A cerebral event should be excluded in a patient presenting with acute confusion and memory loss.
As a GP also working in your local hospital’s emergency department, you get to see and look after patients with a wide spectrum of diseases, both common and rare. You are also acquainted with some patients or their families and this can put extra stress on you.
Arrival at hospital
You had just started your shift and were thinking you had better organise yourself a cup of coffee, as often you just do not get the time, when you were asked to look at an elderly woman who had been brought in by her son whom you happen to know. Over your many years in medical practice you have learnt (at times by the mistake of granting concessions to the ‘rules’) to always care for all patients (including friends, VIPs, unpleasant patients and relatives) in the same methodical way. So you took the patient’s file and some stickers and progress notes to record the history and management and went to meet her.The patient was a pleasant, well kempt, 70-year-old woman surrounded by concerned family. The presenting symptoms were acute confusion and loss of memory. The triage nurse, concerned that it may have been an acute stroke, had given an urgent triage category of 2 (to be seen within 10 minutes) – functionally, to be seen straight away.