The Cincinnati Prehospital Stroke Scale (CPSS) is a one-minute screen for stroke, developed for paramedics and now taught widely to clinicians and the public. It checks three signs: facial droop, arm drift and abnormal speech.
One abnormal finding is a positive screen. In the original validation, a single abnormal sign was associated with about a 72% probability of stroke, and all three with more than 85%.
Zdrovia: https://www.zdrovia.ca/resources/cincinnati-stroke-scale/
Prehospital Stroke Screen
Cincinnati Prehospital Stroke Scale
Check the three signs. Any one abnormal finding suggests a stroke and warrants emergency transport and a time-last-known-well.
Ask the patient to smile or show their teeth.
Eyes closed, both arms held straight out for 10 seconds.
Ask the patient to repeat a simple sentence, e.g. "You can't teach an old dog new tricks."
Abnormal findings
0 of 3 items scored
Score every item to see the result
Item breakdown
These results are estimates based on published clinical data and are for informational purposes only. They do not constitute medical advice, a diagnosis, or a treatment recommendation. Consult a licensed aesthetic practitioner before beginning any treatment. Individual results vary.
Zdrovia's smart blocks drop validated scales into the visit note, keep every item score, and graph the total across visits so the trend is visible at a glance. See how smart blocks work →
How to test each sign
| Sign | How to test | Normal | Abnormal |
|---|---|---|---|
| Facial droop | Ask the patient to smile or show their teeth | Both sides move equally | One side doesn't move as well |
| Arm drift | Eyes closed, both arms out straight, palms up, for 10 seconds | Both arms stay up or move the same | One arm drifts down or doesn't move |
| Speech | Ask them to repeat a simple sentence | Correct words, clear | Slurred, wrong words, or unable to speak |
Score it straight into the chart
Zdrovia's smart blocks drop validated scales into the visit note, keep every item score, and graph the total across visits so the trend is visible at a glance.
What to do with a positive screen
Treat it as an emergency. Call 911, or activate your facility's stroke protocol, and note the time the person was last known to be well, because treatment eligibility depends on it. Check blood glucose if you can, since hypoglycaemia can mimic stroke, and give nothing by mouth.
Limitations
The CPSS misses strokes that don't affect the face, arm or speech, particularly posterior circulation strokes that cause vertigo, imbalance or visual loss. The BE-FAST mnemonic adds Balance and Eyes for that reason. A negative screen in someone with sudden neurological symptoms still needs urgent assessment.
Scoring severity: NIH Stroke Scale (NIHSS) calculator →
Other clinical assessment references