Neurology liaison services in the acute medical receiving unit.
BACKGROUND
Guidelines from the Association of British Neurologists and National Health Service Quality Improvement Scotland suggest that neurologists should be involved in the early management of patients presenting to hospital with acute neurological illness.


OBJECTIVE
We chose to evaluate whether regular neurology review in an acute medical receiving unit in a busy city hospital was feasible, and whether it would have an impact on patient care.


METHODS
Over a 5-week period from Monday to Friday, all neurology patients admitted to an acute medical receiving unit were identified and all headaches and blackouts were reviewed.


RESULTS
Fourteen (24%) were headache patients, 37 (63%) presumed seizure and 8 (13%) had another neurological illness. Diagnosis was made by the admitting physician in six headache patients (43%). The remaining eight headache patients were diagnosed by the visiting neurologist and two physician diagnoses were revised. The diagnosis made by the admitting physician was clarified by the visiting neurologist in 13 blackout patients (35%) and nine other diagnoses were revised (24%). Appropriate outpatient follow-up or transfer was arranged.


CONCLUSIONS
These results suggest that a daily neurology review service is useful in medical receiving units by clarifying diagnoses, directing tests and limiting inappropriate follow-up.
ST6 Neurology, Department of Neurology, Institute of Neurological Sciences, Glasgow, UK.
I
I
Morrison
R
R
Jamdar
P
P
Shah
M
M
Fisher
J P
JP
Leach
D003299:Cooperative Behavior; D003695:Delivery of Health Care; D003943:Diagnostic Techniques, Neurological / Q000592:standards*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000209:etiology*; D006301:Health Services Needs and Demand; D006769:Hospitals, General / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009462:Neurology / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D012017:Referral and Consultation; D012606:Scotland; D013222:State Medicine; D020521:Stroke / Q000150:complications* / Q000175:diagnosis*; D013997:Time Factors; D000078329:Workforce
Acute neurology; epilepsy; headache