RACE scale (Rapid Artery oClusion Evaluation) try to  detect patients with severe clinical neurological involvement. It is a prehospital and paramedic scale, previous to ER arrival.

A value ≥5 associated with larger tissue impairment and ischemia or hemorrhage risk. It could be associated  to vascular occlusion of large vessel in case it was an ischemic stroke. It could be used in ambulance by paramedical care. But like other scales as pre / Cincinnati or LAMS (Los Angeles) used by paramedics not determine if it is an ischemic or hemorrhagic stroke. An important handycap is the risk of transfer patients with a stroke mimic due difficulty to diagnosis with this scales this type of clinical impairments.

It is used in a RACECAT trial. This trial enrolls patients with RACE>4 score pre-transfer by means app. A neurologist according to data reported by paramedics at home of patient randomise 1:1 to drip&ship (community center with tele stroke  vs mother ship (comprehensive center).

    It is important prior training for paramedics to score with this scale, certain values as agnosia, aphasia or bilateral motor impairment can vary  sensitively final score. Also if patient have a previous damage in limb could be scored despite is not due to acute stroke.

The usefulness of these scales (as LAMS, PRE/CINCINNATI, ETC) and target of high specificity and sensitivity are required due to determine which stroke will be candidates for intervention in the future to be referred to high-tech centers or tertiary or comprehensive stroke centers where thrombectomy can take place .