I've certainly worked in a number of places where there are clear guidelines
for referral to neurology outpatients. Most neurologists seem to want a scan
beforehand and some bloods. This might be a good subject for a decision
rule, "which first fits need a scan?" since so many first fits are due to
primary epilepsy.
Adrian Boyle
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of elizabeth gilby
Sent: Wednesday, June 23, 2004 12:53 PM
To: [log in to unmask]
Subject: Re: First fit
Has any department developed a "first fit" guideline in adults?
I am particularly interested in those patients with unprovoked first fits
who have no ongoing neurological signs or symptoms to warrant medical
admission.
If so, what investigations are performed in the ED and does anyone have
experience of investigating these patients via an observation unit? ( ie.
would you scan all first fitters?)
Our neurology department at present offers no first fit clinic and a fairly
long wait for outpatient follow up.
I am trying to develop some guidelines for the management of these patients
but there is not much evidence out there!
Many thanks!
Liz Gilby
ED SpR Bath
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