Why Daniel is on the list
- Record review
- Review recommended
- Unplanned hospital episodes
- 1 in the past year
- Most recent 20 Aug 2026
- Care planning
- No advance care plan
- Not on the palliative care register in this record source
1 indicator present in the record
Unplanned hospital attendance on 20 Aug 2026: Acute right-sided weakness and dysarthria
Shaped after SPICT general indicator (service use) REC_ADMISSION_RECENT
Recorded 20 Aug 2026
Screening
No screening has been run for this patient.
Record review
The record supports a prompt clinical review for a goals-of-care conversation.
Prompt human review is appropriate because this 83-year-old arrived in the emergency department at the cutoff with an acute neurological change, right-sided weakness and dysarthria, under the stroke medical team at acuity 1. Earlier records also describe slower walking, light-headedness, headache and raised blood-pressure readings. This supports timely, proportionate review of priorities and escalation planning alongside urgent assessment, but not an immediate outlook-based conclusion: the snapshot gives no confirmed diagnosis, response to treatment, longitudinal disease history, residence, decision-making capacity, or documented care-planning record.
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What the record shows
Acute high-acuity neurological presentation
The abrupt functional and communication change warrants prompt clinician-led review of immediate priorities, capacity, appropriate escalation and who should be involved, while urgent stroke assessment continues.
1 source in the record
- Eligible20 Aug 2026
Hospital attendance records sudden neurological change, acute right-sided weakness and dysarthria, emergency-department arrival, acuity 1 and stroke-team involvement.
Recent change from usual mobility with intermittent neurological or circulatory symptoms
Slower usual walking, light-headedness, later intermittent headache and raised blood-pressure readings provide context suggesting a recent change from the documented usual baseline, although no causal diagnosis is recorded.
2 sources in the record
- Eligible
A GP telephone encounter states that he was slower on usual walks and had occasional light-headedness, without focal weakness, speech change or severe headache reported that day.
- Eligible
A later GP encounter records higher-than-usual blood-pressure readings and intermittent headache, with urgent-help advice for weakness or speech difficulty.
Recent renal and electrolyte abnormality
A prior marked sodium, creatinine and eGFR abnormality may represent a potentially reversible contributor or comorbidity that the treating clinician should reconcile rather than assuming irreversible decline.
2 sources in the record
- Eligible1 Jul 2026
Renal and electrolyte assessment recorded sodium 150 mmol/L, urea 8.4 mmol/L, creatinine 160 micromol/L and eGFR 42 mL/min/1.73m2.
- Eligible
A later U&E resource records sodium 143 mmol/L, creatinine 84 micromol/L and eGFR 83, indicating that the earlier abnormality was not consistently present in the available results.
What they and their family want
- Telephone is recorded as the patient's administrative contact preference.
- The patient's values, goals, understanding, treatment preferences and preferred participants are not documented.
- Decision-making capacity and communication accessibility during the acute neurological presentation are unknown.
- Family, carers, next of kin, health and welfare attorney, consent to involve others, and any legal planning records are unknown.
- The recorded telephone preference may not be suitable during acute dysarthria and should be reconfirmed when clinically appropriate.
2 sources in the record
- Eligible
An administrative observation records contact preference as telephone; the preceding fictional consultation notes discussion of contact preferences but gives no further preference detail.
- Eligible20 Aug 2026
The acute attendance documents dysarthria; no patient wishes, family details, capacity assessment or legal planning record appears in the snapshot.
Care at present
Unknown; no residence or current home setting is documented in the eligible snapshot.
Before the acute event, the only functional detail is that he took usual walks but had become slower; independence, activities of daily living, cognition, falls history and mobility aids are unknown.
- At the cutoff he was in the emergency department under the stroke medical team.
- GP and diagnostics authored recent encounters and laboratory reports, but the ongoing support arrangement is not documented.
- Residence and usual care setting are unknown.
- Baseline independence, cognition, communication, frailty, mobility aids and personal-care needs are unknown.
- Family and unpaid or paid carer availability is unknown.
- Medication list, diagnoses, allergies, current observations, imaging, treatment and response are unavailable.
2 sources in the record
- Eligible
A GP encounter records slower performance on usual walks; the snapshot has no structured residence, activities-of-daily-living, cognition, mobility-aid or carer information.
- Eligible20 Aug 2026
Current recorded location is the emergency department with the stroke medical team.
Clinical decision support only. A named clinician decides. Generated 12 Sept 2026, committed for the demonstration; wording adjusted to Cairn's language rules where the review used terms Cairn avoids.