Monday, July 19, 2010

Stroke and TIA

Rule Out Stroke In Emergency Room (ROSIER scale)

The aim of this assessment tool is to enable medical and nursing staff to differentiate patients with stroke and stroke mimics.
* Stroke is likely if total scores are > 0. Scores of completely excluded.
The ROSIER scale is not suitable for patients with suspected TIA with no neurological signs when seen. Please use the ABCD2 assessment for patients with suspected TIA. This assessment assists in the identification of patients with a high or low risk of early disabling stroke.

High risk TIA patients (scoring 5 or more on ABCD2 score) should be:-
�� Seen within 24 hours of the event at the TIA clinic (patients referred to the TIA clinic at the RVI need a TIA clinic referral form completed)
�� Out of hours (e.g. at weekends), contact the on-call Stroke Consultant and admit for review,
urgent investigation and initiation of secondary prevention.

Any patient with more than one episode in the last week is at a greater than 30% risk of stroke within a week and should be admitted to EAU for investigation and review by a Consultant Stroke Physician.

This ABCD2 scale is not a substitute for a full medical assessment.

The modified Rankin Scale (mRS) is widely used to assess global outcome after stroke.



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