Curriculum for General Practice - The Royal New Zealand College ...

N Curriculum Neurology for General Practice
Another significant neurological presentation is brain injury.
This can be anything from an internal trauma to a traumatic
brain injury (TBI). The major causes of TBI are motor vehicle
crashes, followed by sports injuries, assaults and falls. The
highest-risk groups for sustaining TBI are children under
5 years of age, men aged 15-30 years, and the elderly. 5
Significant accidents leading to neurological consequences
commonly happen on rural roads.
A general practitioner needs to be vigilant when assessing
both acute and chronic neurological conditions, and be able
to manage them competently and recognise the long-term
nature of some of these conditions.
Communication
The GP will demonstrate the ability to:
• take a comprehensive history of the neurological
symptoms while establishing the relationship and
maintaining a rapport
• communicate restrictions on activities that chronic
neurological conditions might require, such as restrictions
on driving for patients with epilepsy.
• explain common neurological diagnoses and their
implications to their patients and family/whānau in
a manner understandable to the patient
Clinical Expertise
The GP will demonstrate the ability to:
• identify red flags relating to neurological conditions
and refer accordingly, for example temporal arteritis
• manage head injury, including acute assessment,
transfer from a rural area as necessary, and postconcussion
issues
• diagnose common neurological disorders and treat
and prescribe appropriately
• initiate palliative care when required for chronic
or inoperable neurological conditions
• conduct a full neurological examination, taking into
consideration history and time constraints
• investigate for risk of developing neurological conditions
• treat acute neurological emergencies, such as status
epilepticus
• provide ongoing management for patients with paraplegia
or tetraplegia while supporting independence as much as
possible and encourage a team approach
• discuss sequelae of chronic neurological conditions and
the impact on other health care, such as migraine with
aura and oral contraception
• recognise the impact of chronic neurological conditions
on a patient’s relationships, occupations, social status
and everyday function.
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Curriculum for General Practice