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.