🧠 ROSIER Scale (Stroke Recognition)
Differentiate stroke from mimics in the emergency department with the ROSIER scale.
ROSIER Scale (Stroke Recognition)
Loss of consciousness/syncope
Seizure activity
Asymmetric facial weakness
Asymmetric arm weakness
Asymmetric leg weakness
Speech disturbance
Visual field defect
When to use
Rapidly recognise acute stroke at first contact.
How it works
Add face/arm/leg weakness, speech disturbance, visual field defect (+1 each); subtract for loss of consciousness/syncope and seizure (−1 each). Score > 0 makes stroke likely.
Key points
- Score > 0 — stroke is likely; activate the pathway.
- ≤ 0 does not fully exclude stroke — clinical judgement applies.
- Designed for ED use by non-specialists.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.