Objectives This audit evaluates the assessment of first seizures in over 75-year-olds within our centre using NICE guidance (CG137) as our standard. This is in response to the National Audit of Seizure management in Hospitals which revealed significant deficits in current practice.
Design A retrospective audit design was used.
Subjects We reviewed patient records of 74 patients over the age of 75 who presented to A+E with their first seizure between 1 st January and 30th April 2017.
Methods Data entry took place between 14th November and 22nd January when follow-up information should have been available. A proforma based on current NICE guidance was used to evaluate initial assessment, investigations and specialist review.
Results 38 females and 36 males were assessed with an average age of 83 years (range 76–95). NICE recommends that all patients are seen by a specialist within 2 weeks, however only 38% of our patients met this standard. Only 65% of patients indicated for an EEG had one and 34% waited longer than the recommended 4 weeks. Neuroimaging was optimal with 95% of patients receiving an MRI within 4 weeks. In contrast, blood glucose was only measured in 47% of patients and only 51% had a 12-lead ECG despite recommendations that these investigations should be performed routinely.
Conclusions There is a lack of comprehensive A+E assessments and specialist referral for older people both within our centre and nationally. A more thorough and integrated approach is needed to improve outcomes and optimise care.
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