The NIHSS is an internationally accepted tool for the systematic assessment of stroke severity. It comprises a 15-item neurological examination stroke scale used to evaluate the effect of an acute cerebral event on the levels of consciousness, language, neglect, visual-field loss, extra-ocular movement, motor strength, ataxia, dysarthria and sensory loss. It can be used by appropriately trained healthcare professionals and takes approximately 10 minutes to administer. However, the whole NIHSS does not need to be completed to make the initial diagnosis or to decide that hyperacute treatment would be indicated. It can be completed whilst waiting for the scans. The use of such an assessment tool ensures that a standard range of neurological signs and symptoms can be measured consistently over time providing a basis for clinical decision-making. Patients may not be suitable for thrombolysis (NIHSS<4) or thrombectomy (NIHSS<6) if the stroke is mild and not causing the patients difficulties.
Click the link below to complete the free NIHSS online training:
BlueCloud: Individual Memberships for Healthcare Professionals
All staff (stroke nurses and medical staff) involved in the management of hyperacute stroke patients should have completed training in the use of the NIHSS and be proficient in its use. Watch the video below and score the patient on the NIHSS. You might find it useful to open up the NIHSS assessment form below.
Try filling in a version of the form for yourself: Interactive NIHSS score sheet [.pdf, 955KB]
Video provided by kind permission: Mark Garside – Northumbria Healthcare; Chris Price – Newcastle University.
Duration: 4 minutes 58 seconds
