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Customer
Customer Unit
Reminder:
No Pediatric Neurology Consults are available. Please confirm that the patient is 18 years old.
Pediatric Neurosurgical Consults are available.
Patient Gender
Urgency
Consult Type
Suspected Stroke?
tPA Candidate
Suspect large vessel occlusion?
Gaze
Arm Weakness
Alteration of Consciousness
A C-stat score of 2 or greater indicates increased risk of LVO,
consider obtaining CT Angiogram of head and neck for confirmation of LVO.
Please add the indicated points and select the score amount.
Neurological Exam Reason
Neurosurgical Exam Reason
Last Known Normal
Please ensure that CT and/or MRI images have been sent to Net Medical
by the radiology department prior to the consult.
Imaging To Be Sent
Cart Name
Screen Says "Waiting For Call"?
Is the Patient Being Moved
to a Different Unit?
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