ToolsCalculators
Cincinnati Prehospital Stroke Severity Scale (CP-SSS)
Prehospital screen for large-vessel occlusion stroke.
Cincinnati Prehospital Stroke Severity Scale (CP-SSS)
Conjugate gaze deviation present
Corresponds to NIHSS gaze score 1-2.
Incorrectly answers >=1 level-of-consciousness question AND does not follow >=1 command
Cannot hold arm up for 10 seconds (arm falls)
Result0 points
Score <2 makes large-vessel occlusion less likely.
- Large-vessel occlusion likely
- No
When to use
- Prehospital or ED triage of suspected acute stroke to predict large-vessel occlusion.
Formula
Conjugate gaze deviation 2; impaired LOC questions and commands 1; arm weakness 1. Range 0-4; >=2 predicts LVO.
Pearls and pitfalls
- Derived from a subset of NIHSS items to be usable by paramedics.
- A negative score does not exclude stroke or LVO.