Richard Jackson, MD
Suzuki K, Nakajima N, Kunimoto K, Hatake S, Sakamoto Y, Hokama H, et al. Emergent Large Vessel Occlusion Screen Is an Ideal Prehospital Scale to Avoid Missing Endovascular Therapy in Acute Stroke. Stroke. 2018
Kentaro Suzuki et al. developed a new prehospital stroke scale called the Emergent Large Vessel Occlusion (ELVO) screen for use by paramedics to identify large vessel occlusions (LVO) for diversion of transport to the nearest thrombectomy-capable location.
In the introduction, they comment that transport of patients without LVO is “unwise, time consuming, and expensive” and, therefore, the need has arisen for better emergent stroke transportation systems. They base this on data that showed, in their words, unacceptable negative predictive values (NPV) and a possible 20% of missed LVO eligibility.
They comprised their scale based on cortical symptoms with simplicity in mind. The scale consists of paramedic observation of eye deviation, a question regarding naming of eye glasses or a watch, and a question about neglect regarding naming of the number of fingers being held up for visual confrontation. A positive result was an abnormality on any of the three items.