Improving recognition and stabilization of neurological emergency cases in Malaysia

In Malaysia, death statistics related to cerebrovascular accidents have shown a consistent increase in recent years, making it the third most common cause of death following ischemic heart disease and pneumonia. Additionally, it is estimated that by 2030, cerebrovascular accidents will become the second most common cause of death among Malaysians. This alarming trend has highlighted the need for more aggressive action from stakeholders and clinicians to combat this situation.

Recognizing the importance of early recognition and stabilization of neurological emergency cases at the emergency department, the "Neuroemergency Special Interest Group" was established to lessen the gap between treating primary team clinicians and emergency physicians. The group aims to disseminate information and evidence-based management related to neurological emergency cases and promote active involvement and learning through patient care among interdisciplinary teams. While neurological emergency is a known subspecialty for neurologists, emergency physicians currently have no pathway to address it. The versatility of neurological emergency cases makes it most suitable for emergency physicians, as it overlaps with acute critical care interventions and other disciplines. Early recognition, followed by early stabilization and good referral to the appropriate team, is crucial to improving patient outcomes.

The Malaysian NeuroEmergency Special Interest Group (NeuroEM SIG) was recognized as a special interest group in February 2022 by the Malaysia Colleague of Emergency Physicians. The group promotes free monthly virtual CME, with expert speakers selected from emergency physicians, neurologists, neurosurgeons, pediatric neurologists, neuro-ophthalmologists, neuropsychiatrists, neuro-radiologists, and neuro-rehabilitation specialists. Sessions are conducted every Saturday, and each lecture is one hour long, with the number of lectures increased to two per session due to high demand. Lectures are recorded and uploaded to the group's Facebook page and YouTube channel for those who cannot attend. The group also introduced Malaysia Emergency Neurological Life Support (MyENeLS), a modified version of Emergency Neurological Life Support (ENLS) training that includes basic neuroanatomical knowledge and localization to complete the training.

In addition to medical education, the Malaysian NeuroEM SIG is actively involved in promoting public awareness about neurological emergencies through radio stations and collaborations with other departments, as well as working with neurologists as part of the Malaysia Stroke Conference (MSC), one of the biggest conferences in Malaysia.