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they'll administer the scale items in their exact order avoid coaching the patient even though this may be counter to usual clinical practice of trying to elicit the best performance accept the patient's first effort score only what the patient does not what you think they can do during the course of testing you may develop an impression of level of function or lesion those impressions must not influence your scoring again score only observed performance sometimes these rules don't make sense but if all examiner's do the scale the same way the scores will be consistent be sure to include all deficits in your scoring including those deficits that may result from previous strokes not all decisions are simple when you're having trouble deciding on a score try ruling out the extreme score and then weigh the mid scale scores you should keep the stroke scale reference materials such as the scoring guide nearby when you administer and score the NIH Stroke Scale however at the bedside in a cri

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