Stroke assessment in Spanish — ED, neuro, and ICU nurses

Stroke assessment in Spanish: FAST, NIHSS, tPA consent, and thrombectomy — phrase by phrase.

Stroke is a time-is-brain emergency. The language barrier cannot cost you twenty minutes while a qualified interpreter joins the call. You need fast, accurate Spanish for FAST recognition, Cincinnati Stroke Scale, NIHSS screening, time-last-known-well, CT consent, tPA informed consent, and thrombectomy explanation — in the order you will use them, without a dictionary. This page is that reference.

Quick reference. Related pages: Spanish for ICU nurses · Spanish for ED nurses

FAST recognition in Spanish

FAST — Face, Arms, Speech, Time — is your four-item prehospital and initial bedside screen. Each item is a command or a question the patient or family can answer in seconds.

Cincinnati Stroke Scale in Spanish

The Cincinnati Stroke Scale has three items. One abnormal item = 72% stroke probability. All three abnormal = 85%. Score what the patient does on the first attempt only.

Facial droop

Arm drift

Abnormal speech

Time-last-known-well and symptom onset

This is the single most consequential question in the stroke assessment. A wrong answer about last-known-well can exclude an eligible patient from tPA or thrombectomy. Ask it of both the patient and every family member separately before accepting an answer.

NIHSS assessment questions in Spanish

The NIH Stroke Scale has eleven items. The questions below are ordered by NIHSS item number. Score only the first response — do not prompt, coach, or repeat the question.

Items 1a–1c: Level of consciousness, orientation, commands

Items 2–4: Gaze, visual fields, facial palsy

Items 5–6: Motor arm and leg

Items 7–9: Ataxia, sensory, aphasia

Items 10–11: Dysarthria and neglect

CT scan and emergency imaging explanation

tPA (alteplase) informed consent in Spanish

tPA consent must cover: what the drug is, what it can do, the bleeding risk, and the time constraint. Do not rush the explanation — a patient who does not understand what they are consenting to cannot give valid informed consent.

Thrombectomy (clot retrieval) explanation for large vessel occlusion

ICU admission and monitoring explanation

FAQs — stroke assessment in Spanish

How do I run FAST in Spanish at the bedside?

FAST maps to four commands and questions you can deliver in under thirty seconds. Face: "Sonríame, por favor — muéstreme los dientes." Watch for asymmetry. Arms: "Levante los dos brazos. Cierre los ojos y manténgalos arriba por diez segundos." Arm drift with eyes closed is the finding. Speech: "Repita esta frase: el cielo está despejado hoy." Listen for slurred words, wrong words, or silence. Time: "¿A qué hora exactamente notó que algo estaba mal?" and "¿Cuándo fue la última vez que lo vio bien, como de costumbre?" Last-known-well is the question that opens or closes the tPA window.

What are the Cincinnati Stroke Scale items in Spanish?

Three items: facial droop, arm drift, abnormal speech. Facial droop: "Sonríame o muéstreme los dientes." One side doesn't move = abnormal. Arm drift: "Cierre los ojos. Levante los dos brazos al frente como si sosteniera una bandeja. Manténgalos así por diez segundos." One arm drifts or pronates = abnormal. Abnormal speech: "Repita esta frase: no hay excusas válidas hoy." Any dysarthria or paraphasia = abnormal. One of three abnormal = 72% stroke probability. All three = 85%.

How do I ask NIHSS orientation questions in Spanish?

Score the first answer only — do not prompt. Month: "¿En qué mes estamos?" Age: "¿Cuántos años tiene usted?" Both must be correct for a score of zero on item 1b. Commands (item 1c): "Abra y cierre los ojos" and "Cierre la mano y ábrala." Gaze (item 2): "Sígame con los ojos solamente, sin mover la cabeza." Limb ataxia (item 7): "Tóquese la nariz con el dedo y luego tóqueme el dedo a mí — varias veces, rápido." Sensory (item 8): "Le voy a tocar con un alfiler. Dígame si lo siente igual en los dos lados." Neglect (item 11): "Le voy a tocar los dos brazos al mismo tiempo. ¿Cuál siente primero?"

How do I explain tPA and bleeding risk in Spanish?

Three moves: what it is, what it does, what can go wrong. What it is: "Este medicamento se llama activador del plasminógeno — tPA. Es el único medicamento que puede disolver el coágulo que está bloqueando el cerebro ahora mismo." What it does: "Si funciona, usted puede recuperar fuerza, habla, o visión que perdió esta mañana. Necesitamos dárselo en la próxima hora." What can go wrong: "El riesgo más serio es sangrado dentro del cerebro — en unos seis de cada cien personas. Sin el medicamento, el riesgo de quedarse con la debilidad permanente es mucho más alto." Consent close: "¿Me da su permiso para ponerle este medicamento por la vena ahora mismo?"

How do I explain thrombectomy to a Spanish-speaking patient or family?

Most patients have no mental model for a catheter going to the brain. The most reliable framing: "Los médicos meten un tubo muy fino por una arteria en la ingle y lo suben hasta el cerebro, donde sacan el coágulo con un dispositivo especial — como una aspiradora muy pequeña." Then stakes: "Este procedimiento puede restaurar la circulación al cerebro más rápido que el medicamento solo." Time pressure: "Cada minuto que el cerebro está sin sangre se pierden millones de células nerviosas — por eso necesitamos su respuesta ahora." For family consent when the patient cannot communicate: "¿Usted es el familiar más cercano? Necesito su permiso para hacer el procedimiento ahora mismo."

Further reading

ClinicaLingo is a language-training product, not medical interpretation. Stroke informed consent for tPA and thrombectomy requires a qualified interpreter whenever the patient or family cannot communicate in English — do not rely on language-learning tools for life-or-death consent conversations. Always follow your facility's language-access policy.