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Wirral University Hospital NHS Foundation Trust

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Info for GPs: TIA assessment and referral

The following information is for use by General Practitioners and those in Primary Care who want to find out more about TIA, referral to the Rapid Assessment Clinic or Minor Stroke Services.

What is TIA (Transient Ischaemic Attack)?

TIA is a medical emergency.

TIA is an acute loss of focal cerebral function resulting in sudden onset limb weakness, sensory disturbance or speech disturbance. It can also present as a Transient Monocular Blindness (Amaurosis Fuhax).

The risk of having a stroke following a TIA can be estimated using the ABCD 2 Score (Johnston et al. Lancet 2007;369:283–292).

Who is at risk?

ABCD2 score of ≥4 indicates your patient is at high risk of Recurrent TIA or a disabling stroke within the next 48 hours and should be referred immediately to the TIA Rapid Assessment Clinic for review.

Patients will be contacted directly to arrange an appointment within the next 24 hours so make sure you have supplied the correct phone number.

Patients with ABCD2 score of <4 are classed as 'lower risk' and should be referred to the Rapid Access TIA & Minor Stroke Clinic where they will be seen within the next seven days.

If your patient has Symptomatic Carotid Artery Stenosis >70%, they have a 25% chance of having a disabling stroke in the next 18 months.

Symptoms of TIA

Dizziness, fainting, syncope, loss of consciousness, confusion or mental disorientation and seizure are unlikely to be TIAs in the absence of other neurological findings.

If you would like these symptoms to be investigated please refer to a general medical clinic.

Actions to be taken

If your patient has had a TIA please refer NOW using The Rapid Access TIA / Minor Stroke Proforma.

If you are referring to the TIA Rapid Assessment Clinic please make sure you have the patient's correct phone number as they will be contacted within the next 24 hours.

If there was a witness to the patients event please ask that person to accompany the patient to hospital or clinic review.

Make sure you inform your TIA patient not to drive. The DVLa advise that TIA patients do not drive for at least one month following their event.

Please ring 0151 604 7397 if contacted within 24 hours.

If you need to discuss a patient prior to referral, our Stroke Co-ordinators are available 24/7 via the Arrowe Park Switchboard (0151 678 5111) bleep 7009, bleep 2346 or via direct dial on 0151 604 7397.