Abstract
The aim of this paper is to outline the background to several recent papers which highlight deficiencies in acute neurological care- all of which highlight (to differing degrees) issues in relation to neurological assessment with some proposed solutions. Given that 10% of acute emergency admissions are for neurological conditions (up to 20% if stroke included), this should be of concern to all acute medical physicians.
[download-attachments container="div" style="list" dipslay_icon="1" display_count="1" display__size="0"]
References
- Marson T. UK epilepsy audit shows major deficiencies in care: who should respond and how? Pract Neurol 2013;13:2-3 doi:10.1136/
practneurol-2012-000488 - Subarachnoid Haemorrhage: Managing the Flow (2013) Accessed 18th May, 2014 http://www.ncepod.org.uk/2013sah.htm
- Nicholl D, Weatherby S. Subarachnoid haemorrhage: the canary in the mine, or the elephant in the room? Pract Neurol. 2014 Aug;14(4):204-5. doi: 10.1136/practneurol-2014-000816. Epub 2014 Mar 5.
- Nicholl DJ, Yap CP, Cahill V, et al. The TOS study: can we use our patients to help improve clinical assessment? J R Coll Physicians Edinb 2012;42:306–10.
- Nicholl DJ, Appleton JP. Clinical neurology: why this still matters in the 21st century. J Neurol Neurosurg Psychiatry. 2014 May 29. pii:jnnp-2013-306881. doi: 10.1136/jnnp-2013-306881. [Epub ahead of print] Review.
- Wong SH. A bright idea- solving the chronic lack of neurological examination equipment on the wards with the Walton Neurostand. Pract Neurol 2008;8:318-321 doi:10.1136/jnnp.2008.156851
- Bruce BB, Lamirel C, Wright DW, et al. Nonmydriatic Ocular Fundus Photography in the Emergency Department. NEJM 2011;364:387–89.
- Pérez MA, Bruce BB, Newman NJ, Biousse V. The use of retinal photography in non-ophthalmic settings and its potential for neurology. Neurologist. 2012 November ; 18(6): 350–355.doi:10.1097/NRL.0b013e318272f7d7
- Portable Eye Examination Kit http://www.peekvision.org/ Accessed 18th October, 2014
- Matthews B. Practical neurology. Oxford: Blackwell Scientific Publications, 1963;1–256 (page 2).
- Morris Z, Whiteley WN, Longstreth WT Jr, Weber F, Lee YC, Tsushima Y, Alphs H, Ladd SC, Warlow C, Wardlaw JM, AlShahi Salman R. Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ. 2009 Aug 17;339:b3016.
- Choosing Wisely http://www.choosingwisely.org/ Accessed October 18th, 2014
- BBC News Is it right to waste helium on party balloons? http://www.bbc.co.uk/news/magazine-24903034 Dated18 November Accessed October 18th, 2014
- Moore FG, Chalk C. The essential neurologic examination: what should medical students be taught? Neurology 2009; 72: 2020-2023.
- JAMA Evidence: The rational clinical examination- evidencebased clinical diagnosis. Edited by Simel DL & Rennie D. McGraw-Hill, New York 2008.
- BBC News website An electronic revolution in the doctor’s bag 28th Sept 2014. Accessed 18th October 2014 http://www.bbc.co.uk/news/magazine-29376437
Request Permissions
To request copyright permission to republish or share portions of our works, please visit Copyright Clearance Center’s (CCC) Marketplace website by clicking the button below:
