Blogs

Peter J. Papadakos MD, FCCM, FCCP, FAARC, FNIV The worldwide pandemic has developed many stressors on those in the Neuro ICU, such as taking care of critically ill non-Neuro Patients outside of normal comfort level, overworked staff, and working in areas we have not normally had too: such as caring for patients in overflow ICU’s such as recovery rooms. It has also brought into focus an already identified problem, that of ICU staff burnout. The literature defines burnout as “exhaustion of physical or emotional strength or motivation, usually the result of prolonged stress or frustration”. The last two years have greatly increased the stress as hospitals are ...
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“Stories of Hope” is a popular column on the Neurocritical Care Society’s Currents content center. This series has been uplifting patients and providers alike since its founding. To support NCS’s Curing Coma ® initiative, which aims to develop and implement coma treatment strategies that improve human lives, we invite you to share your stories. We are seeking submissions for your "Stories of Hope" that specifically showcase inspiring stories related to coma, stroke or TBI.  We hope to use these experiences to create stories and profiles to feature on Currents , highlighting how coma has impacted families and how donations to Curing Coma can help. ...
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Verticalization for Refractory Intracranial Hypertension: A Case Series Neurocritical Care (08/17/21) DOI: 10.1007/s12028-021-01323-z Lachance, Brittany Bolduc; Chang, WanTsu; Motta, Melissa; et al. https://link.springer.com/article/10.1007%2Fs12028-021-01323-z   Researchers present a retrospective review of six cases of refractory intracranial hypertension in a tertiary care center. The authors also report a novel intervention of verticalization for treating intracranial hypertension refractory to aggressive medical treatment. The patients — five of whom were admitted with subarachnoid hemorrhage and one with intracerebral hemorrhage — were ...
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Hana Nobleza, Marin Darsie, H.E. Hinson, Deepa Malaiyandi, and Diana Greene-Chandos The past year has been hard for all of us. Our resilience, commitment and passion to our patients, and profession have been put to the test. Despite the challenge that the year brought, the Inclusion in Neurocritical Care Committee (INCC), section and its members have been working to uphold the NCS commitment to enhancing Diversity, Equity and Inclusion within the society.   With that said, we wanted to share the upcoming INCC and INCC-related events taking place during the NCS 19 th Annual Meeting later this month. We also wanted to include upcoming INCC activities ...
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The Neurocritical Care Society is excited to launch the 2021 issue of Currents , featuring a compilation of articles published on Currents over the past year. This special annual issue highlights themes of adapting our life, and our practice, to our ever-changing world. Download your copy to read stories of navigating the ongoing pandemic, the commitment to diversity and inclusion, the business of neurocritical care, the popular "Stories of Hope" and more. Currents  highlights innovative ideas and perspectives from multidisciplinary neurocritical care clinicians, and we welcome you to share your insight with us. Please email  Editor-in-Chief Michael ...
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By Wade Smith, MD, PhD, FNCS A 'See You Soon' and a 'Farewell' Dear NCS Members, As I write my final message as NCS President, I’m looking forward to connecting with you all at the NCS 19th Annual Meeting — in both our Chicago and virtual venues. On behalf of the Board of Directors and Annual Meeting Committee, I am pleased to share that NCS will be moving forward with our Annual Meeting as planned, with both in-person and virtual participation options. Offering two ways to attend is a fantastic opportunity to reconnect personally and professionally for the first time in nearly two years. It is our goal to deliver a meaningful experience filled ...
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Co-Chairs of the Member Sites Module Chethan Venkatasubba Rao, MD, FNCS cprao@bcm.edu Briana Witherspoon, DNP, APRN, ACNP Briana.Witherspoon@UTSouthwestern.edu Curing Coma®  is the signature clinical, scientific, and public health effort of the Neurocritical Care Society. Curing Coma is comprised of several modules, all of which share the common goal of advancing the campaign’s mission (1, 2). The role of the Member Sites module is to create and maintain a platform that engages and facilitates multidisciplinary participation from various centers of care such as hospitals, academic institutions, and health care systems. Following this ...
