Typical Neuro Consult Service

[TIAgirl]

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To residents and fellows at ANY neuro program: 😀

How many patients are typically on your consult census a day (average and range)?

How many does a resident see on average a day? How many on average are new consults? How many are follow ups?

 

[typhoonegator]

It will depend on whether consult services are split into general and stroke/ICU or lumped all together. I have done both. If you see stroke consults, you see a lot more people on a daily basis because of all the pre-op clearance calls and post-op deficits calls. I generally tried to see and write a note on every follow-up every day, which sounds rough, but it helps the primary team feel that you are watching, and can help cut down on all the question pages. On an average day, I would need to see 5-8 new patients, plus the new ones from overnight. It can get very busy. The number of follow-ups on your list depends a lot on your and the attending's style regarding signing off. Some attendings hate signing off, and want to keep the patient on the list until they are discharged. Personally, I like to limit follow-ups, and try to sign off when the consulting question has been sufficiently answered and the patient is likely to be neurologically stable until outpatient follow-up. As a PGY-4 general consult resident, I probably had 15 people on my list, but if things went well it could be as short as 5 at the end of the week. On stroke consult as a PGY-3, I had more, maybe 20-ish, but with more rapid list turnover.

ED consults are an entirely different animal. On a 24 hour shift, my record was 28 new consults. That was a bad day.

 

[neurolddoc]

On a 24 hour shift, my record was 28 new consults. That was a bad day.

By the end of the day it's hard to keep track of whether it was the person in Room 7 with a GCS of 13 or the other way around.