Los Angeles Prehospital Stroke Screen (LAPSS)

Los Angeles Prehospital Stroke Screen (LAPSS)
Medical diagnostics
Purpose identifying potential stroke patients

The Los Angeles Prehospital Stroke Screen (LAPSS) is a method of identifying potential stroke patients in a pre-hospital setting.[1]

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.[2]

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%)."[3]

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%.[4]

See also

References

  1. ↑ American Heart Association - Stroke
  2. ↑ LAPSS Protocol
  3. ↑ Kidwell, CS; Starkman, S; Eckstein, M; Weems, K; Saver, JL (31 Jan 2000). "Identifying stroke in the field. Prospective validation of the Los Angeles prehospital stroke screen (LAPSS)". Stroke. 31: 71–6. doi:10.1161/01.str.31.1.71. PMID 10625718.
  4. ↑ Chen, S; Sun, H; Lei, Y; Gao, D; Wang, Y; Wang, Y; Zhou, Y; Wang, A; Wang, W; Zhao, X (2013-08-07). "Validation of the Los Angeles pre-hospital stroke screen (LAPSS) in a Chinese urban emergency medical service population". PLoS One. 8: e70742. doi:10.1371/journal.pone.0070742. PMC 3737357. PMID 23950994.
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