| 응급의학과 전속 신경과 전문의가 응급의학과 의사의 신경계이상환자에 대한 진료 역량에 미치는 영향 |
유지광1
, 이동욱1
, 문형준1
, 이현정1
, 정동길1
, 김현준1
, 김재우1, 이정원2
, 김윤태3
, 김도의1
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1순천향대학교 천안병원 응급의학과
2건국대학교 충주병원 응급의학과
3순천향대학교 천안병원 재활의학과 |
| The effect of a dedicated emergency department neurologist on the competence in the management of emergency physicians on patients with neurologic abnormalities |
| Ji Kwang Ryu1
, Dong Wook Lee1
, Hyung Jun Moon1
, Hyun Jung Lee1
, Dong Kil Jeong1
, Hyun Joon Kim1
, Jae Woo Kim1, Jungwon Lee2
, Yuntae Kim3
, Doh-Eui Kim1
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1Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
2Department of Emergency Medicine, Konkuk University Chungju Hospital, Chungju, Korea
3Department of Physical Medicine and Rehabilitation, Soonchunhyang University Cheonan Hospital, Cheonan, Korea |
| Correspondence |
Doh-Eui Kim ,Tel: 041-570-2119, Fax: 041-592-3806, Email: doikim81@gmail.com,
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Received: June 23, 2020; Revised: October 1, 2020 Accepted: October 20, 2020. Published online: October 31, 2021. |
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| 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.
Method:
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. |
| Key words:
Neurologist; Consultation; Emergency |
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