Girish Mahajan (Editor)

Los Angeles Prehospital Stroke Screen (LAPSS)

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The Los Angeles Prehospital Stroke Screen (LAPSS) is a method of identifying potential stroke victims in a pre-hospital setting.

Contents

Screening Criteria

  • Over 45 years old
  • No history of seizures
  • Neurologic symptoms started to present within the last 24 hours
  • Patient is not hospitalized
  • Blood sugar is 60 - 400 mg/dL
  • Unilateral (and not bilateral) exhibition of Facial Droop, Grip weakness, Arm weakness or other observable motor asymmetries

    • If all of these criteria are met (or not ascertainable) the LAPSS is positive for stroke. Patients may still be experiencing a stroke even if LAPSS criteria are not met.

    Validity

    A January 2000 study, conducted by 3 teams of Los Angeles-based paramedic units resulted in "sensitivity of 91% (95% CI, 76% to 98%), specificity of 97% (95% CI, 93% to 99%), positive predictive value of 86% (95% CI, 70% to 95%), and negative predictive value of 98% (95% CI, 95% to 99%). With correction for the 4 documentation errors, positive predictive value increased to 97% (95% CI, 84% to 99%)."

    In a Chinese study, Beijing paramedics using the protocol, completed LAPSS screenings in an average of 4.3±3.0 minutes (median, 5 minutes). The study resulted in a sensitivity of 78.44% and a specificity of 90.22%.

    References

    Los Angeles Prehospital Stroke Screen (LAPSS) Wikipedia
    (Text) CC BY-SA