Neurological Section

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Cork City Neurology Transfer Agreement

  1. When the CUH is on-call for Acute Neurology, patients who present to the MUH ED should be sent to the CUH for Neurology review if this is indicated. Print version
    1. This will be decided by the medical team on-call in the MUH who will refer patients based on clinical need to the Neurology service in the CUH.
    2. The Medical Registrar in the MUH will call the Medical Registrar assigned to the ED in the CUH to effect transfer.
  2. Patients should not be sent to CUH for the sole purpose of obtaining a CT scan. There is a procedure for accessing CT scans in the MUH at night involving consultant-to-consultant (consultant physician/surgeon on call to MUH contacts Radiology consultant on call to MUH). Print version
  3. If a patient is sent to the CUH for Neurological care, they are being transferred. As such, they should either be admitted there or discharged, after discussion with the Neurologist on-call. They should not be returned to the MUH.
  4. This is a reciprocal policy- when the CUH is ‘off call’ for Neurology, the Medical Registrar assigned to the ED in CUH will contact the Medical Registrar on-call in the MUH to effect transfer.

Transfers from all other hospitals need to be discussed with the Neurologist on-call before transfer, particularly critically ill patients. Print version

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