Bradley M, Nursing M, Tacheva A, Chalissery A. Seizure management in a Model Three hospital: what does specialist neurology add?
Ir J Med Sci 2022;
191:2729-2732. [PMID:
34988859 DOI:
10.1007/s11845-021-02676-2]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 06/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND
The commonest reason for admissions to hospital in Ireland annually for patients with a neurological condition is due to convulsions/epilepsy and their care is often managed by Internal Medicine physicians.
AIMS
The study aims to evaluate the care provided for patients admitted with seizures in a Model Three hospital before and after the commencement of a specialist onsite neurology service.
METHODS
Retrospective chart review of patients admitted from Emergency Department (ED) with the term "seizure" during a 4-month period in 2018 and 2019 was undertaken. Charts evaluated for patient demographics, Length of Stay (LOS), driving and lifestyle advice offered, and rescue medications prescribed upon discharge.
RESULTS
In 2018, a total of 58 patients were admitted with a seizure over a period of 4 months of audit and the mean LOS was 4.25 days (SD = 4.43). Driving advice was documented in 9 patients and Buccal midazolam (Buccalam) for rescue therapy for prolonged seizures was prescribed once. Following the appointment of a neurologist, LOS for patients admitted with seizure dropped to 2.6 days (SD = 3.44, p < 0.05) in the same time frame in 2019. Driving status/recommendations were documented in 27(42%) and buccal midazolam was prescribed for 25 (39%) patients.
CONCLUSION
Access to expert neurology review in a Model Three hospital in Ireland not only improved the provision of safe, timely, and equitable care but also significantly reduced the LOS for patients admitted with seizures.
Collapse