In a review article, studies that included FAST, Recognition of Stroke in the Emergency Room, LAPSS, Melbourne Ambulance Stroke Screen, Ontario Prehospital Stroke Screening Tool, Medic Pre-hospital Assessment for Code Stroke, and CPSS varied in quality.
Validation of the Los Angeles pre-hospital stroke screen (LAPSS) in a Chinese urban emergency medical service population.
Prospective validation of the Los Angeles prehospital stroke screen (LAPSS
Three vignettes were positive for stroke diagnosis according to the LAPSS and CPSS, while four vignettes described patients with hypoglycaemia and dehydration, ptosis, tardive dyskinesia and ataxia secondary to alcohol intoxication.
The answers provided for each of the vignettes were marked according to the validated stroke scales (LAPSS and CPSS) by the principal investigators, and accuracy was determined by using standard formulae for sensitivity, specificity and negative and positive predictive values (NPVs and PPVs).
In general, there was a tendency by the sample at both levels of care (BLS and ILS) to rely on specific signs and symptoms, rather than using validated stroke screening tools such as CPSS and LAPSS. Only 5% of BLS and 18.3% of ILS utilised these tools to aid their diagnosis.
pagename=symp), a modification of CPSS based on the same criteria, has been validated in primary care clinics as well as emergency departments Los Angeles Prehospital Stroke Screen (LAPSS
) (www.strokecenter.org/ trials/scales/lapss.html), a 1-page instrument that uses 5 criteria--age (>45 years), seizure history (none), onset of neurologic symptoms (within 24 hours), ambulatory status (ambulatory prior to event), and blood glucose level (60-400 mg/dL)--and 3 physical characteristics (facial smile/ grimace, grip, and arm weakness) to screen for possible stroke * A positive test is based on the presence of 1 or more key features for CPSS or FAST, and on a Yes (or Unknown) response to all the screening criteria in LAPSS
Identifying stroke in the field: prospective validation of the Los Angeles Prehospital Stroke Screen (LAPSS