Los Angeles Prehospital Stroke Screen (LAPSS)

The Los Angeles Prehospital Stroke Screen is a method of identifying potential stroke victims in a pre-hosptial setting. The system includes the Cincinnati Prehospital Stroke Scale in addition to age criteria, blood glucose criteria and several other factors.

Use
The screening criteria are as follows:

If LAPSS criteria for stoke met, call receiving hospital with "STROKE CODE", if not then return to the appropriate treatment protocol. (Note: The patient may still be experiencing a stroke even if LAPSS criteria are not met.

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%)."

In a Chinese study, Beijing paramedics using the protocol, completed LAPSS screenings in an average of 4.3 minutes. The study resulted in a sensitivity of 78.44% and a specificity of 9.22%. The average time of completing the LAPSS was 4.3±3.0 minutes (median, 5 minutes). The sensitivity and specificity of the LAPSS in this study was 78.44% and 90.22%.