Incorporating the NIHSS Assessment into FAST

One of the challenges facing paramedics is differentiating between patients having a stroke and those with symptoms that mimic a stroke. Sometimes it will be relatively clear that a patient has had a stroke, but often it is not clear-cut and some patients with stroke will not exhibit any of the FAST symptoms.

The NIHSS is a neurologic examination stroke scale used to quantify the severity of a stroke in the acute setting and includes signs additional to what is included in FAST and are very important in the diagnosis of stroke such as ataxia (lack of coordination), visual field loss, nystagmus (involuntary movement of the eye), and sensory loss.

The below video demonstrates how the NIHSS assessment can be incorporated into the FAST stroke assessment.