[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-572223-105":53,"doc-detail-572223-en":120},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":113,"head_meta":115,"extra_data":117,"updated_unix":119},105,"en","le-rn-st-r-ok-e-syst-em-of-c-ar-e-stroke-care-hub-and-spoke-model-and-nih-stroke-scale","LE RN St r ok e Syst em of C ar e - stroke care “hub and spoke” model and NIH Stroke Scale","","Louisiana’s statewide stroke care system is guided by an evidence-based “hub and spoke” model to improve widespread access to lifesaving treatment, including tPA for occlusive stroke within the first few hours. The framework connects Comprehensive Stroke Center and Primary Stroke Center hubs with spoke hospitals using telemedicine. It also defines the LERN Communication Center role in directing trauma, stroke, and STEMI patients to appropriate hospitals, and includes instructions for administering the NIH Stroke Scale items covering level of consciousness and key neurologic functions.",{"@graph":63,"@context":112},[64,80,95],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/le-rn-st-r-ok-e-syst-em-of-c-ar-e-stroke-care-hub-and-spoke-model-and-nih-stroke-scale/572223/",4,{"url":78,"name":59,"@type":81,"author":82,"headline":59,"publisher":85,"fileFormat":88,"inLanguage":57,"description":61,"dateModified":89,"datePublished":89,"encodingFormat":88,"isAccessibleForFree":90,"interactionStatistic":91},"DigitalDocument",{"name":83,"@type":84},"supergirl","Person",{"url":68,"name":86,"@type":87},"DocShare","Organization","application/pdf","2026-10-13",true,{"@type":92,"interactionType":93,"userInteractionCount":4},"InteractionCounter",{"@type":94},"ViewAction",{"@type":96,"mainEntity":97},"FAQPage",[98,104,108],{"name":99,"@type":100,"acceptedAnswer":101},"What model guides Louisiana’s statewide stroke care system?","Question",{"text":102,"@type":103},"The system is guided by an evidence-based “hub and spoke” model that supports broad access to lifesaving stroke care and treatment.","Answer",{"name":105,"@type":100,"acceptedAnswer":106},"How does the LERN Communication Center help stroke patients?",{"text":107,"@type":103},"The LERN Communication Center serves as a resource to direct stroke patients to appropriate hospitals within the statewide systems of care.",{"name":109,"@type":100,"acceptedAnswer":110},"What does the NIH Stroke Scale section on level of consciousness assess?",{"text":111,"@type":103},"It evaluates the patient’s alertness level and includes LOC questions (month and age) and LOC commands (open/close eyes, grip/release hand) with scoring rules.","https://schema.org",{"og:url":78,"og:type":114,"og:title":59,"og:site_name":86,"og:description":61},"article",{"robots":116,"canonical":78},"index,follow",{"doc_id":118,"site_id":56},572223,1791926233,{"code":4,"msg":5,"data":121},{"doc_id":118,"user_id":122,"nickname":83,"user_avatar":123,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":124,"file_id":125,"file_url":126,"file_type":127,"file_size":128,"view_count":4,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":129,"language":130,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":131,"faqs":132,"seo_title":133,"seo_description":61,"update_tm":119,"read_time":134},962088121634,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","v.20140811  \nLE RN St r ok e Syst em of C ar e  \nLERN’s ongoing development of Louisiana’s statewide stroke care system is guided by the evidence-based “hub and spoke” model that facilitates widespread patient access to lifesaving care and treatment with tissue plasminogen activator (tPA), the only FDA approved intervention for treatment of an occlusive stroke within the first few hours.  \nLouisiana’s “hub and spoke” model includes Comprehensive Stroke Center and Primary Stroke Center hubs, and spoke hospitals connected by telemedicine.  \nMore information about the LERN Stroke System of Care can be found online at  \n[www.lern.la.gov](www.lern.la.gov)  \nLERN Communication Center – 1-866-320-8293  \nThe LERN Communications Center (LCC) is a key component of our statewide systems of care for trauma, stroke and STEMI. The LCC serves as a resource for directing stroke patients to appropriate hospitals.  \nN IH ST ROKE SCALE ( N IH SS)  \n1a. Level of Consciousness (LOC)  \n0 = Alert, keenly responsive  \n1 = Not alert; but arousable by minor stimulation  \n2 = Not alert; requires repeated stimulation, or is obtunded and needs strong/painful stimuli to make movements  \n3 = Responds only with reflex motor or autonomic effects or totally unresponsive, flaccid, and areflexic Examiner must choose a response if full evaluation is prevented by such obstacles as ET tube, language barrier, oral trauma/bandages etc. A3 is only scored only if the patient makes no movement (other than reflexive posturing) in response to noxious stimuli.  \n1b. LOC Questions – “What month is it?” and “How old are you?”  \n0 = Answers both questions correctly  \n1 = Answers one question correctly  \n2 = Answers neither question correctly  \nScore only initial answer (no credit for being close) . Patients unable to speak due to intubation, oral trauma, severe dysarthria, language barrier, etc. are scored 1. Aphasic and stuporous patients, score 2.  \n1c. LOC Commands – “Open and close your eyes”, and “Grip and release your hand”  \n0 = Performs both tasks correctly  \n1 = Performs one task correctly  \n2 = Performs neither task correctly  \nSubstitute another one-step command if hands cannot be used. Credit given if attempt made but  \nunable to complete due to weakness. If patient does not respond to command, task should be  \ndemonstrated and result scored. Only first attempt scored.  \nNI H SS ( c ont i nued )  \n2. Best Gaze (only horizontal movement tested)  \nEstablish contact and ask patient “follow my finger”  \n0 = Normal  \n1 = Partial gaze palsy  \n2 = Forced deviation or total gaze paresis  \nAppropriate for aphasic patients. Forced deviation or total gaze paresis is not overcome by oculocephalic maneuver. Score voluntary or reflexive, horizontal movements (not caloric test) . Test patients with ocular trauma, bandages, blindness, etc., for reflexive movement. Patients with conjugate deviation of the eyes (overcome by voluntary or reflexive activity) and those with peripheral nerve paresis (oculomotor valve CN III, IV, VI) are scored 1.  \n3. Visual Fields – Use confrontation, finger counting, or visual threat. Confront upper/lower quadrants of visual field  \n0 = No visual loss  \n1 = Partial hemianopia  \n2 = Complete hemianopia  \n3 = Bilateral hemianopia  \nTest patients with unilateral blindness or enucleation in remaining eye. Patients with clear-cut  \nasymmetry, including quadrantanopia, are scored 1. Blind patients are scored 3. Test again using  \ndouble simultaneous stimulation. Score 1 for extinction and record under item \\#13 .  \nNI H SS ( c ont i nued )  \n4. Facial Palsy  \nBy words or pantomime, encourage the patient to “Show me your teeth.” “Raise your eyebrows.” “Close your eyes.”  \n0 = Normal symmetrical movements  \n1 = Minor paralysis (flattened nasolabial fold, asymmetry on smile)  \n2 = Partial paralysis (lower face)  \n3 = Complete paralysis  \nRemove bandages, tape, tubes before testing if possible. In poorly responsive patients, some symmetry of grimace to noxious","cbCairwIssDjbwI1","https://ap.wps.com/l/cbCairwIssDjbwI1","pdf",436761,22,"English","# LERN Stroke System of Care\n## Hub and spoke model\n## LERN Communication Center\n## NIH Stroke Scale (NIHSS)\n## 1a. Level of Consciousness (LOC)\n## 1b. LOC Questions\n## 1c. LOC Commands\n## 2. Best Gaze\n## 3. Visual Fields\n## 4. Facial Palsy\n## 5 & 6. Motor Arm\n## 7 & 8. Motor Leg\n## 9. Limb Ataxia\n## 10. Sensory\n## 11. Best Language","[{\"question\":\"What model guides Louisiana’s statewide stroke care system?\",\"answer\":\"The system is guided by an evidence-based “hub and spoke” model that supports broad access to lifesaving stroke care and treatment.\"},{\"question\":\"How does the LERN Communication Center help stroke patients?\",\"answer\":\"The LERN Communication Center serves as a resource to direct stroke patients to appropriate hospitals within the statewide systems of care.\"},{\"question\":\"What does the NIH Stroke Scale section on level of consciousness assess?\",\"answer\":\"It evaluates the patient’s alertness level and includes LOC questions (month and age) and LOC commands (open/close eyes, grip/release hand) with scoring rules.\"}]","LE RN St r ok e Syst em of C ar e - stroke care “hub and spoke” model and NIH Stroke Scale | PDF",8]