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Transient Ischaemic Attack

Checked: 23-05-2023 by Vicky Ryan Next Review: 23-05-2025

Service Overview

One stop rapid access clinics for the assessment of suspected TIAs are available at Bristol Royal Infirmary and Weston General Hospital, covering patients from the whole of BNSSG with referrals now managed centrally.

If uncertain whether to refer to TIA clinic there is a Primary Care Stroke Advice Line: 0117 414 5619 (Mon - Fri 08:00 - 16:00) based at the Southmead HASU.

Referral Guidance

Patients should be referred using the BNSSG One Stop TIA Referral Form (word doc) which is also available in EMIS.

This should be emailed to BNSSGTIAService@uhbw.nhs.uk. Please note that from 17^th May 2023, referrals are managed centrally and will be sent to the relevant centre for assessment

Please print and hand this information leaflet to the patient.

For all suspected TIA patients treat as advised below and tell patients not to drive.

All patients should be initiated on Aspirin 300mg stat and then once daily until TIA clinic review if not contraindicated or alternative advised according to current treatment - see below.

Current treatment	Prescribe until clinic
Oral anticoagulant (warfarin, coumarin, DOAC/NOAC)	Confirm symptoms fully resolved. Continue anticoagulant. Do not start Aspirin
Aspirin 75mg monotherapy	Step up to Aspirin 300mg daily
Clopidogrel 75mg monotherapy	Switch to Aspirin 300mg daily
Any combination of anti-platelets or ticagrelor or prasugrel	Stop all current combinations/ or anti-thrombotic. Commence Aspirin 300mg only
If Aspirin intolerant	Start Clopidogrel 75mg once daily

Red Flags

If symptoms or signs persist at time of presentation then treat as suspected stroke (see Stroke Remedy page)

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.