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MAZE
medical
practice
t:
e:
w:
Occupational Medicine
Corporate Health Consulting
Maritime & Offshore Medicine
Remote Site Telemedicine
Travel & Expatriate Health
Workplace Drug Testing
+44 (0)28 9332 3341
office@mazemedical.co.uk
http://mazemedical.co.uk
Dr Trevor Maze
Occupational Physician
The Working Wounded –
Managing The Ill Employee:
High blood pressure & stroke
What is high
blood pressure?
We need a blood
pressure to drive our
circulation
High BP diagnosed in
20-30% of NI people
What is high
blood pressure?
Uncontrolled high BP may be silent until a catastrophic event,e.g., stroke or heart attack
What is high
blood pressure?
This is why we
encourage BP
screening
(see Elaine Anderson
afterwards)
What is a
stroke?
Damage to brain
cells usually due to a
bleed or clot
interrupting blood
supply to that part of
the brain
How to
recognize
a stroke?
Usually sudden onset of:
•Weak or numb face, arm or
leg, usually one-sided
•Blurred vision or loss of sight
•Severe headache
•Difficulties with
•balance & coordination
•talking or understanding
what others are saying
•swallowing
How common
are strokes?
incidence 2/1000
prevalence 15/1000
disability 6/1000
60% due to high BP
What is a
transient
ischaemic
attack?
“mini-stroke”, but
symptoms disappear
within 24 hours
Can be a warning
Needs medical RV
Act FAST
campaign
Early treatment
improves chance
of good recovery
& saves lives
Facial weakness: Can he
smile? Has his mouth or eye
drooped?
Arm weakness: Can he raise
both arms? Is one arm weak?
Speech problems: Can he
speak clearly and
understand what you say?
Time to call 999: If he fails any
of these tests call 999
immediately.
How do high
blood pressure
and stroke
impact on work?
Driving with high
blood pressure
Group 1 - DVA need
not be notified
Continue driving unless there are unacceptable side effects due to treatment
Driving with high
blood pressure
Group 2 - notify DVA
Disqualifies from driving
if resting BP consistently
180+/100+ mm Hg
Re/licensing permitted
when controlled
provided no side effects
of treatment that may
interfere with driving
Driving after a
stroke
DVA needs to
know if:
Class 1
•residual symptoms cause limb weakness, or visual disturbance, or problems with co-ordination, memory or understanding
•epileptic attacks occurred >24 hours after the stroke
•brain surgery was required as part of the treatment
•more than one stroke event within the past 3 months
Driving after a
stroke
DVA needs to
know if:
Class 1
TIA – no need to notify DVA, but must
not drive for 1 month.
STROKE – must not drive for 1 month.
May resume driving thereafter if clinical
recovery is satisfactory. Notify DVA if
residual neurological deficit 1 month
after episode (visual field defects,
cognitive defects & impaired limb
function).
Seizures occurring within 24 hours of a
stroke/TIA may be treated as provoked
for licensing purposes in the absence
of any other relevant history.
Driving after a
stroke
DVA needs to
know if:
Class 2
Licence revoked for 1 year following
stroke or TIA. Consider for re-licensing
provided no debarring residual
impairment likely to affect safe driving
and no other significant risk factors.
Licensing may be subject to
satisfactory medical reports including
exercise ECG test.
If there are recurrent TIAs or strokes
functional cardiac testing is required.
Working after a
stroke
Living with a long–term
health condition affects
many aspects of life.
Physical symptoms – getting
out of breath, feeling tired or
pain
Can also affect your
feelings, and have a major
bearing on how you cope
Medications may impair
Returning to
work
Disability
Discrimination
•You cannot dismiss on
grounds of chronic illness
or because regular
treatment needed
•you must make
reasonable changes to
workspace and working
conditions to help him
do his job
Returning to
work
Disability
Discrimination
Talk about expectations
(yours & his)
•may need to adjust job
remit or work pattern
•avoid taking on too much
too soon
•tiredness may still be an
issue – work reduced hours in
the first instance
•flexible hours may help if he
has good & bad days
How to support
& accommodate
employees with
hypertension
or stroke
Understand how:
•his health condition
affects him
•he sees his future
work capabilities
How to support
& accommodate
employees with
hypertension
or stroke
Have clear job task
analyses – not
aspirational post-
holder criteria – so
that OH can give you
clear advice & you
can stand over any
decisions
How to support
& accommodate
employees with
hypertension
or stroke
Obtain an
Occupational Health
opinion before he
returns to work
returning to
work &
finishing work
Pensionable early
retirement is not
necessarily justifiable
on health grounds
returning to
work &
finishing work
Take advice from
occupational health
& human resources
before terminating
employment
Speech Matters
Graham House
Knockbracken Healthcare
Park
Belfast
BT8 8BH
Dr Trevor Maze
Occupational Physician
The Working Wounded –
Managing The Ill Employee:
High blood pressure & stroke
MAZE
medical
practice
t:
e:
w:
Occupational Medicine
Corporate Health Consulting
Maritime & Offshore Medicine
Remote Site Telemedicine
Travel & Expatriate Health
Workplace Drug Testing
+44 (0)28 9332 3341
office@mazemedical.co.uk
http://mazemedical.co.uk
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