This document discusses the pre-hospital Cincinnati Stroke Scale used by EMS. It recommends obtaining general measures like properly positioning the patient, permitting hypertension and maintaining adequate blood volume. Neuroimaging like CT/MRI of the brain, ECG and blood tests should be performed. Additional tests include blood glucose, electrolytes to rule out hypoglycemia or metabolic disturbance, coagulation studies as a basis for anticoagulation/thrombolysis, platelet and cardiac enzyme levels to identify risks. An ECG can detect arrhythmias or cardioembolic risk. Lumbar puncture may also be considered. For ABCD2 scores ≥4, appropriate therapy should be administered.