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