Journal Article

127 Analysis of neurological examinations performed by non-specialists referring to acute neurology

Haider, Salman, Chandratheva, Arvind, Aojula, Anuriti, Sacks, Benjamin, Simister, Robert, Johnson, Rebecca, Lester, Sabrina

2025

Overview

BackgroundIn the acute setting, performance of a targeted neurological examination by non-neurologists prior to referral is an expected standard of care.AimsThe aims were to characterise the reasons for acute neurology service referral and determine the percentage of neurological examinations including fundoscopy performed by non-neurologists prior to acute neurology input.MethodsConsecutive referrals to the acute neurology service at two hospital sites over a four-month period in 2024 were analysed. An expected standard of documented neurological examination prior to specialist referral was created and independently verified by a panel of neurology consultants.ResultsOf 232 referrals across two hospital sites, 39.3% had a targeted neurological examination documented, 10% had no documented neurological examination and 9% had only GCS or pupillary reflexes documented. For lower limb examinations, deep tendon reflexes were the least commonly performed component, documented in 35% of referrals. Of the referrals that qualified for fundoscopy assessment (n=43), an examination was documented in 16%. Seizures were the most common reason for referral (19.8%).DiscussionThis audit highlights that the majority of acute neurology referrals lacked a documented neurological examination. Future efforts will include identifying and overcoming real and perceived barriers to performing a neurological examination amongst [e-mail]

• Publisher: BMJ Publishing Group LTD
• Subject: Neurology