NICE checklist for rapid hospitalisation for strokes

A checklist that identifies TIA patients who require rapid admission to hospital has been laid out by NICE in draft guidelines.

GPs and other pre-hospital health professionals have been told to use the Fast Arm Speech Test (FAST) to diagnose stroke or TIA and check if the patient is hypoglycaemic.

For patients with a TIA a subsequent validating system, such as ABCD2, should be used to work out their risk of stroke.

Those at high risk - classified as an ABCD2 score of four or more - need immediate initiation of aspirin and specialist assessment and brain imaging within 24 hours of symptom onset. Those with a lower score also need aspirin and should be given special assessment within one week of symptom onset.

Additionally, patients with non-disabling stroke who are candidates for carotid intervention should undergo carotid imaging within one week.

Those with low levels of carotid stenosis who are not eligible for surgery, will still need BP control, cholesterol lowering and to be given antiplatelet drugs.

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