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The Cincinnati Prehospital Stroke Scale is a system used to diagnose a potential stroke in a pre-hospital setting. It tests three signs for abnormal findings which may indicate that the patient is having a stroke. If any one of the three tests shows abnormal findings, the patient may be having a stroke and should be transported to a hospital as soon as possible.

1. Facial droop: Have the person smile or show his or her teeth. If one side doesn’t move as well as the other so it seems to droop, that could be sign of a stroke.

• Normal: Both sides of face move equally
• Abnormal: One side of face does not move as well as the other (or at all)

2. Arm drift: Have the person close his or her eyes and hold his or her arms straight out in front for about 10 seconds. If one arm does not move, or one arm winds up drifting down more than the other, that could be a sign of a stroke.

• Normal: Both arms move equally or not at all
• Abnormal: One arm does not move, or one arm drifts down compared with the other side

3. Speech: Have the person say, “You can’t teach an old dog new tricks,” or some other simple, familiar saying. If the person slurs the words, gets some words wrong, or is unable to speak, that could be sign of stroke.

• Normal: Patient uses correct words with no slurring
• Abnormal: Slurred or inappropriate words or mute

Interpretation: Patients with 1 of these 3 findings as a new event have a 72% probability of an ischemic stroke. If all 3 findings are present the probability of an acute stroke is more than 85%

References:
1. Hurwitz AS, Brice JH, Overby BA, Evenson KR (2005). “Directed use of the Cincinnati Prehospital Stroke Scale by laypersons”. Prehosp Emerg Care 9 (3): 292–6. doi:10.1080/10903120590962283. PMID 16147478.

2. American Heart Association (2011). Advanced Cardiovascular Life Support Provider Manual. USA: First American Heart Association Printing. p. 137. ISBN 9-781616-690106.