Why every mini-stroke must be treated as an emergency Health professionals fail too often to take transient ischaemic attacks seriously, as personal experience showed Sally Jarvis
SUMMARY
When nurse Sally Jarvis had a transient ischaemic attack (TIA) she was advised to book an appointment with her GP the following week. Instead, she sought immediate treatment which may have prevented her from having a stroke. She argues that health professionals must spot the signs of TIA and treat it as an emergency. Author Sally Jarvis is an agency nurse and supporter of this month’s Stroke Association’s Action on Stroke Month.
NURSING STANDARD
Basic skills
PHOTOTAKE
As a nurse I am used to telling people about the symptoms of transient ischaemic attack (TIA) or mini-stroke, and the importance of seeking emergency treatment. However, a recent report by the Stroke Association shows that about one quarter of patients believe health professionals are too quick to dismiss TIA. I know from first-hand experience that there is nothing funny about having mini-stroke symptoms dismissed. One evening as I was getting ready to go out, my arm and hand suddenly went numb. I looked in the mirror and saw the left side of my face had dropped. As soon as I had regained the use of my arm and hand, I phoned my doctor’s surgery and got through to the out-of-hours call centre. After explaining that I thought I was having a TIA or possibly a stroke, I was advised to monitor my symptoms and make an appointment to see my GP after the weekend. Eventually, I was taken to an emergency department and examined. As it was the weekend and the unit was busy, I was not
that I acted on my symptoms and got the treatment I needed. I dread to think what the outcome might have been if I had done otherwise. Approximately 46,000 people are diagnosed with their first TIA every year. Given how often the condition goes undiagnosed, the real figure could be much higher. TIA should always be treated as a medical emergency and there is a huge risk of having a major stroke following a TIA, particularly in the first week. As health professionals, it is our duty to recognise the signs and ensure patients receive treatment.
offered a CT scan and was told the best course of action was to book an appointment with my doctor the following week. The thought of waiting over the weekend, with no support for 72 hours, left me feeling like a ticking time bomb. I asked for a private referral to a consultant and the advice and treatment from him was excellent. I am convinced it prevented me from having a stroke. Physically, I have now recovered from my TIA. However, its effects have changed my life. Every day I take consolation in the knowledge
My experience as a patient has taught me that when confronted with something as complex as TIA, we need to return to basic nursing skills. I would remind all healthcare professionals of the following points when dealing with suspected TIA: 4Observation – how are they acting, how do they look? 4Rapport – put the patient at ease and gain their trust. They might share information that they had omitted earlier. 4Family history – is there a history of stroke or TIA? Not all TIA symptoms are the same. As well as the FAST test (Face, Arms, Speech, Time), other symptoms can include sudden weakness, memory loss, or vision loss. Urgently investigating and treating people who have a TIA or minor stroke could reduce their risk of another stroke by 80 per cent. Let’s remember that even if the symptoms are fleeting, we need to take TIA seriously, treat every patient as unique, and ultimately, trust what they tell us: they know their body best NS To find out more, visit www.stroke.org.uk/strokemonth
may 21 :: vol 28 no 38 :: 2014 25
Nursing Standard 2014.28:25-25. Downloaded from journals.rcni.com by UNIVERSITY OF SYDNEY on 09/11/16. For personal use only.
SUMMARY
When nurse Sally Jarvis had a transient ischaemic attack (TIA) she was advised to book an appointment with her GP the following week. Instead, she sought immediate treatment which may have prevented her from having a stroke. She argues that health professionals must spot the signs of TIA and treat it as an emergency. Author Sally Jarvis is an agency nurse and supporter of this month’s Stroke Association’s Action on Stroke Month.
NURSING STANDARD
Basic skills
PHOTOTAKE
As a nurse I am used to telling people about the symptoms of transient ischaemic attack (TIA) or mini-stroke, and the importance of seeking emergency treatment. However, a recent report by the Stroke Association shows that about one quarter of patients believe health professionals are too quick to dismiss TIA. I know from first-hand experience that there is nothing funny about having mini-stroke symptoms dismissed. One evening as I was getting ready to go out, my arm and hand suddenly went numb. I looked in the mirror and saw the left side of my face had dropped. As soon as I had regained the use of my arm and hand, I phoned my doctor’s surgery and got through to the out-of-hours call centre. After explaining that I thought I was having a TIA or possibly a stroke, I was advised to monitor my symptoms and make an appointment to see my GP after the weekend. Eventually, I was taken to an emergency department and examined. As it was the weekend and the unit was busy, I was not
that I acted on my symptoms and got the treatment I needed. I dread to think what the outcome might have been if I had done otherwise. Approximately 46,000 people are diagnosed with their first TIA every year. Given how often the condition goes undiagnosed, the real figure could be much higher. TIA should always be treated as a medical emergency and there is a huge risk of having a major stroke following a TIA, particularly in the first week. As health professionals, it is our duty to recognise the signs and ensure patients receive treatment.
offered a CT scan and was told the best course of action was to book an appointment with my doctor the following week. The thought of waiting over the weekend, with no support for 72 hours, left me feeling like a ticking time bomb. I asked for a private referral to a consultant and the advice and treatment from him was excellent. I am convinced it prevented me from having a stroke. Physically, I have now recovered from my TIA. However, its effects have changed my life. Every day I take consolation in the knowledge
My experience as a patient has taught me that when confronted with something as complex as TIA, we need to return to basic nursing skills. I would remind all healthcare professionals of the following points when dealing with suspected TIA: 4Observation – how are they acting, how do they look? 4Rapport – put the patient at ease and gain their trust. They might share information that they had omitted earlier. 4Family history – is there a history of stroke or TIA? Not all TIA symptoms are the same. As well as the FAST test (Face, Arms, Speech, Time), other symptoms can include sudden weakness, memory loss, or vision loss. Urgently investigating and treating people who have a TIA or minor stroke could reduce their risk of another stroke by 80 per cent. Let’s remember that even if the symptoms are fleeting, we need to take TIA seriously, treat every patient as unique, and ultimately, trust what they tell us: they know their body best NS To find out more, visit www.stroke.org.uk/strokemonth
may 21 :: vol 28 no 38 :: 2014 25
Nursing Standard 2014.28:25-25. Downloaded from journals.rcni.com by UNIVERSITY OF SYDNEY on 09/11/16. For personal use only.
