Long-Term Care

The Cincinnati Pre-Hospital Stroke Scale

LTC Nursing Assistant Trainer, December 17, 2009

The Cincinnati Pre-Hospital Stroke Scale is a sensitive, quick examination for stroke. This assessment can readily be used by long-term care nursing personnel. Early identification of cerebrovascular accidents (CVA) and transient ischemic attacks (TIA) in the long-term care facility can have a dramatic effect on the mortality and morbidity of the residents. The Cincinnati Pre-Hospital Stroke Scale will help you quickly and accurately identify the neurological status of a resident presenting with CVA/TIA signs and symptoms. It consists of three parts – arm drift, facial droop, and speech impairment:

  • Arm drift – Ask the resident to extend his or her arms, palms up. If he or she has had a stroke, the neurological deficit will cause the affected hand to roll over and then drift downward.
  • Facial droop – Observe the resident’s face while it is relaxed. Look at the normal contours and creases. Next, ask the resident to smile as if to show the upper teeth. The face may appear normal in a relaxed position, but asymmetrical when the resident smiles, which suggests a stroke.
  • Speech impairment – Stand where the resident can see your face. Ask him or her to repeat a simple phrase, such as, “You can’t teach an old dog new tricks.” If the resident cannot repeat the entire phrase, suspect a stroke.

This is an excerpt from HCPro’s book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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