The number needed to scan, must be quite easy to find out in the
literature. But locally our neurology service has a 1st fit assessment
clinic they organise the appropriate tests. Obviously some turn out not
to be first fits but syncopal episodes.
Andy Webster
+44 226750279 (home)
+44 7989 587971 (mobile)
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Adrian Boyle
Sent: 23 June 2004 13:22
To: [log in to unmask]
Subject: Re: First fit
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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