Organization and Integration of Components (Continued) COR LOE New, Revised, or Unchanged Powers et al 2019 Guidelines for Management of AIS e355 2. Emergency Evaluation and Treatment 2.1. Stroke Scales 2.1. Stroke Scales COR LOE New, Revised, or Unchanged The use of a stroke severity rating scale, preferably the NIHSS, is recommended. I B-NR Recommendation reworded for clarity from 2013 AIS Guidelines. COR unchanged. LOE amended to conform with ACC/AHA 2015 Recommendation Classification System. See Table XCV in online Data Supplement 1 for original wording. Formal stroke scores or scales such as the NIHSS (Table 4) may be performed rapidly, have demonstrated utility, and may be administered by a broad spectrum of healthcare providers with accuracy and reliability.75,76 Use of a standardized scale quantifies the degree of neurological deficit, facilitates communication, helps identify patients for fibrinolytic or mechanical intervention, allows objective measurement of changing clinical status, and identifies those at higher risk for complications such as intracerebral hemorrhage (ICH).71 73,77 See Table XV in online Data Supplement 1. Table 4. National Institutes of Health Stroke Scale Tested Item Title Responses and Scores 1A Level of consciousness 0 Answers both correctly 2 Answers neither correctly 1C Response to 0 Performs both tasks correctly movements 1 Partial gaze palsy 2 Complete gaze palsy 3 Visual fields 0 No visual field defect 1 Minor facial weakness 2 Partial facial weakness 3 Complete unilateral palsy 5 Motor function (arm) a. Left 1 Drift before 10 s b. Right 2 Falls before 10 s 3 No effort against gravity 6 Motor function (leg) 0 No drift a. Left 1 Drift before 5 s b. 