Diagnosis and initial management of acute stroke and transient ischaemic attack: summary of NICE guidance

doi:10.1136/bmj.a786

Published 24 July 2008, doi:10.1136/bmj.a786
Cite this as: BMJ 2008;337:a786

Practice

Guidelines

Diagnosis and initial management of acute stroke and transient ischaemic attack: summary of NICE guidance

Sharon Swain, health services research fellow in guideline development¹, Claire Turner, senior project manager in guideline development for the development group¹, Pippa Tyrrell, senior lecturer, honorary consultant in stroke medicine²^,3, Anthony Rudd, consultant stroke physician ⁴, on behalf of the Guideline Development Group

¹ National Collaborating Centre for Chronic Conditions, Royal College of Physicians of London NW1 4LE , ² Stroke Medicine, University of Manchester, Manchester, ³ Salford Royal NHS Foundation Trust, Salford M6 8HD , ⁴ St Thomas’s Hospital, London SE1 7EH

Correspondence to: S Swain Sharon.Swain@rcplondon.ac.uk

The first 150 words of the full text of this article appear below.

Why read this summary?

In England, stroke is estimated to cost the economy about £7bn( ${euro}$ 8.8bn; $13.9bn) a year. This total comprises direct costs tothe National Health Service of about £2.8bn, cost of informalcare of £2.4bn, and cost because of lost productivityand disability of £1.8bn.¹ In the United Kingdom, thenational sentinel stroke audits² ³ have shown that over thepast 10 years increasing numbers of patients are being treatedin stroke units, evidence based practice is increasing, andreductions in mortality and length of hospital stay have decreased.One of the main aims of the guidance issued by the NationalInstitute for Health and Clinical Excellence (NICE) is to ensurethat the specialist treatment and expertise recommended areavailable to all patients in England and Wales. This articlesummarises key recommendations in the NICE guideline for thediagnosis and initial management of acute stroke and transientischaemic attack.⁴

Recommendations

NICE recommendations . . . [Full text of this article]

Rapid symptom recognition and diagnosis
Outside hospital
In hospital
Brain imaging for suspected transient ischaemic attack
Brain imaging for early assessment of acute stroke
Urgent carotid endarterectomy and carotid stenting
Specialist care in acute stroke
Thrombolysis in people with acute ischaemic stroke
Aspirin and anticoagulation treatment for acute ischaemic stroke
Nutrition and hydration in acute stroke
Assessment of swallowing function
Oral nutrition supplementation
Hydration
Early mobilisation and optimum position of patients with acute stroke

Overcoming barriers

Further information on the guidance
Background
Methods
Futureresearch

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