응급의학과 전속 신경과 전문의가 응급의학과 의사의 신경계이상환자에 대한 진료 역량에 미치는 영향The effect of a dedicated emergency department neurologist on the competence in the management of emergency physicians on patients with neurologic abnormalities
- Other Titles
- The effect of a dedicated emergency department neurologist on the competence in the management of emergency physicians on patients with neurologic abnormalities
- Authors
- 유지광; 이동욱; 문형준; 이현정; 정동길; 김현준; 김재우; 이정원; 김윤태; 김도의
- Issue Date
- Oct-2021
- Publisher
- 대한응급의학회
- Keywords
- Neurologist; Consultation; Emergency
- Citation
- 대한응급의학회지, v.32, no.5, pp 408 - 415
- Pages
- 8
- Journal Title
- 대한응급의학회지
- Volume
- 32
- Number
- 5
- Start Page
- 408
- End Page
- 415
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/20003
- ISSN
- 1226-4334
- Abstract
- 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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