MIAMI EMERGENCY NEUROLOGIC DEFICIT (MEND) PREHOSPITAL CHECKLIST

Date: Name: Age: Sex:

BASIC DATA EXAMINATION

WITNESS NAME: ★ WITNESS PHONE: ★ BP: L ______ / ______ R ______ / ______ Pulse: Rate & Rhythm: ______ Resp ______

Dispatch time: EMS arrival time: MEND EXAM

Departure to ED time: ED arrival time: On scene: Perform LOC & basic exam (Cincinnati Prehospital Stroke Scale

HISTORY in shaded boxes) En route: If time allows, perform the complete MEND exam.
LAST TIME PATIENT WITHOUT SYMPTOMS ★ DATE: _________ TIME _________
MENTAL STATUS CHECK IF ABNORMAL

YES NO T-PA EXCLUSIONS ADDITIONAL HISTORY

ON SCENE EN ROUTE

  Head trauma at onset ★ Symptoms __________________  Level of Consciousness (AVPU) ★  

  Seizure (shaking or staring) at onset ★
  Taking warfarin (Coumadin)
  History of bleeding problems
Allergies ___________________  Speech “You can’t teach an old dog new tricks.” ★  
Abnormal = wrong words, slurred speech, no speech
Medications _________________  Questions (age, month) 
Past History _________________  Commands (close, open eyes) 

  Possible brain hemorrhage Last Meal ___________________ CRANIAL NERVES R L R L

(severe headache, stiff neck, ↓LOC) Events Prior _________________  Facial Droop (show teeth or smile)    
Abnormal — one side does not move as well as other
MANAGEMENT
 Visual Fields (four quadrants) ★  

 Do NOT treat hypertension  Horizontal Gaze (side to side)  

 Do NOT allow aspiration → Keep NPO, head up, O2 2-4 L LIMBS R L R L

 Do NOT give glucose (unless glucose <50) → IV NS; check fingerstick: ________  Motor — Arm Drift (close eyes and hold out both arms) ★    
Abnormal — arm can’t move or drifts down
 ECG rhythm ________________________ → If AMI, 12-lead time: ____________
 Leg Drift (open eyes and lift each leg separately) ★  
STROKE-SPECIFIC ED REPORT (see starred items on checklist)  Sensory — Arm and Leg (close eyes and touch, pinch)  
 Coordination — Arm and Leg (finger to nose, heel to shin)  
SYMPTOM ONSET NEUROLOGIC EXAM WITNESS
★ TIME (last time w/o sxs) ★ Level of consciousness ★ Name
★ Trauma (history) ★ Speech/language ★ Contact info
★ Seizure (staring, ★ Visual fields
shaking) ★ Moto strength

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