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Related Experiment Video

Updated: Jul 11, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Published on: January 15, 2017

A stroke scale for emergency triage.

Christine M Whelley-Wilson¹, George C Newman

¹Stroke Program, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin, USA.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association

|October 2, 2007

Summary

This summary is machine-generated.

The Emergency Triage Stroke Scale (ETSS) accurately predicts the National Institutes of Health Stroke Scale (NIHSS) for acute ischemic stroke patients. This simplified scale aids emergency medical service providers and nurses in stroke assessment and treatment decisions.

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Area of Science:

Neurology
Emergency Medicine
Clinical Assessment Tools

Background:

The National Institutes of Health Stroke Scale (NIHSS) is standard for acute ischemic stroke but complex for non-specialists.
Emergency medical service (EMS) providers and triage nurses require a simplified tool for rapid stroke assessment.

Purpose of the Study:

To develop and validate the Emergency Triage Stroke Scale (ETSS) as a predictor of the NIHSS.
To assess the ETSS's utility for EMS providers and triage nurses lacking specialized stroke training.

Main Methods:

The ETSS was designed to mirror NIHSS domains using routine EMS assessments.
48 acute ischemic stroke patients were evaluated by ED residents, nurses, EMS personnel (ETSS), and ED attendings/stroke physicians (NIHSS).
Statistical analyses included ANOVA, linear regression, Spearman correlation, and K statistic for reproducibility.

Main Results:

Excellent agreement was found between residents and nurses using the ETSS.
A strong correlation existed between NIHSS and ETSS scores from residents/nurses.
EMS providers showed good performance, though with a tendency to overestimate scores in severe cases.
All ETSS raters effectively predicted thrombolytic therapy candidacy (predicted NIHSS 4-23).

Conclusions:

The ETSS is a simplified prehospital stroke scale that correlates well with the NIHSS.
With clearer instructions and education, EMS personnel can achieve reliable ETSS results.
The ETSS facilitates better stroke assessment and management in prehospital settings.