When I was a lad I was taught always to admit a patient who had their
first fit, on the basis that you didn't have any indication of whether
this was progressive or not until time had elapsed.
Within days of the Royal Preston Hospital opening 24 years ago I
admitted one such 40 year old from a house where the electricity had
been cut off. The House Officer was pretty stroppy about it and
practically told me to Foxtrot Oscar. The gentleman in question was the
first person to drown in one of the hospital baths....
It's another little anecdote - perhaps we should have a clinically
From: [log in to unmask]
[mailto:[log in to unmask]] On Behalf Of elizabeth gilby
Sent: 23 June 2004 12:53
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
who have no ongoing neurological signs or symptoms to warrant medical
If so, what investigations are performed in the ED and does anyone have
experience of investigating these patients via an observation unit? (
would you scan all first fitters?)
Our neurology department at present offers no first fit clinic and a
long wait for outpatient follow up.
I am trying to develop some guidelines for the management of these
but there is not much evidence out there!
ED SpR Bath
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