What to do if a patient reports symptoms of stroke or TIA?
Any patient who presents with neurological symptoms suggestive of a cerebrovascular event should be immediately referred to A&E Department to be assessed especially with the time window for thrombolysis is only 4.5 hours from the onset of symptoms. If the patient develops these symptoms and phones for advice, he/she should be advised to call 999 immediately to be brought to hospital.
Patients with a TIA, that is, they have no neurological symptoms at the time of assessment (within 24 hours), should be referred to be assessed and investigated urgently in a specialised Neurovascular Clinic.
Those who score 4 or above on the ABCD2 score are at a higher risk to develop stroke. And will be seen within 24 hours from GP assessment. Patients with lower score (0-4) will be seen as soon as possible and certainly within 7 days. It is, therefore, imperative that the referral is faxed over to the TIA service as soon as the patient has been seen by the GP.
Patients should be given Aspirin immediately, and risk factors for cerebrovascular disease should be assessed and treated appropriately. Where possible; do an ECG (attach to referral form), blood glucose and lipid profile. Give lifestyle advice including smoking, alcohol and diet, and inform patients that they cannot drive until they are assessed in the clinic (please see the attached pathway).
Patients with a carotid territory TIA and a significant carotid stenosis (> 70%) are referred to the Vascular Team for consideration of urgent endarterectomy.
Sandwell Services for Stroke Contacts
- Dr Kamel Sharobeem, Lead Clinician for Stroke
- Dr Sissi Ispoglou, Consultant Stroke Physician
- Dr David Gull, Consultant Stroke Physician
- Dr Sachin Vasishta, Consultant Stroke Physician
- Jackie Wilkinson, Stroke Co-ordinator
- April Hawkins, Matron for Stroke Service
- Urgent enquiries for Sandwell patients 0121 5531831 bleep 6020