The ambulance arrived in A&E with Angela at 8.10am (30 minutes from onset). Her partner drove to the hospital to be with her. On examination Angela had no speech defects and was found to have a right sided facial and upper and lower limb weakness and right homonymous hemianopia. This would be detected by using the NIHSS scale. In some hospitals the Rosier score is used to determine how likely a diagnosis of stroke is.
Introducing the ROSIER scale
Duration: 1 min 05 sec
Using the ROSIER scale
Duration: 3 mins 00 sec
Here is Angela’s Rosier score
The A&E team now contact the stroke team to notify them of Angela’s admission.
ROSIER Scale: Stroke Assessment
The aim of this assessment tool is to enable medical and nursing staff to differentiate patients with stroke and stroke mimics. A score of +1 means that stroke is likely.
Assessment Date: 23/09/09 Time 08:10
Symptom Onset: Date: 23/09/09 Time 07:40
GCS E=4 M=6 V=5 BP: 160/90 *BM: 4.5
*If BM < 3.5 mmol/l treat urgently and reassess once blood glucose normal
Has there been loss of consciousness or syncope? Y (-1) | N (0)
Has there been seizure activity? Y (-1) | N (0)
Is there a NEW ACUTE onset (or on awakening from sleep)?
I. Asymmetric facial weakness Y (+1) | N (0)
II. Asymmetric arm weakness Y (+1) | N (0)
III. Asymmetric leg weakness Y (+1) | N (0)
IV. Speech disturbance Y (+1) | N (0)
V. Visual field defect Y (+1) | N (0)
*Total Score (-2 to +5)
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Q. What is Angela’s likely diagnosis – stroke / non-stroke? Select your answer from the options below.
Stroke – Correct
Non-stroke – Wrong
Angela has a ROSIER score of +4, making it likely that she has had a stroke.
