Neurology Book

Approach

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Los Angeles Prehospital Stroke Screen

Aka: Los Angeles Prehospital Stroke Screen, LAPSS
  1. Indications
    1. Cerebrovascular Accident Assessment
    2. See Ischemic Stroke Management Protocol
  2. Criteria (Positive if all 6 major items present)
    1. Age over 45 years
    2. No prior history of Seizure disorder
    3. New onset of neurologic symptoms in last 24 hours
    4. Patient was ambulatory at baseline (prior to event)
    5. Blood Glucose in range 60 to 400
    6. Unilateral asymmetry (one of categories below)
      1. Facial droop
      2. Grip weakness or absence
      3. Arm weakness
  3. Interpretation: Positive answers to all 6 questions above
    1. Contact hospital en-route
    2. Alert hospital of possible CVA patient
  4. Efficacy
    1. Test Sensitivity: 93%
    2. Test Specificity: 97%

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