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The different grades of the Risser sign give a measure of bone maturity and thus of the skeletal growth to be expected. In Europe, a scale ranging from Risser 0 to Risser 5 defines the grades from beginning ossification to complete fusion of the apophysis to the iliac bone. In the USA, 4 grades are defined.
The NIH scale is, however, the standard that stroke scales developed for EMS are compared to for sensitivity and specificity. 4. Cincinnati Prehospital Stroke Scale. The Cincinnati Prehospital Stroke Scale (CPSS) takes the least amount of time to perform and is one of the most widely used in EMS. The CPSS or, as it is sometimes referred to, Cincinnati scale assesses for: Facial droop Ask the patient to smile and show their teeth. A droop to one side is a positive finding.