The Los Angeles Prehospital Stroke Screen (abbreviated LAPSS) is a method of identifying potential
stroke
A stroke is a disease, medical condition in which poor cerebral circulation, blood flow to the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemorr ...
patients in a pre-hospital setting.
Screening criteria
* No history of seizures or epilepsy
*Age 45 years or older
*At baseline, patient is not bedridden and does not use a wheelchair
*Blood glucose between 60 and 400 mg/dL
*Obvious asymmetry-unilateral weakness with any of the following motor exams:
*#Facial Smile/Grimace
*#Grip
*#Arm Strength
If all of the above criteria are met (or not ascertainable) the LAPSS is positive for stroke. Patients may still be experiencing a stroke even if LAPSS criteria are not met.
Validity
A January 2000 study, conducted by 3 teams of
Los Angeles
Los Angeles ( ; es, Los Ángeles, link=no , ), often referred to by its initials L.A., is the largest city in the state of California and the second most populous city in the United States after New York City, as well as one of the world ...
-based
paramedic
A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research.
Not all ambulance personnel are p ...
units resulted in "sensitivity of 91% (95% CI, 76% to 98%), specificity of 97% (95% CI, 93% to 99%), positive predictive value of 86% (95% CI, 70% to 95%), and negative predictive value of 98% (95% CI, 95% to 99%). With correction for the 4 documentation errors, positive predictive value increased to 97% (95% CI, 84% to 99%)."
In a Chinese study,
Beijing
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Beijing ( ; ; ), Chinese postal romanization, alternatively romanized as Peking ( ), is the Capital city, capital of the China, People's Republic of China. It is the center of power and development of the country. Beijing is the world's Li ...
paramedics using the protocol, completed LAPSS screenings in an average of 4.3±3.0 minutes (median, 5 minutes). The study resulted in a sensitivity of 78.44% and a specificity of 90.22%.
See also
*
FAST (stroke)
FAST is an acronym used as a mnemonic to help detect and enhance responsiveness to the needs of a person having a stroke. The acronym stands for Facial drooping, Arm weakness, Speech difficulties and Time to call emergency services.
*F - Facial dro ...
*
Cincinnati Prehospital Stroke Scale
References
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Stroke
Medical assessment and evaluation instruments
Emergency medical services in the United States