Stroke Clinical Guidelines

As the purpose pf the Australian Stroke Foundation’s guidelines state, “The Clinical Guidelines for Stroke Management 2017 provides a series of best-practice recommendations to assist decision-making in the management of stroke and transient ischaemic attack (TIA) in adults, using the best available evidence. The Clinical Guidelines should not be seen as an inflexible recipe for stroke management; rather, they provide a guide to appropriate practice to be followed subject to clinical judgment and patient preferences.”

Although these guidelines are not to be viewed “as an inflexible recipe for” clinical practice, it is worth noting that the general public can assume that health professionals are obliged to comply with them. This was demonstrated last year in response to dosages of chemotherapy given to patients in an Australian Oncology Unit that did not comply with the clinical guidelines. So health professional be cautious, is my advice, and rightly so!

Clinical guidelines are developed, reviewed and compiled by our professional colleagues. Across Australia, hundreds of clinicians and academic researchers have been working on the 2017 guidelines for more than 12 months. Each sub-group of experts has had to reach agreement about the interpretation of their reviews and appraisals of the available evidence. Our colleagues have essentially done hundreds of mini-systematic reviews to reach the final recommendations. Our thanks go to them for their diligence, hard work and integrity.

In recent years, clinical guidelines have seen the recommendations against, for the very first time. Yes, ordinarily clinical guidelines are recommendations for, but in more recently years, we have seen the inclusion of recommendations against. This is helpful, as some of what we assumed was effective in the past, has now been shown to be ineffective.

I’ll leave you to peruse the sections of the guidelines that are of professional interest you, but if you’re working with people at risk of, experiencing, recovering from, and/or living with, stroke, then you should familiarise yourself with your country’s most recently published clinical guidelines. In Australia, these are the clinical guidelines featured in this month’s journal club.