Assessment Tool: Cincinnati Prehospital Stroke Scale (CPSS)

Assess all three items and record findings. Any single abnormal finding should trigger immediate stroke alert. Document the time of assessment and last known well.

Cincinnati Prehospital Stroke Scale (CPSS)

A rapid three-item screen for identifying acute stroke. Any abnormal finding has a sensitivity of 66% and specificity of 87% for stroke. All three abnormal findings increases specificity to 97%.

Clinical note: Any single abnormal finding warrants immediate stroke alert. Do not delay CT imaging or thrombolytic time-window assessment to complete the full screen.
Facial Droop

Ask the patient to show teeth or smile. Observe for asymmetry.

Arm Drift

Ask the patient to close eyes and hold both arms out in front, palms up, for 10 seconds.

Abnormal Speech

Ask the patient to say: "You can't teach an old dog new tricks."