The Cincinnati Prehospital Stroke Scale
The scale checks three findings: facial droop, arm drift, and abnormal speech. If any one is abnormal, the probability of stroke is high. Ask the patient to smile, hold both arms out with eyes closed, and repeat a simple phrase.
Time Is Brain
Establish the last known well time, because it determines eligibility for clot-busting therapy. Check blood glucose to rule out hypoglycemia, which can mimic stroke. Maintain the airway, give oxygen if hypoxic, and avoid giving anything by mouth.
Destination Decisions
Transport rapidly to a stroke-capable facility and pre-notify the hospital. Keep the patient calm, elevate the head slightly if no contraindication, and monitor for seizures or declining consciousness. Document findings and times carefully.