Cincinnati Stroke Scale in the Field: The 3-Test EMT Screen

The Cincinnati Prehospital Stroke Scale explained — facial droop, arm drift, speech — plus documentation and LVO screening tips.

October 26, 2026 · 5 min read

The Cincinnati Prehospital Stroke Scale is the fastest, most reliable field screen for stroke. Three checks, under a minute, one positive finding is enough to activate stroke alert.

The three items

  • Facial droop: 'show me your teeth' — asymmetry is positive.
  • Arm drift: eyes closed, both arms out for 10 seconds — one drifting down is positive.
  • Speech: repeat a set sentence — slurred, wrong words, or unable is positive.

What one positive finding means

Any single positive = 72% probability of stroke. Establish last-known-well time, notify the receiving hospital, and transport to a stroke center.

Add an LVO screen

Cincinnati misses about a third of large-vessel occlusions. Layer LAMS or RACE on top when your system supports thrombectomy-capable destinations.

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