-1-1 telecommunicator, may improve stroke outcomes. Objectives. To modify the CPSS for over-the-phone administration andto assess whether untrained adults can follow the CPSS instructions, identify deficits in stroke survivors… 

The effect of Cincinnati Prehospital Stroke Scale on telephone triage of stroke patients: evidence-based practice in emergency medical services

The use of CPSS assists nurses by reducing the triage error and supports the evidence-based care and needs to be developed to cover signs and symptoms of posterior-circulation stroke patients.

The accuracy of Johannesburg-based ambulance personnel in identifying stroke

Despite not using validated screening tools, the ambulance personnel sampled in this study were able to identify stroke with high accuracy and should be considered to identify how these diagnoses were reached.

The use of Cincinnati prehospital stroke scale during telephone dispatch interview increases the accuracy in identifying stroke and transient ischemic attack symptoms

Centres that use CPSS more frequently during phone dispatch showed greater agreement with on-the-scene prehospital assessments, both in correctly identifying more cases with stroke/TIA symptoms and in giving fewer false positives for non-stroke/Tia cases.

The role of the Cincinnati Prehospital Stroke Scale in the emergency department: evidence from a systematic review and meta-analysis

The CPSS is a standardized and easy-to-use stroke screening tool whose implementation in emergency systems protocols, along with proper and consistent coordination with local, regional, and state agencies, medical authorities and local experts are suggested.

Feasibility study to assess the use of the Cincinnati stroke scale by emergency medical dispatchers: a pilot study

The goal of this pilot study was to determine the feasibility of an EMD applying the Cincinnati stroke scale tool during a 911 call, and to report the time required to administer the tool.

Statewide Survey of 911 Communication Centers on Acute Stroke andMyocardial Infarction

The results suggest that the development of statewide telecommunication training program to improve knowledge and care for suspected stroke or MI is needed in North Carolina and Dispatching for stroke and MI could be enhanced by requiring all communication centers to be EMD-certified.

Accuracy of Stroke Recognition by Emergency Medical Dispatchers andParamedics—San Diego Experience

  • P. RamanujamK. Guluma J. Dunford
  • Medicine
    Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
  • 2008
In the EMS system, EMD using MPDS Stroke protocol with a high compliance has a higher sensitivity than paramedics using CSS.

Emergency Medical Services Capacity for Prehospital Care of Stroke Patients in North Carolina

Overall deficiencies in EMS stroke care capacity were observed regardless of system patient volume and population density, and Education of EMS personnel on stroke should continue to be an area of focus, particularly the frequency and content of trainings.

Emergency medical services (EMS): first line of defense against stroke

The concept of a “Chain of Recovery” was developed to improve the care of stroke patients by incorporating the pre-hospital and hospital management.

Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack.

The aim was to systematically identify and review the evidence pertaining to the test accuracy of validated stroke recognition scales, as used in a prehospital or emergency room (ER) setting to screen people suspected of having stroke.



Ability of laypersons to use the Cincinnati Prehospital Stroke Scale.

  • A. LiferidgeJ. BriceB. OverbyK. Evenson
  • Medicine, Psychology
    Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
  • 2004


It is suggested that the CPSS may be a useful tool in early prehospital detection of stroke by dispatchers because of its ability to convey CPSS instructions to the patient and relay findings to the investigator.

Shortening the NIH Stroke Scale for Use in the Prehospital Setting

The derivation analyses suggested the 8 NIHSS-15 items that were most predictive of “good outcome” 3 months after stroke, in order of decreasing importance, which may be useful to triage acute stroke patients in communities and to provide a baseline stroke severity for prehospital acute stroke trials.

Design and retrospective analysis of the Los Angeles Prehospital Stroke Screen (LAPSS).

The LAPSS is a promising tool that may enable paramedic recognition of stroke with a high degree of sensitivity and simplicity in a short period of time and a substantial time savings will potentially occur if neuroprotective agents are administered by paramedics in the field.

Frequency and accuracy of prehospital diagnosis of acute stroke.

Prehospital evaluation of potential stroke patients can be accomplished promptly after the EMS system is activated because paramedic-level interventions are frequently required and almost 20% of patients with potential stroke have acute medical conditions for which effective specific therapies are available.

Emergency Calls in Acute Stroke

It is found that motor deficits and speech problems were the most dramatic symptoms that led to activation of the EMS and educational efforts are needed to improve recognition of atypical stroke symptoms by stroke victims and EMS professionals.

Activation of emergency medical services for acute stroke in a nonurban population: the T.L.L. Temple Foundation Stroke Project.

Logistic regression analysis comparing those who called 911 with those who did not activate EMS found that individuals who were employed were 81% less likely to have EMS activated (OR 0.19, 95% CI 0.04 to 0.63).

Feasibility of Neuroprotective Agent Administration by Prehospital Personnel in an Urban Setting

Prehospital NA administration can potentially significantly reduce the time to first intervention in stroke patients, and this study determined the potential reduction in time to treatment of stroke patients when NAs were administered in the prehospital setting.

Emergency medical services dispatcher identification of stroke and transient ischemic attack.

  • G. H. PorteousM. CorryW. Smith
  • Medicine
    Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
  • 1999
People who activate EMS for stroke frequently use the word "stroke" and/or describe symptoms compatible with stroke in their calls, so EMS dispatch protocols should be sensitive for these symptoms to ensure more accurate and timely ambulance dispatch.