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Management of Arterial Partial Pressure of Carbon Dioxide in the First Week after Traumatic Brain Injury: Results from the CENTER-TBI Study Intensive Care Medicine (07/24/21) DOI: 10.1007/s00134-021-06470-7 Citerio, Giuseppe; Robba, Chiara; Rebora, Paola; et al. https://link.springer.com/article/10.1007%2Fs00134-021-06470-7   A secondary analysis of data from the CENTER-TBI study found substantial practice variation among countries and centers in terms of arterial partial pressure of carbon dioxide (PaCO 2 ) levels for patients in the first week after traumatic brain injury (TBI). Additionally, patients who received intracranial pressure monitoring ...
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Diane McLaughlin, DNP, UF Health Jacksonville, Department of Neurology and Kimberly McPhearson, DO, Mayo Clinic Jacksonville, Department of Critical Care Neurological checks (neuro checks) are brief, serial bedside exams performed by nursing to evaluate for changes in clinical status or neurological function. Historically conducted hourly in the neuroscience intensive care unit (NSICU), patients undergo these evaluations regardless of the time of day. A typical neuro check often includes assessment for pupillary response and level of consciousness, most often rated via the Glasgow Coma Scale (GCS) score, which assesses a patient’s ability to open their eyes ...
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By Yingying Su In 2012, the brain injury evaluation quality control center of the National Health Commission of the people's Republic of China (BQCC / PRC / NHC) was established and attached to Xuanwu Hospital of Capital Medical University. So far, the standardized training of brain death (BD) determination in China has gone through a ten-year journey. In the past ten years, we have completed two "five-year plans," and implemented the “Xinghuo” training plan and the “Liaoyuan” training plan.   The training objectives of the “Xinghuo” training program first focus on the professional doctors (working time longer than 5 years) or technicians (working time ...
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By Jocelyn Owusu-Guha, PharmD, BCCCP and Pamela L. Buschur, PharmD, BCPS, OhioHealth Riverside Methodist Hospital, Columbus Ohio Nimodipine, a lipophilic calcium channel antagonist, has been established as a standard of care in the management of aneurysmal subarachnoid hemorrhage (SAH). Approved by the Food and Drug Administration in 1988, nimodipine has been shown in multiple clinical trials to decrease the incidence of delayed cerebral ischemia and improve neurological outcomes. 1-2 The current American Heart Association and American Stroke Association guidelines recommend the administration of nimodipine to all patients with aneurysmal SAH. 3 The conventional ...
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By: Kelly A. Rath and Diane C. McLaughlin On Behalf of the NCS APP Leadership Section “The brain is the organ of destiny. It holds within its humming mechanism secrets that will determine the future of the human race.” Wilder Penfield, Neurosurgeon   Despite historically considered “born” in the beginning of the 20 th century, and many reports of early neurosurgery being performed centuries before that, neurocritical care itself is a relatively new specialty.  The Neurocritical Care Society was founded in 2002, with the field being recognized as a neurological subspecialty in 2005. 1   Fewer than 1500 neurointensivists hold this credential worldwide despite ...
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By Shweta Goswami, MD; Eunice J Lee, MD; Rachael Scott, PharmD, BCCCP; Naomi Niznick, MD; Sasha Yakhkind, MD; Pouya Ameli, MD, MS; and Marc Babi, MD The role of practice management education—an umbrella term to describe salary negotiation, billing and coding, law and malpractice, and so on—has been lacking in residency and fellowship programs across the country. In fact, prior surveys have indicated a nearly universal lack of confidence in these topics among trainees across different specialties. Meanwhile, some specialties such as family medicine have shown that formal practice management training is an effective approach in improving coding compliance, ...
