View source for Medicine:Los Angeles Prehospital Stroke Screen (LAPSS)

{{Infobox diagnostic
| name            = Los Angeles Prehospital Stroke Screen (LAPSS)
| image           = 
| alt             = 
| caption         = 
| pronounce       =  
| purpose         = identifying potential stroke patients
| test of         =
| based on        =
| synonyms        = LAPSS
| reference_range =
| calculator      = 
| DiseasesDB      = <!--{{DiseasesDB2|numeric_id}}-->
| ICD10           = <!--{{ICD10|Group|Major|minor|LinkGroup|LinkMajor}} or {{ICD10PCS|code|char1/char2/char3/char4}}-->
| ICD9            = 
| ICDO            =
| MedlinePlus     = <!--article_number-->
| eMedicine       = <!--article_number-->
| MeshID          = 
| OPS301          = <!--{{OPS301|code}}-->
| LOINC           = <!--{{LOINC|code}}-->
}}
The '''Los Angeles Prehospital Stroke Screen''' (LAPSS) is a method of identifying potential [[Medicine:Stroke|stroke]] patients in a pre-hospital setting.<ref>[http://stroke.ahajournals.org/content/34/1/71.full American Heart Association - Stroke]</ref>

==Screening criteria==

* No history of seizures or epilepsy
*Age 40 years or older
*At baseline, patient is not wheelchair bound or bedridden
*Blood glucose between 60 and 400 mg/dL
*Obvious asymmetry-unilateral weakness with any of the following motor exams: 
*#Facial Smile/Grimace
*#Grip
*#Arm Strength

If '''all''' of the above 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.<ref>[http://file.lacounty.gov/SDSInter/dhs/1040516_1232StrokeCVATIA.pdf Department of Health Services, County of Los Angeles - Treatment Protocol] </ref>

==Validity==
A January 2000 study, conducted by 3 teams of {{wipe|Los Angeles}}-based [[Medicine:Paramedic|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%)."<ref>{{cite journal | title=Identifying stroke in the field. Prospective validation of the Los Angeles prehospital stroke screen (LAPSS). | date=31 Jan 2000 | pmid=10625718 | volume=31 | issue=1 | journal=Stroke | pages=71–6 | last1 = Kidwell | first1 = CS | last2 = Starkman | first2 = S | last3 = Eckstein | first3 = M | last4 = Weems | first4 = K | last5 = Saver | first5 = JL | doi=10.1161/01.str.31.1.71| doi-access = free }}</ref>

In a Chinese study, [[Place:Beijing|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%.<ref>{{cite journal | title=Validation of the Los Angeles pre-hospital stroke screen (LAPSS) in a Chinese urban emergency medical service population. | date=2013-08-07 | pmid=23950994 | doi=10.1371/journal.pone.0070742 | volume=8 | issue=8 | pmc=3737357 | journal=PLOS ONE | pages=e70742 | last1 = Chen | first1 = S | last2 = Sun | first2 = H | last3 = Lei | first3 = Y | last4 = Gao | first4 = D | last5 = Wang | first5 = Y | last6 = Wang | first6 = Y | last7 = Zhou | first7 = Y | last8 = Wang | first8 = A | last9 = Wang | first9 = W | last10 = Zhao | first10 = X| bibcode=2013PLoSO...870742C }}</ref>

==See also==
* [[Medicine:FAST (stroke)|FAST (stroke)]]
* [[Medicine:Cincinnati Prehospital Stroke Scale|Cincinnati Prehospital Stroke Scale]]

==References==
{{reflist}}

[[Category:Stroke]]

{{Sourceattribution|Los Angeles Prehospital Stroke Screen (LAPSS)|1}}