Los Angeles Prehospital Stroke Screen (LAPSS)

The Los Angeles Prehospital Stroke Screen (LAPSS) is a method of identifying potential stroke victims 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

• FAST (stroke)
• Cincinnati Prehospital Stroke Scale

References

1. American Heart Association - Stroke
2. LAPSS Protocol
3. "Identifying stroke in the field. Prospective validation of the Los Angeles prehospital stroke screen (LAPSS).". US National Library of Medicine National Institutes of Health. 31 Jan 2000. Retrieved 3 February 2014.
4. "Validation of the Los Angeles pre-hospital stroke screen (LAPSS) in a Chinese urban emergency medical service population.". US National Library of Medicine National Institutes of Health. 2013-08-07. Retrieved 3 February 2014.