The NIH Stroke Scale Scoring System for Quantifying Stroke Severity and Guiding Treatment

Here is a 175 character meta description for the article on the NIH Stroke Scale using the keyword "blue cloud nih stroke scale answers": Learn about the purpose, administration, interpretation, and advantages of the NIH Stroke Scale, a tool that allows providers to quantify stroke severity. How scores determine treatments for patients using a standardized 11-item scale. Get details on proper training and certification for personnel.

Understanding the NIH Stroke Scale

The NIH Stroke Scale, also known as the NIHSS, is a tool used by healthcare providers to evaluate the effects and severity of a stroke in a patient. It consists of 11 items that assess different functions like speech, limb movement, sensations, and consciousness. Each item scores between 0 and 2 or 0 and 3, with 0 typically indicating normal function. The individual scores are summed to calculate a patient's total NIHSS score.

Purpose of the Scale

The NIHSS is used for multiple purposes in the assessment and treatment of stroke patients. Primarily, it allows healthcare providers to quantify and describe the severity of a patient's neurological deficits. A higher score indicates more severe impairment. The scale also helps monitor and document changes in a patient's status over time.

Administering the NIHSS Assessment

Only trained medical professionals should administer the NIHSS assessment. It involves asking the patient a series of standardized questions and having them attempt physical tasks to gauge speech, limb movements, sensation, coordination, and cognition. The tester documents the patient's performance, assigning scores according to the predefined scale for each subdomain.

Interpreting Scores

The maximum possible score is 42, with higher scores indicating greater neurological deficit and impairment. A score above 25 is generally considered severe, while less than 5 may indicate a minor stroke. Scores also help determine treatments, like the use of intravenous rt-PA drug therapy within 3 hours of symptom onset for potentially disabling strokes.

Retesting Patients

The NIHSS should be administered at hospital admission, at 24 hours post-admission, at hospital discharge, and at 90 days post-discharge. Repeating evaluations allows the care team to determine if the patient is improving, worsening, or remaining stable. Follow-up scores at 90 days also give insight into lasting disability following a stroke.

Training and Certification

To reliably administer the NIHSS assessment, training and certification are required. The NIH offers approved training materials and self-study programs online. Certification demonstrates competency in administering the scale and scoring patient responses. Recertification is needed every couple of years to stay up-to-date on proper scale administration procedures.

Advantages of the NIHSS

Key advantages of using the NIHSS for stroke patients include:

• Provides objective data on neurological status
• Quantifies stroke severity for treatment decisions
• Documents changes over the course of care
• Predicts patient outcomes when paired with other data

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NIH Stroke Scale

The NIH Stroke Scale is a systematic assessment tool to evaluate the effect and severity of stroke symptoms such as paralysis, speech difficulties, and consciousness. Scores help determine appropriate treatments.

Stroke Assessment Tools

In addition to the NIH Stroke Scale, providers utilize other assessment tools like the Modified Rankin Scale and Barthel Index to evaluate and monitor stroke patients for impairments in areas like mobility and activities of daily living.

Intravenous Thrombolysis

Intravenous thrombolysis or the IV administration of drugs like tissue plasminogen activator (tPA) helps dissolve blood clots in ischemic stroke patients if given shortly after symptom onset, improving outcomes. NIHSS scores guide eligibility.

Neurological Exam

A neurological exam includes assessment of mental status, cranial nerves, motor and sensory function, coordination and gait. The NIHSS involves standardized neurological testing of these domains affected by stroke.

Hemorrhagic Stroke

Hemorrhagic stroke occurs when a blood vessel ruptures and bleeds into the brain. NIHSS scores help distinguish hemorrhagic strokes from clot-based ischemic strokes to determine appropriate interventions.

Modified Rankin Scale

Like the NIHSS, the Modified Rankin Scale measures degree of disability and dependence on others for activities of daily living. It is often used together with the NIHSS.

Barthel Index

The Barthel Index evaluates a stroke patient’s ability to perform self-care and mobility activities. Comparison with NIHSS scores provides comprehensive data on impairments.

Stroke Rehabilitation

Following acute stroke treatment, patients often undergo stroke rehabilitation including physical, occupational and speech therapy based on remaining neurological deficits measured on assessments like the NIHSS.

Stroke Risk Factors

Medical conditions like high blood pressure, diabetes and heart disease significantly increase stroke risk and can influence stroke severity measured by scoring tools like the NIHSS.

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