www.emtldr.com

/Neurology

The NIH Stroke Scale is a commonly used stroke evaluation tool. I find what is missing is the reason as to why it is done. This is a NIHSS stroke scale with comments regarding the vascular territory each component looks at. It sounds a lot nicer handing over to the neuro/stroke team to say “Calling regarding a patient with a NIHSS 7 likely L-MCA stroke evidenced by R motor weakness and expressive aphasia”. That is the purpose of this document. Attached below is a copy/pastable template written in the negative to speed up documentation. Note that for NIHSS scoring purposes, you will need to load some images (interpreting a scene / identifying objects) to show the patient (LMGTFY). Download the Printable NIHSS Screener By Vascular Territory below.

COPYPASTA: NIHSS Score of 0, documenting all negatives. (Delete and Highlight positive findings as required)
Normal level of consciousness, alert.
Oriented to month and age.
Obeys commands uneventfully.
No gaze palsy.
No facial paresis (shows teeth, raises eyebrows and closes against resistance).
No drift on elevating arms to 90deg for 10 seconds.
Able to raise legs off bed for 5 seconds.
No limb ataxia (finger-nose, heel-shin tests).
Sensation intact bilaterally.
Normal language skills.
Identifies objects uneventfully.
Reading briskly.
No dysarthria. Pronouncing consonants clearly.
No inattention or neglect noted on testing with double stimulus.