rate what they actually do - ✔✔
tips for scoring - ✔✔ use patient's first response
-
ataxia - ✔✔ lack of muscle coordination,
... [Show More] reflects the affected coordination of one who has experienced a stroke
Significance of NIH stroke scale - ✔✔ necessary prognostic tool for discerning deficits within different parts of body.
provides in common language to understand nature of stroke and severity amongst interdisciplinary team.
is the NIH stroke scale a measure of disability? - ✔✔ no, it is a measuring tool of impairments.
Relevance to medical specialties - ✔✔ emergency physicians, neurologists
- ✔✔ - administer scale items in their - exact order
- avoid coaching patient
- accept patient's 1st effort
- score only what patient does
- be consistent
NIH level of consciousness item 1a - ✔✔ 0 = alert
1 = not alert; aroused with minor verbal stimulation
2 = not alert; requires strong or painful stimulation
3 = reflex movements only or totally unresponsive *coma*
NIH level of consciousness item 1B - ✔✔ based on 2 questions
1) patient's age
2) month
0 = answers both questions correctly
1 = answers one question correctly
2 = answers neither questions correctly
NIH level of consciousness item 1C - ✔✔ ask patient to perform 2 tasks
1) close your eyes, now open them
2) make a fist (independent limbs)
NIH Best Gaze - ✔✔ tests voluntary horizontal eye movements.
- notice position of the eyes at rest,
- move finger/object horizontally and ask patient to follow moving target
0 = score if acts performed correctly
1 = partial gaze palsy
2 = forced deviation
*consider if eye movements are normal*
NIH Visual field test - ✔✔ eyes are tested independently
patient must be looking directly at your eyes for peripheral tests.
1) cover opposing eye - test peripheral field
0 = no visual loss
1 = partial hemianopia
2 = complete hemianopia
3 = bilateral hemianopia
NIH Visual palsy test - ✔✔ 1) ask patient to show teeth
2) ask patient to show grimace (discern for symmetry)
3) ask patient to squeeze eyes shut, open them, then raise eye brows
0 = for normal symmetrical movements
1 = minor paralysis or asymmetry when grinning/smiling
3 = complete paralysis [Show Less]