Neurology Emergency patient

Emergency Services: Available 24 hours and all days of the week

What constitutes a Neurology Emergency?

Stroke – within 3-4 hours of stroke onset – patient will be eligible for thrombolysis therapy; other strokes with onset less than a week will be seen and evaluated in emergency. Strokes which have occurred earlier than a week will be evaluated only in the OPD.

• Seizures or ‘Fits’ – that have occurred in the previous 24 hours.
• Excessive drowsiness or Unconsciousness – Patients who are sleeping excessively and non-responsive to spoken words
• Severe Headache – Severe headache with or without fever which may suggest a brain infection, meningitis or brain haemorrhage or even brain tumour.

Who will I meet when I bring the patient to Emergency?

• When you wish to avail the emergency neurology service, you will be first seen by a Casualty medical officer (CMO) in the emergency ward, who will assess your complaints and then refer you appropriately either to the neurologist / neurosurgeon / psychiatrist.
• Following this you will be seen by the Neurology residents and if required, appropriate investigations will be done and admitted if required. In case the medical problem that pertains to any other system in the body (outside the brain), and is non-neurological, you will be referred to any general hospital.
• If the patient does not warrant admission, NIMHANS being a tertiary care hospital; once the appropriate investigations and treatment are given in the emergency, patient can be further referred to any general hospital based on the medical issues.

How long will it take to see the Neurologist in the Emergency?

– You will be seen within 15-20 minutes by the neurology team. Then, based on the condition of the patient, will be seen by the consultant neurologist.

I am an earlier patient of Neurology, in what situations should I come to casualty instead of the follow up OPD?

• Patients with seizures (fits), who experience recurrent seizures,
• Sudden loss of vision, speech disturbance or weakness of any part of the body,
• Sudden difficulty in swallowing or difficulty in breathing,
• Sleeping excessively and not responding to any verbal commands,
• Severe headache with vomiting and/or fever.

Can I meet my earlier doctor if I come to Casualty?

– You will be seen initially by the duty team doctor and then your previous doctor will be informed, who will see you later after appropriate investigations. I am not sure if it is an emergency, what do I do? – If you do not have the symptoms as mentioned above then you can come and meet your doctor in the follow-up OPD. Please see the reference card given earlier for day and time.

Will I be admitted or referred to another hospital?

– You will be assessed by the neurologist and based on the medical condition, you will be either admitted or referred to a general hospital. In case you require ICU care and there is non-availability of ICU beds, you will be referred to general hospital for emergency ICU management.

Is there a way I can phone a doctor in an emergency?

– No. However, you can come to our casualty and Emergency wing 24x 7.