NIHSS Certification
Study online at https://quizlet.com/_cos23a
1. 11 components 1. LOC (Question & Command)
of NIHSS 2. Gaze
3. Visual field
4. Facial palsy
5. Upper extremity
6. Lower extremity
7. Limb ataxia
8. Sensory
9. Best language
10. Dysarthria
11. Extinction & inattention
2. 1A - LOC 0 = Alert
1 = Not alert; aroused with minor verbal stimulation
2 = Not alert; requires strong or painful stimulation
3 = Reflex movements only or totally unresponsive (COMA ~ try rub on chest)
---
1a. Level of Consciousness: The investigator must choose a response, even if a
full evaluation is prevented by such obstacles as an endotracheal tube, language
barrier, orotracheal trauma/bandages. A 3 is scored only if the patient makes no
movement (other than reflexive posturing) in response to noxious stimulation.*
3. 1B - LOC Ques- Month of year
tions (2) Patient age
-----
0 = Answers both questions correctly
1 = Answers one question correctly
2 = Answers neither question correctly
, NIHSS Certification
Study online at https://quizlet.com/_cos23a
---
1b. LOC Questions: The patient is asked the month and his/her age. The answer
must be correct - there is no partial credit for being close. Aphasic and stuporous
patients who do not comprehend the questions will score 2. Patients unable to
speak because of endotracheal intubation, orotracheal trauma, severe dysarthria
from any cause, language barrier or any other problem not secondary to aphasia
are given a 1. It is important that only the initial answer be graded and that the
examiner not "help" the patient with verbal or non-verbal cues.*
4. 1C - LOC Com- Two tasks
mands - Close your eye for me and now open
- Make a fist with your hand
--------
LEVEL OF CONSCIOUSNESS: COMMANDS
0 = Performs both tasks correctly
1 = Performs one task correctly
2 = Performs neither task correctly
--
1c. LOC Commands: The patient is asked to open and close the eyes and then to
grip and release the non-paretic hand. Substitute another one step command if
the hands cannot be used. Credit is given if an unequivocal attempt is made but
not completed due to weakness. If the patient does not respond to command,
the task should be demonstrated to them (pantomime) and score the result (i.e.,
follows none, one or two commands). Patients with trauma, amputation, or other
physical impediments should be given suitable one-step commands. Only the first
attempt is scored.*
5. Oculocephalic "Doll eyes" in comatose patient
Maneuver Used to determine whether vestibule-ocular reflex pathway from medulla to the
midbrain is intact
Study online at https://quizlet.com/_cos23a
1. 11 components 1. LOC (Question & Command)
of NIHSS 2. Gaze
3. Visual field
4. Facial palsy
5. Upper extremity
6. Lower extremity
7. Limb ataxia
8. Sensory
9. Best language
10. Dysarthria
11. Extinction & inattention
2. 1A - LOC 0 = Alert
1 = Not alert; aroused with minor verbal stimulation
2 = Not alert; requires strong or painful stimulation
3 = Reflex movements only or totally unresponsive (COMA ~ try rub on chest)
---
1a. Level of Consciousness: The investigator must choose a response, even if a
full evaluation is prevented by such obstacles as an endotracheal tube, language
barrier, orotracheal trauma/bandages. A 3 is scored only if the patient makes no
movement (other than reflexive posturing) in response to noxious stimulation.*
3. 1B - LOC Ques- Month of year
tions (2) Patient age
-----
0 = Answers both questions correctly
1 = Answers one question correctly
2 = Answers neither question correctly
, NIHSS Certification
Study online at https://quizlet.com/_cos23a
---
1b. LOC Questions: The patient is asked the month and his/her age. The answer
must be correct - there is no partial credit for being close. Aphasic and stuporous
patients who do not comprehend the questions will score 2. Patients unable to
speak because of endotracheal intubation, orotracheal trauma, severe dysarthria
from any cause, language barrier or any other problem not secondary to aphasia
are given a 1. It is important that only the initial answer be graded and that the
examiner not "help" the patient with verbal or non-verbal cues.*
4. 1C - LOC Com- Two tasks
mands - Close your eye for me and now open
- Make a fist with your hand
--------
LEVEL OF CONSCIOUSNESS: COMMANDS
0 = Performs both tasks correctly
1 = Performs one task correctly
2 = Performs neither task correctly
--
1c. LOC Commands: The patient is asked to open and close the eyes and then to
grip and release the non-paretic hand. Substitute another one step command if
the hands cannot be used. Credit is given if an unequivocal attempt is made but
not completed due to weakness. If the patient does not respond to command,
the task should be demonstrated to them (pantomime) and score the result (i.e.,
follows none, one or two commands). Patients with trauma, amputation, or other
physical impediments should be given suitable one-step commands. Only the first
attempt is scored.*
5. Oculocephalic "Doll eyes" in comatose patient
Maneuver Used to determine whether vestibule-ocular reflex pathway from medulla to the
midbrain is intact
