Assessment of the stroke patient using the NIH stroke scale.
The NIH scale requires no advanced expertise to complete. Any level of EMS provider can use the form if given proper orientation and training, with an in-service to explain the form and clear up any ambiguous language in it. Scenario-based practice sessions following a short class are ideal. A nurse from a hospital's stroke team would be the best person to teach the class, since he/she would be intimately familiar with the form and how to use it. The NIHSS is the ideal assessment tool to make prehospital examination of stroke patients more aggressive. Although ideal, the NIHSS should only be used when transport time allows. By no means should a stroke patient's transport be delayed to administer the scale. If conditions and time do not allow, the provider should revert back to the CPSS as an assessment tool. If transport time allows, however, the NIHSS is the proper exam to use. It is aggressive, simple to use and cases the transition of the patient from ambulance to emergency department. It also saves time for the patient by allowing the doctor to provide proper treatment more quickly. The forms are free to copy from the NIHSS and, therefore, costs are minimal to implement its use. Any solution that assists patient, physician and provider in an aggressive yet economical manner needs to be implemented. The positive aspects of the NIHSS in prehospital care span across the board and will be realized in patient care.
Powers
D W
DW
Surfside Beach Rescue Squad, Surfside Beach, SC, USA.
D004632:Emergency Medical Services / Q000592:standards*; D006801:Humans; D009316:National Institutes of Health (U.S.); D010808:Physical Examination; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D020521:Stroke / Q000145:classification* / Q000175:diagnosis* / Q000503:physiopathology; D014481:United States