E5: Assessment (TIA)
Immediate referral for appropriately urgent specialist assessment and investigation is considered in all patients presenting with a TIA or minor stroke.
Key: e = element | k = knowledge | s = skill
Knowledge and understanding of…
e5k_1:
the anatomy and physiology of the central nervous system
e5k_2:
risk factors for stroke and transient ischaemic attack
e5k_3:
the signs and symptoms of transient ischaemic attack
e5k_4:
how to distinguish between stroke and transient ischaemic attack
e5k_5:
the features of atypical presentation of transient ischemic attack, stroke, and mimics; and when to exclude identified mimics from the stroke care pathway
e5k_6:
the investigations, interventions, and treatments for transient ischaemic attack
e5k_7:
local protocols for imaging and reporting
e5k_8:
the indications, contraindications, and limitations for imaging, investigations, and interventions
e5k_9:
any complications of surgical procedures
e5k_10:
the results of investigations
e5k_11:
how to initiate emergency and ongoing treatment for transient ischaemic attack and vascular prevention
e5k_12:
the timeframe for emergency and follow-on investigations, interventions, and treatments for transient ischaemic attack
e5k_13:
management options for transient ischaemic attack, stroke, mimics, and other conditions
e5k_14:
the future risk of stroke and transient ischaemic attack
e5k_15:
the implications of transient ischaemic attack for lifestyle; driving; occupation, including voluntary work or education; and social participation
Skills and ability to...
e5s_1:
perform a physiological assessment and assess vital signs
e5s_2:
take and interpret a thorough medical history, including information from carers, family, and other agencies where possible, and carry out decision-specific mental capacity assessments as appropriate
e5s_3:
identify risk factors and apply vascular risk assessment tools for transient ischaemic attack and screening tests for stroke
e5s_4:
identify and, where appropriate, classify transient ischaemic attack (high risk/lower risk), stroke, and atypical stroke, and exclude stroke mimics
e5s_5:
recognise patients who have had a stroke rather than a transient ischaemic attack and refer for appropriate investigation and management
e5s_6:
identify emergency interventions and treatments for transient ischaemic attack available locally and refer patients efficiently and effectively
e5s_7:
determine, plan, and initiate the appropriate screening, assessments and investigations, and interventions and treatments, and their level of urgency
e5s_8:
recognise stroke-related communication difficulties and adapt methods of communication to discuss with the patient, carer, and family: current event; need for and timeframes of assessments and investigations; rationale for interventions and treatments, their timeframes, and possible side effects; and provide timely information, advice and support
e5s_9:
apply radiological knowledge for recognised investigations
e5s_10:
apply technical knowledge for recognised investigations and interventions
e5s_11:
obtain and interpret the results of investigations, formulate an immediate and ongoing management plan, and initiate treatments within the relevant timelines
e5s_12:
apply surgical knowledge for recognised vascular interventions
e5s_13:
recognise and manage postoperative complications after surgical interventions
e5s_14:
establish the cause of transient ischaemic attack
e5s_15:
identify the service(s) to which the individual should be referred and liaise effectively with those services
e5s_16:
identify local management and referral routes for transient ischaemic attack, stroke, mimics, and other conditions
e5s_17:
communicate and discuss with the patient, carer, family, and health and social care professionals: diagnosis and results of investigations; risk of future vascular event and actions to be taken if a further vascular event occurs; methods of secondary prevention; subsequent needs and aspirations; and a management plan
e5s_18:
communicate and discuss with the patient, carer, and family advice on: lifestyle; driving; occupation including voluntary work or education; and social participation
