Jill is just amazing! Come see her speak….

Jill Viggiano headshot

Business Men And Women of
PORTLAND BUSINESS LUNCHEON
Invite you to Downtown April 26 with

Jill Viggiano

 You are invited to join us for our Downtown PBL luncheon, on Wednesday, April 26th at the University Club in downtown Portland. Our guest speaker will be Jill Viggiano.
Jill Viggiano spent 19 years working in commercial real estate before retiring to become a full time mom. As an active volunteer, Jill couldn’t help but raise her hand and take on leadership roles in the community.
The opportunity to form and advance philanthropic organizations and their causes kept her engaged in both local and national efforts. Jill’s style is to create a team environment where cooperation and accomplishment happen while having fun.
When her husband survived a massive stroke in 2008, Jill focused her skills on his recovery. She now assists him in his day-to-day needs as well as in his speaking career.
Jill wrote Painful Blessing, a book about her spouse and caregiver experience shedding light on the real life impact of acquired brain injury, and providing hope and encouragement to those facing significant challenges.
Jill’s story will touch your soul and inspire you to press through any circumstance. The cost of lunch is $25.00. Register today and invite a friend.
LUNCHEON DETAILS
RSVP REQUIRED
UNIVERSITY CLUB
1225 SW 6th Ave. Portland, OR 97204
WEDNESDAY APRIL 26TH
11:45 AM- 1:15 P

 

NIH Stroke Scale

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The NIH Stroke Scale

Medical professionals and even the public have been trained to recognize basic signs of stroke. These include three features of stroke: slurred speech, drooping of one outstretched arm, and drooping of one side of the face when attempting to smile. When one of these signs is present it’s a fairly sensitive indicator of stroke. When all three are present, sensitivity for stroke is approximately 90%. However, when evaluating patients for inclusion in stroke protocols and prior to fibrinolytic stroke treatments, medical professionals use a slightly more sophisticated series of questions. They often use the NIH stroke scale.

The NIH offers training and certification in the administration and scoring of the stroke scale. An overview of the scale is listed below.

The stroke scale items should be presented in order and the score should be reported after each numbered category has been assessed. The score should be based on the patient’s actual performance and what is witnessed by the examiner. It should not be a reflection of what the examiner thinks the patient is able to do. Remember, the patient could be experiencing an acute stroke, so time is of the essence. The examiner should work quickly. On the other hand, the patient should not be coached or aided by anyone, including the examiner. If the patient cannot perform one of the items, indicate the corresponding score, and move onto the next item.

National Institutes of Health (NIH) Stroke Scale

1a. Level of consciousness 0 = Alert and responsive1 = Arousable to minor stimulation

2 = Arousable only to painful stimulation

3 = Unarousable or reflex responses

1b. Questions

Ask patient’s age and month. Must be exact.

0 = Both correct1 = One correct

2 = Neither correct

1c. Commands

Ask patient to open/close eyes, grip and release non-affected hand.

0 = Both correct1 = One correct

2 = Neither correct

2. Best gaze

Horizontal extraocular movements by voluntary or reflexive testing.

0 = Normal1 = Partial gaze palsy; abnormal gaze in one or both eyes

2 = Forced eye deviation or total paresis which cannot be overcome by oculocephalic maneuver

3. Visual fields

Test by confrontation or threat as appropriate. If monocular, score field of good eye.

0 = No visual loss1 = Partial hemianopia, quadrantanopia, extinction

2 = Complete hemianopia

3 = Bilateral hemianopia or blindness

4. Facial palsy

If stuporous, check symmetry of grimace to pain. Paralysis (lower face).

0 = Normal1 = Minor paralysis (normal looking face, asymmetric smile)

2 = Partial paralysis

3 = Complete paralysis (upper and lower face)

5a. Left motor arm

5b. Right motor arm

 

Arms outstretched 90° (if patient is sitting) or 45° (if supine) for 10 seconds. Encourage best effort, note paretic side.

0 = No drift1 = Drift but does not hit bed

2 = Some antigravity effort, but cannot sustain
3 = No antigravity effort, but minimal movement present

4 = No movement at all X = Unable to assess due to amputation, fusion, etc

6a. Left motor leg

6b. Right motor leg

 

Raise leg to 30° (always test patient supine) for 5 seconds.

7. Limb ataxia

Check finger-nose-finger; heel-shin; score only if out of proportion to weakness.

0 = No ataxia (or aphasic, hemiplegic)1 = Ataxia present in one limb

2 = Ataxia present in two limbs X = Unable to assess as above

8. Sensory

Use safety pin. Check grimace or withdrawal if stuporous. Score only stroke related losses.

0 = Normal1 = Mild to moderate unilateral sensory loss but patient aware of touch

2 = Severe to total sensory loss, patient unaware of touch (or bilateral sensory loss or comatose)

9. Best language

Ask patient to describe cookie jar picture, name objects, read sentences. May use repeating, writing, stereognosis.

0 = Normal1 = Mild-moderate aphasia

2 = Severe aphasia (almost no information exchanged)
3 = Mute, global aphasia, or coma

10. Dysarthria

Ask patient to read or repeat a list of words.

0 = Normal1 = Mild-moderate dysarthria

2 = Severe, unintelligible or mute

X = Intubation or mechanical barrier

11. Extinction and inattention

Simultaneously touch patient on both hands, show fingers in both visual fields, ask patient to describe deficit, left hand.

0 = Normal, none detected (or severe visual loss with normal cutaneous responses)1 = Neglects or extinguishes to bilateral simultaneous stimulation in any sensory modality (visual, tactile, auditory, spatial, or personal inattention)

2 = Profound hemi-inattention or extinction in more than one modality

Most people receive a score 0 after taking the NIH stroke scale. Scores as low as one to four could indicate a mild stroke. The highest possible score is 42 which would obviously be consistent with a profound stroke. The NIH stroke scale can be administered in less than 10 minutes in skilled hands. It provides excellent baseline for stroke treatment assessment and can be used for prognosis.

Images used with the NIH Stroke Scale:

stroke-img1

You know how.

Down to earth.

I got home from work.

Near the table in the dining room.

They heard him speak on the radio last night.

stroke-img2

For more information:  https://www.aclsmedicaltraining.com/