A TIA is a sign that part of the brain is not getting enough blood and that there is a risk of a more serious stroke in the future. There is no way of knowing whether a stroke or a TIA is occurring during the first few hours, so a TIA should be treated as an emergency and medical help should be sought immediately (see Stroke Association factsheet 1
). If in any doubt the best advice is to call 999.
People we talked to had sought help at different stages and through a range of different routes, including a routine or urgent GP appointment, calling an ambulance, calling NHS Direct or going straight to the Accident and Emergency Department. Some said it was difficult to know when or whether to seek medical help. It could sometimes be difficult to convince the GP’s receptionist that a ‘same day’ or ‘emergency’ appointment was needed. Often this was because people did not recognise their symptoms as being serious (see ‘Symptoms’
and ‘Delay in seeking help’
) and so help was not sought immediately, particularly where the episode only lasted a short time.
Phillip (above) rang the surgery the next morning and was quite surprised that it was treated as very urgent and he was referred to hospital that same day. Even where the symptoms did not seem to go away quite so quickly, it could still be easy to misinterpret what was happening.
Yvonne was on her way to work when she began to experience a range of symptoms and felt very unwell. She thought it was probably a reaction to some medication she’d been prescribed, or the beginning of a migraine, so she carried on with her day and did not seek medical advice or help immediately, despite the fact that colleagues told her she looked really unwell. Yvonne left it till she had a routine appointment to see the GP the following Monday. Like Phillip
, she was surprised at how urgently her GP reacted when she was referred immediately to a TIA clinic but even then was still not aware of the urgency because she did not know what TIA stood for (see ‘Understanding TIA/minor stroke
’ and ‘Delay in seeking help’
In some cases people said they had a general awareness of what might be happening and so were more inclined to make the call to the GP more quickly. Martyn rang the GP himself as he had an idea that his symptoms might indicate a TIA(see ‘Medication, treatment and surgery’
In many cases it was a partner, friend or relative who called for help. Typically this was where the person experiencing symptoms was unable to communicate, or had collapsed. Rosemary was prompted to call an ambulance when her husband Brian (Interview 08) woke from a nap complaining that his vision was blurred and he was feeling dizzy and somewhat disorientated. Rosemary called for help sooner rather than later because since her husband’s heart attack she had been told if in doubt to call the paramedics immediately.
When Geoff woke up one night feeling that he was going to be sick, it became evident to Enid his wife that he was also unable to move. Realising that he needed help straight away Enid called the GP, who recognised the urgency and arranged for an ambulance to take Geoff to hospital where he was assessed and immediately admitted for treatment.
When Adrian had a TIA at home one evening, his partner recognised what she thought were the symptoms of stroke from having seen the ‘FAST’ campaign advert
on TV (FAST stands for ‘F
peech – T
ime to call 999’). She called the ambulance straight away and paramedics arrived at home where he was assessed before being taken to hospital.
While several people said the FAST campaign had helped them be alert to possible symptoms, those with visual disturbance or a feeling of disorientation did not necessarily make the connection between their symptoms and FAST.
In most cases where an ambulance was called, the person was examined at home by the paramedics, and then usually taken in to A&E to be assessed (see Adrian above). One woman collapsed in the supermarket and a supervisor called for an ambulance. Some people we talked to were able to go home straight away, but others stayed in hospital.
Some people said they did not want to stay in hospital and were reluctant to be admitted. Adrian (above) said he had been glad that he was able to return home as he hated hospitals. Clare had been taken ill at work and a colleague had called for an ambulance. She was taken to hospital and was admitted overnight.
Not everyone was satisfied with the way they were dealt with when they were assessed in A&E. Gilly was taken to A&E by her colleague after collapsing at work, and although the emergency doctor she saw there thought it possible that she had had a TIA she was discharged and referred to a generalised clinic specialising in ‘unexplained events’ rather than one that dealt specifically with strokes.
In Gillian’s case it was felt initially that she might have a urine infection, and the next day when she saw her GP and the tests came back clear she was told that no further action was needed. However Gillian felt that it was important to know what had happened to her so that she could get a diagnosis and treatment.