The effect of a dedicated emergency department neurologist on the competence in the management of emergency physicians on patients with neurologic abnormalities
- Author:
Ji Kwang RYU
1
;
Dong Wook LEE
;
Hyung Jun MOON
;
Hyun Jung LEE
;
Dong Kil JEONG
;
Hyun Joon KIM
;
Jae Woo KIM
;
Jungwon LEE
;
Yuntae KIM
;
Doh-Eui KIM
Author Information
1. Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
- Publication Type:Original Article
- From:Journal of the Korean Society of Emergency Medicine
2021;32(5):408-415
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Objective:Although accurate diagnosis in neurologic emergencies is critical, the emergency department (ED) suffers from a shortage of neurologists. The purpose of this study was to investigate the effect of a dedicated neurologist on the competence in the management of ED physicians on patients with neurologic abnormalities.
Methods:We retrospectively reviewed the medical records of patients with neurologic abnormalities between 1 March 2016 and 30 September 2019. Two periods, including control and intervention periods, were assigned. Neurology consultations were routinely performed by an ED physician in the control period and by a physician of the ED working with a dedicated neurologist in the intervention period.
Results:In the control period, the most frequent chief complaints were dizziness (22.45%), focal motor weakness (except the face, 19.62%), altered mental status (9.98%), dysarthria (9.62%), seizures (8.57%), and headaches (6.87%). In the intervention period, the rate of final disposition by the ED physician was significantly increased in patients with dizziness (P<0.001), altered mental status (P=0.003), dysarthria (P<0.001), seizure (P<0.001), headaches (P<0.001), facial palsy (P<0.001), and memory impairment (P=0.043).
Conclusion:ED physicians who were educated by a dedicated neurologist could effectively enhance the competence in the management of the patient with neurologic abnormalities. We suggest that the method implemented in this study can be a good alternative for solving the gap in neurology department consultation.
