A Diagnosis Study of a New Prehospital Strokeidentification Test, the PreHospitalt Ambulans Stroke Test (PreHAST), to be Used to Triage Patients With Suspected Stroke
A Diagnosis Study of a New Prehospital Strokeidentification Test, the PreHospitalt Ambulans Stroke Test (PreHAST), to be Used to Triage Patients With Suspected Stroke
The aim of the Pre-HAST study is to improve identification and triage of patients with
 suspected stroke in order to get the right patient to the right level of care as fast as
 possible. Furthermore, the scale is also intended to use follow stroke symptoms in emergency
 care. The test is more extensive then the FAST or Cincinatti Stroke Scale and is in some
 aspects similar to the NIHSS but is shorter, easier and faster to perform to improve
 interexaminator variability and improve validity in less trained personal. The test is
 intended for awake patients with suspected stroke
PreHAST (PreHospital Ambulance Stroke Test)

 -  for suspected stroke in awake patients The following parameters are tested.

 1. Commands • Evaluates ability to understand verbal commands (impressive aphasia?)
 and to carry out complex commands (apraxia?)

 • Give the command: open and close your eyes! Grip your hand! (non-paretic side) 0
 - two correct 2 - one or none correct

 2. Eye position • Evaluates involuntary deviation of the gaze (déviation conjugée?).
 If present, this implies a serious injury and thus 2 p are given.

 • Observ if the patient have the eyes trained to one direction unmotivated 0 -
 normal 2 - Patient gaze in one direction only or preferably

 3. Visual field

 -  The test should be conducte in both left and right visual field simulatneously
 to evaluate both if hemianopsia and/or negelct are present. Both symptoms
 implieas a sever injury and thus 2 p are given

 -  Look the patient in the eyes and wave in both visual fields simultaneously.
 Ask the patient to point at the hand or hands waving.

 0 - normal 2 - Only distinguishes one hand

 4. Facial palsy Ask the patient to smile 0 - normal 1 - one side of the mouth is
 hanging

 5. Arm paresis Is tested in lying or sitting position, one arm at the time. Start with
 the strongest arm. Lift the arm 45 degrees and ask the patient to keep in the
 position for 10 s. Count audible. If the patient can't lift the arm, assist.

 If the inability to keep the arm elevated is due to pain - score 0 Right Left 0 -
 can maintain the arm in postition for 10 s 1 - The arm drifts down from the initial
 position within 10 s but does not rely on support 2 - Falls down to support within
 10 s or directly

 6. Leg paresis Test in lying or sitting position, one leg at the time. Start with the
 strongest leg. Lift the leg 30 degrees and ask the patient to keep in the position
 for 10 s. Count audible. If the patient can't lift the leg, assist.

 If the inability to keep the leg elevated is due to pain - score 0 Right Left 0 -
 can maintain the leg in position for 5 s 1 - The leg drifts down from the initial
 position within 5 s but does not rely on support 2 - Falls down to support within 5
 s or directly

 7. Sensory (pain)

 -  Evaluation of eventual loss of sensory function. It is important that pain is
 tested as not to miss a serious and not too uncommon type of stroke localized
 in the brain stem (Wallenberg´s syndrome).

 -  Pinch the bend of the arms and legs, respectively. The stimuli shall be done
 simultaneously at the left and right side. Ask the patient if he/she can feel
 the stimuli in the same way on both sides. If the patient only registers
 stimuli on one side, 2 p are given.

 0 - normal

 1 - registers stimuli on both sides but less on one side 2 - Only registers
 the stimuli on one side

 8. Language • Evaluate if the patient has an understandable speech as stroke can cause
 both slurred speech (dysarthria) and affected ability to find words (aphasia). This
 test does not distinguish between dysarthria or dysphasia . Patient who does not
 speak at all (is mute) is given 2 p.

 -  Ability to talk is noted during the examination. If uncertain, ask the patient
 to repeat: "the weather is pretty today" 0 - Normal 1 -Slight or moderate
 dysartria or aphasia. Communication possible. 2 - Severe dysarthria or
 aphasia. Communication basically not possible.
Inclusion Criteria:

 -  Suspected stroke

 Exclusion Criteria:

 -  Unconscious