Cerebral Vascular Accident (CVA)/Stroke Recognition

A CVA occurs when there is a blockage or rupture of an artery in the brain. Most strokes originate from an occlusion and are painless. However, some are accompanied with a headache. Patients complaining of severe headaches should be screened for a CVA and the provider should maintain a high index of suspicion for hemorrhagic stroke. Symptom resolution within 24 hours indicates a possible transient ischemic attack (TIA) and is predictive of a CVA in the future. Complete the Portland Prehospital Stroke Screen (PPSS). If positive, proceed to C-STAT and transport as indicated.


Image source: Multnomah County EMS Protocols. Used with permission.
CVA Recognition Skill Verification Table

Stroke assessment



3 (instructor)



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Oregon EMS Psychomotor Skills Lab Manual Copyright © 2023 by Chris Hamper, BS, NRP; Carmen Curtz, Paramedic, BS; Holly A. Edwins, Paramedic, B.S.; and Jamie Kennel, PhD, MAS, NRP is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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