- The Washington Times - Thursday, February 13, 2003

PHOENIX, Feb. 13 (UPI) — By asking three simple questions, most people can diagnose stroke and act quickly to get the victim to a hospital for treatment, researchers reported Thursday.

Even a child can make the right call by using the questions to assess one-sided weakness in the arms or face and slurring of speech, said Dr. Jane Brice, assistant professor of emergency medicine, North Carolina-Chapel Hill School of Medicine, Chapel Hill, N.C. Brice tested the accuracy of the bystander diagnosis with a study of volunteers and stroke survivors.

The bystanders were able to accurately diagnose 96 percent of speech deficits and 97 percent of one-side arm weakness. They were less accurate with diagnosing facial weakness — spotting it only 72 percent of the time — but Amy Hurwitz, a medical student who co-authored the study, said this was expected because it is more difficult for a stranger to "know if there is something unusual about a smile."

Brice and Hurwitz presented the results at the American Stroke Association 28th International Stroke Conference.

Brice explained that the test is based on a stroke diagnosis scale developed by the researchers at the University of Cincinnati, and is called the Cincinnati Pre-Hospital Stroke Scale.

In the study, Brice and her fellow researchers played the part of 911-dispatchers while 100 visitors to the UNC Medical Center were recruited as bystanders and stroke survivors played the part of stroke victims. The bystanders were asked to place a phone call to the dispatcher who then walked the bystander through the three-part test.

The bystander asks the victim to "show us your teeth," which is a smile test to detect facial weakness. The victims are also asked to close their eyes and raise their arms to detect one-sided arm weakness. And finally, the bystander asks the victim to repeat a simple sentence like "The sky is blue in Cincinnati." Slurred speech and one-sided facial or arm weakness are all classic signs of stroke, said Brice.

Edgar J. Kenton III, professor clinical neurology, Thomas Jefferson University, chief, cerebrovascular diseases, Wynnewood, Pa., said that this "public approach" to stroke diagnosis is likely to speed the time to treatment. Kenton, who wasn't involved in the study, explained that clot-busting drugs used to treat many strokes can only be given within the first three hours after stroke. Thus he and other stroke specialists are constantly seeking ways to speed treatment.

"This is so simple that even a child could use it. Look at how many children have saved their parents by doing CPR and this so much simpler," said Kenton. Although the study used a 911-dispatcher model, Kenton said he thinks the test should also be promoted for use by the general public.

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