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意识丧失、虚脱及相关驾驶限制:一项回顾性病例记录审查——关于驾驶限制的重要提醒

Loss of consciousness, collapse and associated driving restrictions: a retrospective case note review - an important reminder regarding driving restrictions.

作者信息

Williamson Adam, Muir Scott

机构信息

1 Clinical Teaching Fellow in General Medicine, Department of Acute Medicine, Queen Elizabeth University Hospital, UK.

2 Consultant Physician and Clinical Pharmacologist, Department of Acute Medicine, Queen Elizabeth University Hospital, UK.

出版信息

Scott Med J. 2017 May;62(2):43-47. doi: 10.1177/0036933017694779. Epub 2017 May 10.

DOI:10.1177/0036933017694779
PMID:28490286
Abstract

Background and aims National guidelines outlining medical standards for fitness to drive are provided by The Driver and Vehicle Licensing Agency. We aimed to establish whether patients presenting with collapse or loss of consciousness received documented advice regarding driving restrictions, if appropriate for their working diagnosis. Methods and results A retrospective case note review was undertaken over a four-month period for emergency patients clinically coded as seizure/convulsion (R568) and collapse/syncope (R55X); 163 patients had a primary or working diagnosis on discharge that suggested driving status and restrictions could have been reviewed. Six groupings of diagnoses were noted, and variation was seen amongst documentation for each. Current driving status was documented for 32 patients, and 34 had restriction advice documented; 73% (119 patients) had further investigations or clinic review planned. Conclusion Documentation of driving status and restrictions is poor. This audit serves to remind clinicians of the importance of considering driving status when discharging patients who have presented with collapse or loss of consciousness. Recent high-profile media coverage regarding medical driving restrictions, both locally and nationally, have emphasised the need for knowledge of The Driver and Vehicle Licensing Agency guidance.

摘要

背景与目的

驾驶与车辆许可局制定了概述适合驾驶的医学标准的国家指南。我们旨在确定出现晕倒或意识丧失的患者是否收到了关于驾驶限制的书面建议,这些建议是否适用于他们的诊断。方法与结果:对为期四个月的急诊患者进行回顾性病例记录审查,这些患者临床编码为癫痫/惊厥(R568)和晕倒/昏厥(R55X);163例患者出院时的初步或主要诊断表明,其驾驶状态和限制可能需要重新评估。记录了六类诊断,各类诊断的记录情况存在差异。32例患者记录了当前驾驶状态,34例记录了限制驾驶的建议;73%(119例患者)计划进行进一步检查或门诊复查。结论:驾驶状态和限制的记录情况不佳。本次审核旨在提醒临床医生,对于出现晕倒或意识丧失的患者,在出院时考虑其驾驶状态的重要性。近期本地和全国范围内关于医学驾驶限制的高关注度媒体报道强调了了解驾驶与车辆许可局指南的必要性。

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