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By: NCS Research Operations Subcommittee: Caitlin Brown PharmD, Michelle Schober MD, Shraddha Mainali MD, Cassia Righy MD, Minjee Kim MD, Tom Lawson CNP, Jennifer Kim MD, PhD, Ruchi Jha MD Can you tell me a little about yourself and how you got involved in the Neurocritical Care Society?   I am a Pediatric Neurointensivist and Associate Professor of Pediatric Critical Care Medicine at Primary Children’s Hospital.  I grew up in the United States and Colombia and completed all my medical training in both countries.  During my pediatric critical care fellowship at the University of Miami I became interested in bench research. Since that time, I have developed ...
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Yasser B. Abulhasan, MBChB, FRCPC, FNCS, Chairman, Neurocritical Care-MENA Chapter of IPACCMS It was a great pleasure organizing the 2 nd Neurocritical Care Regional Meeting in the Middle East and Africa in conjunction with the 17 th edition of the Emirates Critical Care Conference (ECCC). The meeting got delayed by more than a year due to the COVID-19 pandemic, ultimately taking place in a hybrid format (both in person and virtual) on June 18 and 19, 2021. This was a challenging yet exciting event from the start. We wanted to exceed expectations after the success of the First Regional Meeting. But after finalizing the scientific content, speakers, workshops, ...
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Ryan Hakimi, DO, MS, NVS, RPNI, CPB, FNCS This series will be a running feature highlighting billing, coding, practice management, and other business aspects of neurocritical care. When assembling and organizing a Neuro ICU team, one must begin with the end in mind. It is important to note that each organization defines financial success of the Neuro ICU differently. To meet the organization’s marker of success, one must first determine how it is defined by the organization and then adapt staffing and documentation to best meet these goals while considering the case mix and payer mix. Here we describe some common models with pros and cons for each: ...
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By Wade Smith, MD, PhD, FNCS Fulfilling Our Mission Through Education Dear NCS Members, Fall brings with it many new beginnings, and as students return to school, we as neurocritical care practitioners can take the time to enhance our own practice, as well. While we may have already completed our formal education, continuing education is a crucial part of our career. By keeping up with what’s new in the field, we stay current with the science and knowledge that helps us improve patient care. As an NCS member, you have access to a library of certification courses , continuing education programs and clinical resources that keep you in the know ...
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Prevalence, Characteristics, and Outcomes of Undetermined Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis Stroke (08/04/21) DOI: 10.1161/STROKEAHA.120.031471 Malhotra, Konark; Zompola, Christina; Theodorou, Aikaterini; et al. https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.031471   Researchers evaluated the prevalence, radiological characteristics, and clinical outcomes of intracerebral hemorrhage (ICH) of undetermined etiology. The study involved a systematic review and meta-analysis of studies involving patients with spontaneous ICH, as well as an assessment of the rates for ICH secondary to hypertensive arteriopathy and ...
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Risk of Acute Myocardial Infarction and Ischaemic Stroke Following COVID-19 in Sweden: A Self-Controlled Case Series and Matched Cohort Study The Lancet (08/14/21) Vol. 398, No. 10300, P. 599 DOI: 10.1016/S0140-6736(21)00896-5 Katsoularis, Ioannis; Fonseca-Rodríguez, Osvaldo; Farrington, Paddy; et al. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00896-5/fulltext   COVID-19 is an independent risk factor for acute myocardial infarction (MI) and ischemic stroke, according to new research out of Sweden. The study is believed to be the largest one conducted thus far on the association between COVID-19 and acute cardiovascular ...
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Reviewed by Shannon Hextrum, MD Early coma induction for status epilepticus after benzodiazepine therapy shortens duration of status and ICU length of stay.  De Stefano P, Baumann SM, Semmlack S, et al. Safety and Efficacy of Coma Induction Following First-Line Treatment in Status Epilepticus: A Two-Center Study [published online ahead of print, 2021 May 27].  Neurology . 2021;10.1212/WNL.0000000000012292. doi:10.1212/WNL.00000000000122   Read the full article. Background: The treatment approach for status epilepticus (SE) endorsed by international guidelines recommends benzodiazepines as first-line therapy, followed by additional non-anesthetic ...
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