This app is intended to help students learn the RACE (or R.A.C.E.) scale.
It is provided for general informational purposes only. Please read my full disclaimer and privacy policy.
The RACE (Rapid Arterial oCclusion Evaluation) scale is a prehospital stroke scale to predict the presence of large vessel occlusion (LVO) in patients with a presumed stroke and to direct interventions. It is based on the National Institutes of Health Stroke Scale.
The RACE scale is not typically in BLS protocols but is addressed on this site in case the situation changes, in case one needs to know it for a higher medical position, or in case one wants to learn it for amusement or for personal enrichment.
The criteria (with brief instructions) are:
| Facial Palsy (Paralysis):
Ask the patient to smile or to show his/her teeth. |
|
| Result | Score |
| Symmetrical Movement | 0: |
| Slightly Asymmetrical Movement | 1: |
| Completely Asymmetrical Movement | 2: |
| Arm Motor Function:
Ask the patient to raise his/her arms 45 degrees if the patient is in supine position or 90 degrees if sitting. |
|
| Result | Score |
| Upheld > 10 Seconds | 0: |
| Upheld < 10 Seconds | 1: |
| Unable to Raise | 2: |
| Leg Motor Function:
Ask the patient to raise each leg 30 degrees with the patient in supine position. |
|
| Result | Score |
| Upheld > 5 Seconds | 0: |
| Upheld < 5 Seconds | 1: |
| Unable to Raise | 2: |
| Head and Gaze Deviation:
Observe for eyes and head deviation to one side. |
|
| Result | Score |
| Eye movements to both sides were possible and no head deviation was observed (no deviation) | 0: |
| Eyes and head deviation to one side was observed (deviation) | 1: |
| Aphasia (if right hemiparesis):
Ask the patient (1) “Close your eyes?” and (2) “Make a fist?" |
|
| Result | Score |
| Performs both tasks correctly | 0: |
| Performs only one task correctly | 1: |
| Performs neither task correctly | 2: |
| Agnosia (if left hemiparesis):
Ask the patient: (1) “Whose arm is this?” (while showing the affected arm) and (2) “Can you move your arm?” |
|
| Result | Score |
| Recognizes arm and attempts to move arm (recognizes and moves) | 0: |
| Does not recognizes arm or attempts to move arm (recognizes or moves) | 1: |
| Does not recognize arm and is unaware of arm (neither recognizes nor moves) | 2: |
The RACE scale (based on a left or right side evaluation and not both simultaneously) has a total score of 0-9 points. According to racescale.org, A total score ≥ 5 indicates the possibility of a large vessel occlusion with a sensitivity of 85% and specificity of 69%. According to the American Stroke Association, a total score >5 points is associated with detection of a LVO.
For more information please see Instructions to Evaluate the RACE Scale and Assessing Stroke - Scores & Scales as well as the mother sites these files are found on.
In order to permit this app to function on a small screen some of the criteria have been abbreviated.
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