Table 1

The SAVE scale

ItemScoringSimplified instructions and NIHSS source
Speech

  • 0 Normal

  • 1 Any aphasia or dysarthria

Determined during clinical interview or by asking the patient to name objects. Positive if any points are scored on NIHSS items 9 or 10
Arm

  • 0 Normal

  • 1 Asymmetric arm drift or weakness

Ask the patient to raise both arms or help place them in an outstretched position. Watch for asymmetric drift or weakness. Positive if there is any difference between NIHSS items 5a and 5b
Vision

  • 0 Normal

  • 1 Hemianopia or quadrantanopia

Use finger counting or wiggling in all four visual quadrants. If the patient is unable to participate use visual threat on each side. Visual threat can still be tested for patients with their eyes closed by gently holding their eyes open and watching/feeling for a blink response timed to the threat stimulus. Positive with any points scored on NIHSS item 3
Eyes

  • 0 Normal

  • 1 Gaze preference, forced gaze deviation, or abnormal horizontal eye movements

Ask the patient to follow your finger while slowly moving it horizontally from side to size. Patients struggling with finger following can be asked to follow the examiner’s face from side to side instead. If the patient’s eyes are closed the eyelids can be gently held open to look for gaze deviation to one size. Positive with any points scored on NIHSS item 2
Total score (0 – 4):Assessment date and time:

  • NIHSS, National Institutes of Health Stroke Scale; SAVE, Speech Arm Vision Eyes.