CPSS (Cincinnati Prehospital Stroke Scale)
Cincinnati Prehospital Stroke Scale (Kothari 1999): facial droop, arm drift, and abnormal speech each 0 (normal) or 1 (abnormal); any single abnormal item is a positive screen.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Facial droop
- 1
- Arm drift
- 1
- Abnormal speech
- 0
Result: CPSS: positive screen (2 of 3 abnormal). Stroke is possible; activate the stroke pathway per Kothari 1999.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- 0/3 abnormal
- Negative screen. Stroke is less likely on these three items; continue clinical judgment.
- >=1/3 abnormal
- Positive screen. Activate the stroke pathway per local protocol; CPSS is sensitive but not specific.
What you enter
- Facial droop (0 normal / 1 abnormal)
- Arm drift (0 normal / 1 abnormal)
- Abnormal speech (0 normal / 1 abnormal)
What this is
Apply the Cincinnati Prehospital Stroke Scale - a three-item bedside screen for acute stroke: facial droop (asymmetry when the patient smiles), arm drift (one arm drifts down when both arms are held out for 10 seconds), and abnormal speech (slurred, wrong words, or unable to speak). Any single abnormal finding is a positive screen. Sophie Well presents the three checks with the standard prompts and reports how many of the three are abnormal.
When to use it
Use this when a prehospital crew or first-responder encounters a patient with sudden neurologic symptoms and you need a fast, validated screen to trigger a stroke alert and the closest-appropriate-facility routing decision. Cincinnati is intentionally simple - three items, no scoring threshold beyond "any positive" - so it can be applied in under a minute by a single rescuer. For destination decisions that distinguish large-vessel occlusion from smaller strokes (and therefore comprehensive versus primary stroke center routing), pair it with a large-vessel screen such as RACE or LAMS.
How this is calculated
Kothari RU, Pancioli A, Liu T, Brott T, Broderick J. Cincinnati Prehospital Stroke Scale: reproducibility and validity. Ann Emerg Med. 1999;33(4):373-378. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.
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