St George's University Hospitals NHS Foundation Trust, London, UK
St George's University Hospitals NHS Foundation Trust, London, UK and Croydon University Hospital, Croydon, UK.
Clin Med (Lond). 2018 Oct;18(5):418-421. doi: 10.7861/clinmedicine.18-5-418.
Acute neurological problems are common, accounting for 10-20% of medical admissions. In the coming years, there will be increased neurology involvement in the acute care of these patients complementing traditional outpatient-based services. Models of acute neurology are reliant on close collaboration between the emergency department, acute medicine and neurology and should integrate with existing hyperacute stroke pathways. In this article the authors briefly describe the two models of acute neurology set up recently in our neuroscience group and suggest a clinical approach that may help non-neurologists involved in acute care settings The authors emphasise some of the lessons learnt in delivering the service, particularly the importance of focusing on the acute problem and tailoring the examination and investigations to tackling it in the context of the patient's functional level and personal circumstances. Early neurology intervention can reduce admission and hospital length of stay.
急性神经系统问题很常见,占住院患者的 10-20%。在未来几年,神经内科将更多地参与这些患者的急症治疗,补充传统的门诊服务。急性神经病学模式依赖于急诊科、急症科和神经科之间的密切合作,并应与现有的超急性脑卒中治疗途径相整合。本文作者简要描述了我们神经科学组最近建立的两种急性神经病学模式,并提出了一种可能有助于参与急症治疗的非神经科医生的临床方法。作者强调了在提供服务过程中吸取的一些经验教训,特别是关注急性问题并根据患者的功能水平和个人情况对检查和调查进行调整以解决问题的重要性。早期神经科干预可以减少住院时间和住院时间。