> I tried to do the same here at Poole
> There is some good evidence that the only important
> serological tests needed are Na and Glucose.
> Regarding identifying SOL, this is difficult. Only a small
> number will have such a lesion and 50% of those with a lesion
> will have a normal CT... ie MRI is what is really needed.
> Essesntially if there are no other reasons to admit them
> under the physicians, we admit them, scan them during daytime
> hours(CT but preferably MRI) and then follow them up in the
> A+E clinic.
What do you do in clinic that can't be done as well or better at the time or
by the GP? Also not intrigued about "if there are no other reasons to admit
them... we admit them". Why are they better under A and E than under
physicians? Are there things you pick up that physicians don't? Or is this
just a straightforward review of the radiology? (And if so, why not either
give them the results at the time or the option of getting them sent on
rather than coming to clinic- because of covering a fairly large area, I
tend to be a bit wary about bringing patients back for something that can be
sorted at their GP's surgery or over the telephone). It sounds as though
you've got an interest in "fits" (I presume you're looking at more that
straighforwards new onset epilepsy) than most A and E departments don't,
which sounds interesting. What sorts of stuff are you picking up? Do you
find that A and E training gives particular advantages in this field, and if
so, what?
Matt Dunn
Warwick
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