Jenna K Bulger, Khalid Ali, Adrian Edwards, Chelsey Hampton, Charlene Jones, Chris Moore, Alison Porter, Tom Quinn, Anne Seagrove, Helen Snooks, Nigel Rees, Gary Ford
Journal of Paramedic Practice, Vol. 10, Iss. 6, 01 Jun 2018, pp 256 - 259

Background: In secondary care, the urgency of review for transient ischaemic attack (TIA) has relied upon the use of the ABCD2 score, but this tool is not validated for use by emergency ambulance crews. There is a need to evaluate alternative care pathways for patients who might be eligible for direct referral to TIA clinics without prior conveyance to the emergency department (ED).

Aim: The aim of this national survey was to describe current service provision across the UK for pre-hospital emergency care of patients with TIA.

Methods: The authors approached all UK Ambulance trusts (n=13) by email, asking them to
provide details of TIA patient referral pathways. Findings: Twelve ambulance services responded to the survey and nine reported that they had no current pathway; one had discontinued a pathway because of service reconfiguration; and three were currently using one. All pathways used the ABCD2 tool to screen patients and classified patients as low-risk if the ABCD2 score was 3 or below. Non-conveyance exclusion criteria varied. Although compliance with referral pathways was audited in an initial pilot in one service, no other evaluations of the effectiveness of pathways were reported.

Conclusion: A minority of UK ambulance services report introducing referral pathways for low-risk TIA patients, avoiding initial assessment in the ED. Safety, effectiveness and acceptability of such pathways have not been evaluated to date.

Return to article listing

To view this article

information Please use the options below to create a subscription. If you have any queries about your account please contact our subscriptions department or telephone free 0800 137201 (UK callers only) or +44 (0)1722 716997 for callers outside the UK.

Existing users sign in Personal subscription Pay per article

Sign in