Thanks to Giulia Giovannetti for developing this.
Neurological Observations MUST include the following:
Head injury is witnessed, reported, suspected, or cannot be excluded.
Post fall Neurological Observations must be completed for at least 12 hours and at the above intervals as a minimum:
During this time If there is any deterioration in the patient’s condition including level of consciousness, pupil reaction, limb power, cardiovascular observation you must revert to ½ hourly neurological observation and seek URGENT medical review.
Patients should be reviewed if no change in condition at 12 hours to ascertain if neurological observations are still indicated – this decision must be documented in the medical notes.
Under no circumstances should Neurological observations be omitted because the patient is asleep
Admitted with Head Injury
During this time If there is any deterioration in the patient’s condition, including level of consciousness, pupil reaction, limb power or cardiovascular observation you must revert to ½ hourly neurological observations and seek URGENT medical review. Patients should be reviewed if no change in condition at 12 hours to ascertain if neurological observations are still indicated – this decision must be documented in the medical notes.
Under no circumstances should Neurological observations be omitted because the patient is asleep.
During this time If there is any deterioration in the patient’s condition, including level of consciousness, pupil reaction, limb power or cardiovascular observation you must seek URGENT medical review and revert to ½ hourly neurological observations as a minimum, or ¼ hourly, if still within the first 2 hours post thrombolysis.
Under no circumstances should Neurological observations be omitted because the patient is asleep.
YAS crews may on occasions (rarely) bring us a Major Trauma patient that meets the criteria for bypass to the MTC because they have a problem that the crew cannot manage, or they won’t survive to LGI e.g. an unmanageable airway/ incompressible haemorrhage. In these instances we will get a pre-alert either from the crew or more likely the Major Trauma Triage Co-ordinator in EOC with some information but primarily the reason the patient is coming to us.
For ALL conditions leading to bradycardia treating the underlying condition is the most appropriate treatment and for some the only thing that will work (i.e. severe hypothermia) Read more
Seizures are a common neurological emergency in the neonatal period, occurring in 1–5 per 1000 live births.1 The majority of neonatal seizures are provoked by an acute illness or brain insult with an underlying aetiology either documented or suspected, that is, these are acute provoked seizures (as opposed to epilepsy). They are also invariably focal in nature.
Clinical diagnosis of neonatal seizures is difficult. This is in part because there may be no, or very subtle, clinical features, and also because neonates frequently exhibit non-epileptic movements that can be mistaken for epileptic seizures.
How to apply the FERNO traction splint for our in-hospital patients
LVADs (Left Ventricular Assist Device) are becoming more common and there are patients in our region with them as a bridge to transplant or recovery and in some cases a destination therapy.
The patient and their family will likely know more about this device than you and should have brought spare parts. Our local LVAD centre is Wythenshaw however, there are other units around the country the patient may direct you to.
The patient may not have a palpable pulse, the blood pressure will be low and the heart pump sounds like a buzz when you listen.
If patient is unresponsive or has a history of collapse its important to troubleshoot the device and resusitation may be required
