Okay. We've looked at a set
of initial healthcare orders.
Now I want to introduce you
to the NIH Stroke Scale.
That's the National Institutes
of Health Stroke Scale,
so you'll often heard it just called NIHSS.
This is a standardized tool
that's used across
the United States to evaluate
potential stroke patients.
So, you'll receive special training once
you're a practicing nurse, and usually,
they're members on the stroke team that
respond that have been trained in this scale.
So the score for each ability is
a number between 0 and 4.
0 is normal functioning, and
4 is completely impaired.
So 42 is the highest, and
the higher the score,
the more impairment the
So it's not important that you look at
the specifics of it. I just want you to be
aware that this is a standardized
tool. It's an efficient way
to consistently assess patients
and see where they stand,
because most people are familiar
with this in the healthcare world,
that the higher the score, the more
severe the possibility of impairment.
Okay. So they've got multiple neurological
items on each stroke scale.
They look at level of consciousness, language,
neglect -- remember we talked about
right and left side neglect. They've got
some problems with their visual
field, some weird eye movements,
their motor strength, we'll look and
see if it is equal on both sides.
Ataxia, problems with movement,
Dysarthria is a motor speech disorder caused by weakness
in the muscles used to speak, often resulting in slowed or slured speech.
Or they have some sensory loss. So, this
is not a slide for you to memorize.
This is just information for you to know.
These are the categories that we would look
at each one of these items, the
one who is trained,
will do the NIH stroke scale, score it,
and come up with a total number.
Takes less than 10 minutes to complete.
It can be done by a certified nurse
or a physician. So, remember, you
need special training in this scale
to evaluate the patient. Now, we do it in
the patient that's admitted, so this would
likely be done in the ER. It'll give us a
baseline to know where the patient was.
Now, neuro patients can change
for lots of different reasons.
So we're going to do it at the baseline, when
they come in. We're going to it 2 hours
after whatever treatment is decided upon,
then likely at 24 hours, after symptoms,
then 7-10 days, 3 months, etc. Now that
timetable can be adjusted based on
what each patient needs, but the
important takeaway points are, it's
quick. If you're trained,
< 10 minutes to do a very thorough
exam and we'll utilize it
it to see how the patient is progressing,
either getting better or losing some ground.