If ‘yes’ to any of these at onset, TIA is an Gradual onset or spread of symptoms (hours to Choose an unlikely diagnosis, so consider alternative days) item. referral route. An urgent neurology Seizure or loss of consciousness without a residual Choose an referral is generally required for focal neurological deficit item. these presentations. Transient Amnesia unaccompanied by a focal Choose an If in doubt discuss with Stroke Consultant neurological deficit item. Contact details: 01438 immediately: 314333 (switchboard number) Details of discussion with consultant (including their name) if TIA clinic referral advised after discussion: Click here to enter text. TIMINGS First onset of symptoms? Date: Click here to enter Time: Click here to a date. enter text. If they have had more than one episode, when did they last Date: Click here to Time: Click here to notice their symptoms? enter a date. enter text. When were they first seen by GP/Nurse re their suspected TIA Date: Click here to Time: Click here to enter a date. enter text. ANTI-COAGULATION AND AF STATUS Is the patient is taking anticoagulant therapy? (Delete any that don’t apply) Choose an item. Warfarin/Acenocoumarol/Phenindione Date & result of latest INR Click here to enter text. Heparin/low molecular weight heparin NOAC: Apixaban/Dabigatran/Rivoroxaban Previous AF Choose an item. Details: Click here to enter text. Suspected new AF Choose an item. Details: Click here to enter text. PRESENTING COMPLAINTS/PRESENTATION
If ‘yes’ to any of these at onset, TIA is an unlikely diagnosis, so consider alternative referral route. An urgent neurology referral is generally required for these presentations. If in doubt discuss with Stroke Consultant immediately: Contact details: 01438 314333 (switchboard number) Gradual onset or spread of symptoms (hours to days) Choose an item. Seizure or loss of consciousness without a residual focal neurological deficit Choose an item. Transient Amnesia unaccompanied by a focal neurological deficit Choose an item. Details of discussion with consultant (including their name) if TIA clinic referral advised after discussion: Click here to enter text. TIMINGS First onset of symptoms? Date: Click here to enter a date. Time: Click here to enter text. If they have had more than one episode, when did they last notice their symptoms? Date: Click here to enter a date. Time: Click here to enter text. When were they first seen by GP/Nurse re their suspected TIA Date: Click here to enter a date. Time: Click here to enter text. ANTI-COAGULATION AND AF STATUS Is the patient is taking anticoagulant therapy? Choose an item. (Delete any that don’t apply) Warfarin/Acenocoumarol/Phenindione Date & result of latest INR Click here to enter text. Heparin/low molecular weight heparin NOAC: Apixaban/Dabigatran/Rivoroxaban Previous AF Details: Choose an item. Click here to enter text. Suspected new AF Details: Choose an item. Click here to enter text. PRESENTING COMPLAINTS/PRESENTATION
ENHT%20NEW-TIA-REFERRAL-2018.docx