Table 1 The PreHospital Ambulance Stroke Test

1. Commands

 Only verbal instruction: Close your eyes! Grip your hand! (non-paretic side)

0 - Both correct

2 – One or none correct

2. Eye position

 Observe if the patient “gaze” at one side without purpose

0 - Normal

2 - The patient”gaze” preferably or only at one side

3. Visual field

 Look the patient straight in the eyes and wave on either side simultaneously. Ask the patient to point at the hand or hands waving.

0 - Normal

2 – Apprehends only waving on one side

4. Facial palsy

 Ask the patient to smile

0 – Normal

1 – One corner of the mouth hanging

5. Arm paresis

 Laying or sitting position. One arm at a time. Start with the best arm.  Lift arm 45° and ask to hold 10 s. Count down verbally.  Assist if doesn’t manage to lift herself.

 If inability to hold is caused by pain score 0.

0 – Holds for 10 s

Right

Left

Score

Score

1 – Drifts but does not reach bed in 10 s

2 – Drifts and reach bed in 10 s or falls immediately

6. Leg paresis

 Laying or sitting position. One leg at a time. Start with the best leg. Lift leg 30° and ask to hold 5 s. Count down verbally. Assist if doesn’t manage to lift herself.

 If inability to hold is caused by pain score 0.

0 – Holds for 5 s

Right

Left

Score

Score

1 – Drifts but does not reach bed in 5 s

2 - Drifts and reach bed in 5 s or falls immediately

7. Sensory (pain)

 Pinch the bend of the arms and legs, respectively. Pinch simultaneously at left and right side. Ask if she can feel the pinch in the same way on both sides.

0 - Normal

1 – Apprehends less or different on one side

2 – Apprehends only on one side

8. Speech and language

 Note in the course of conversation. If uncertain, ask patient to repeat a simple sentence, such as “the weather is pretty today”. Score 2, if mute.

0 - Normal

1 –Slight or moderate dysarthria or aphasia. Communication possible.

2 – Severe dysartria or aphasia. Communication not intelligible.

PreHAST score

Sum up total score

(0–19 points)