2.2 Methods
Urgent consultation requires a doctor to first contact the consultation physician in the neurology department by phone and then fill out the electronic case application, which includes the patient’s name, age, and gender; the hospital admission number; bed number; consultation specialty; and reason for consultation. The consultant should arrive at the applicant ward within 10 minutes after receiving the phone call. Urgent consultation is often conducted by the Chief resident in the neurology department from Monday to Friday and by attending physicians on weekends and holidays. For difficult cases, young physicians are expected to consult with the senior attending physician on duty.
After reviewing the patient’s data, the neurological physician conducted neurological examination, clinical diagnosis and suggested further examination and treatment. For patients who had multiple consultations, this study regarded the conclusion of the last consultation as the final diagnosis. Diagnoses of non-neurological diseases were obtained from the patient’s hospital discharge records. If the same case was referred for consultation more than twice, it was still regarded as only 1 case. This study analyzed the following parameters: the purpose of consultation, the disease spectrum of consultation, the Department distribution of non-neurological diseases and the consistency rate with the emergency consultation criteria.
There were no reported criteria for urgent neurologic consultation. Therefore, we defined the following criteria for urgent consultation in the department of neurology [1,8]: (1) stroke within 24 hours; (2) cases of critical illness requiring the assistance of neurological physicians; (3) acute gas poisoning within 24 hours requiring emergency hyperbaric oxygen treatment; (4) other newly emerging neurological disease symptoms, neurological signs, or imaging abnormalities; (5) recurrent symptoms with poor therapeutic effects; (6) patients to receive emergency surgery who had had neurological diseases previously for preoperative evaluation; and (7) cases with medical disputes.