All Journals from Susan M Fair
Abstract
Symptoms compatible with a transient ischaemic attack (TIA) are a common reason to seek medical attention. Most TIAs resolve within an hour and leave no residual symptoms or signs. This can make the diagnosis problematic, but perhaps more importantly, can lead both patient and doctor to underestimate the importance of the event, and the urgency with which it should be addressed. The risk of a subsequent stroke is high: around 8% after seven days and 17-18% after three months.1,2 This review aims to discuss some of the issues surrounding the investigation and management of TIAs, including the potential role of Acute Medicine in the provision of timely and appropriate management for these patients.
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A key component of training in Acute Medicine is the assessment and initial resuscitation of severely ill medical patients. The curriculum for General Internal Medicine (Acute Medicine) states that all specialists in Acute Medicine should attain Level 3 competencies in all emergency presentations.1 Different training programmes have variable exposure to the emergency department, to which the majority of these patients present. One module, currently being developed at City Hospital, Birmingham, is for the Acute Medicine Specialist Registrars (SpRs) to attend all medical alerts in Accident and Emergency (A&E) Department. This means that the SpR works as part of the receiving team, seeing patients first hand, rather than taking secondary referrals. At our hospital over 80% of alerts brought in the resuscitation room are medical emergencies.
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