Neurological on-call transfers



CUH Department of Neurology Admissions policy:

The Neurology service endeavours to provide a rapid service for both direct admissions under the service, as well as consultations, as follows:

  1. Direct admissions under service during daytime will be seen on the same day.
  2. Overnight direct admissions under the Neurology service will be seen on the following morning.
  3. AMAU consultations should be seen on the day of request. Please phone the consult registrar to refer a case.

Cases appropriate for direct admission under Neurology service:

  1. Any patient where primary reason for admission is clearly neurological in nature, irrespective of co-morbidities
  2. Patients with acute stroke or history convincing for TIA age 64 or younger
  3. Meningismus or Headaches with abnormal CSF analysis and/or imaging (excluding subarachnoid haemorrhage)
  4. First or untreated seizures (in the absence of alcohol or illicit drug use) NB: if patient well/stable, consider referral to the Rapid Access Seizure Clinic (RASC)

Cases appropriate for Neurology consultation rather than direct admission:

  1. Patients where primary reason for admission is not neurological in origin, irrespective of prior or concurrent Neurological illness
  2. ‘Neurology patients’ (i.e. patients that already attend or have attended the Neurology outpatient clinic) who present with a non-neurological problem, particularly sepsis
  3. Seizures in the setting of alcohol or drug abuse
  4. Meningismus/headache with normal CSF analysis and normal imaging
  5. Acute Headaches
  6. Syncope
  7. Back pain

Of note, some cases may be appropriate for referral to the TIA clinic or Rapid Access Seizure Clinic, both of which are now in place.

This policy serves as a guideline. The Neurologist on-call is available by phone to discuss individual cases.

CUH-MUH city wide neurlogy transfers (July 2015)

  1. Patients will not be transferred from CUH to MUH. Patients that present to CUH with acute neurological presentations will be managed by the CUH. Admitting NCHDs shouldadhere to the admissions policy of the CUH Neurology department.
  2. Patients that present to the MUH with acute neurological presentations will be assessed by the ED/medical team at MUH. If transfer to CUH for immediate neurological care is sought, the consultant physician on call in MUH needs to contact the Neurologist oncall in CUH in person to discuss the case and request transfer. Interhospital transfers between the Neurology services at CUH and MUH can no longer be authorised by NCHDs. The consultant Neurologist oncall in CUH needs to be personally informed about potential transfers coming under their care. In general, cases appropriate for interhospital transfer are those with serious or lifethreatening emergencies that will require immediate neurological assessment.
  3. This policy also applies to other hospitals in the South/SouthWest Hospital Group.
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The Neurologist on-call is always available to discuss any case by phone.


The role of the Neurology service in the AMAU

Neurological Admissions CUH The Neurology service at CUH endeavours to provide a rapid service for both direct admissions under the service as well as consultations, as follows:

  1. Direct admissions under service during daytime will be seen on the same day
  2. Overnight direct admissions under the Neurology service will be seen on the following morning before 10am
  3. AMAU consultations will be seen on the day of request. Please submit written consult requests to 2A before 11am and call the registrar on-call for consults in person. Print version

Cases appropriate for direct admission under Neurology service:

  1. Any patient where primary reason for admission is clearly neurological in nature, irrespective of co-morbidities
  2. Patients with acute stroke or history convincing for TIA age 64 or younger
  3. Meningismus with abnormal CSF analysis
  4. First or untreated seizures if not suitable for CDU (First Seizure guideline)

Cases appropriate for Neurology consultation rather than direct admission:

  1. Patients where primary reason for admission is not neurological in origin, irrespective of prior or concurrent Neurological illness
  2. ‘Neurology patients’ (i.e. patients that already attend or have attended the Neurology outpatient clinic) who present with a non-neurological problem, particularly sepsis
  3. Seizures in the setting of alcohol or drug abuse (please also see First Seizure guideline)
  4. Meningismus with normal CSF analysis
  5. Acute Headaches
  6. Syncope
  7. Back pain

This policy serves as a guideline. The Neurologist on-call is available by phone to discuss cases. Print version this page



Content by Dr Daniel Costello, Dr Íomhar O' Sullivan 30/05/2011. last review Dr ÍOS 30/05/2011