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KMID : 0385920210320050408
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Journal of the Korean Society of Emergency Medicine
2021 Volume.32 No. 5 p.408 ~ p.415
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The effect of a dedicated emergency department neurologist on the competence in the management of emergency physicians on patients with neurologic abnormalities
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Ryu Ji-Kwang
Lee Dong-Wook
Moon Hyung-Jun
Lee Hyun-Jung
Jeong Dong-Kil
Kim Hyun-Joon
Kim Jae-Woo
Lee Jung-Won
Kim Yun-Tae
Kim Doh-Eui
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Abstract
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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.
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KEYWORD
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Neurologist, Consultation, Emergency
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