Performing The Scale
Throughout the NIHSS it is important that the examiner does not coach or help with the assigned task. The examiner may demonstrate the commands to patients that are unable to comprehend verbal instructions, however the score should reflect the patient's own ability. It is acceptable for the examiner to physically help the patient get into position to begin the test, but the examiner must not provider further assistance while the patient is attempting to complete the task. For each item the examiner should score the patients first effort, and repeated attempts should not affect the patient's score. An exception to this rule exist in the language assessment (Item 9) in which the patients best effort should be scored. Some of the items contain "Default Coma Scores", these scores are automatically assigned to patients that scored a 3 in item 1a.
Read more about this topic: National Institutes Of Health Stroke Scale
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