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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/689

Title: Stroke
Other Titles: National clinical guideline for diagnosis and initial management of acute stroke and transient ischaemic attack (TIA)
Keywords: stroke
transient ischaemic attack
Issue Date: 2008
Publisher: Royal College of Physicians
Citation: National Collaborating Centre for Chronic Conditions. Stroke: national clinical guideline for diagnosis and initial management of acute stroke and transient ischaemic attack (TIA) . London: Royal College of Physicians, 2008.
Abstract: Stroke is a preventable and treatable disease. It can present with the sudden onset of any neurological disturbance, including limb weakness or numbness, speech disturbance, visual loss or disturbance of balance. Over the last two decades, a growing body of evidence has overturned the traditional perception that stroke is simply a consequence of aging which inevitably results in death or severe disability. Evidence is accumulating for more effective primary and secondary prevention strategies, better recognition of people at highest risk and thus most in need of active intervention, interventions that are effective so on after the onset of symptoms, and an understanding of the processes of care that contribute to a better outcome. In addition, there is now good evidence to support interventions and care processes in stroke rehabilitation. In the UK, the National Sentinel Stroke Audits 2,3 have documented changes in secondary care provision over the last 10 years, with increasing numbers of patients being treated in stroke units, more evidence-based practice, and reductions in mortality and length of stay. In order for evidence from research studies to improve outcomes for patients, it needs to be put into practice. National guidelines provide clinicians, managers and service users with summaries of evidence and recommendations for clinical practice. Implementation of guidelines in practice, supported by regular audit, improves the processes of care and clinical outcome. This guideline covers interventions in the acute stage of a stroke (‘acute stroke’) or transient ischaemic attack (TIA). Most of the evidence considered relates to interventions in the first 48 hours after onset of symptoms, although some interventions of up to 2 weeks are covered as well. This guideline is a stand-alone document, but is designed to be read alongside the Intercollegiate Stroke Working Party guideline ‘National clinical guideline for stroke’* which considers evidence for interventions from the acute stage into rehabilitation and life after stroke. The Intercollegiate Stroke Working Party guideline is an update of the 2004 2nd edition and includes all the recommendations contained within this guideline. This acute stroke and TIA guideline is also designed to be read alongside the Department of Health’s (DH) ‘National stroke strategy’ (NSS). Where there are differences between the recommendations made within this acute stroke and TIA guideline and the NSS, the Guideline Development Group (GDG) members feel that their recommendations are derived from systematic methodology to identify all of the relevant literature.
Description: Stroke has a sudden and sometimes devastating impact on the patient and their family who need continuing information and support. Clinicians dealing with acute care need to be mindful of the rehabilitation and secondary care needs of patients with stroke to ensure a seamless transition across the different phases of care. All aspects of care must be patient-centred and where possible based on full discussion with the patient and/or carer, for example some aspects of the guideline may not be appropriate for patients who are dying or who have other severe comorbidities. Healthcare professionals should also follow a code of practice accompanying the Mental Capacity Act 2005 (summary available from www.dca.gov.uk/menincap/bill-summary.htm).
URI: http://hdl.handle.net/123456789/689
ISBN: 978-1-86016-339-5
Appears in Collections:Guidelines

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