Blogs

Richard Choi, DO Please note this opinion piece reflects the views of the author and does not necessarily reflect the position of ChristianaCare.   The recent wave of increased social and racial injustice awareness as well as the significant increase in anti-Asian hate crimes 1 have had me reflecting on my life-long cultural and racial experiences.  As a Chinese-Korean American child growing up in Spain in the 80s and 90s, I unfortunately became accustomed to experiencing racist behaviors and slurs such as people holding their eyes in a slanted-eye gesture while yelling ‘Ching Chong.’ In order to blend in, I “white-washed” myself: I refused to speak ...
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Lindner A, Rass V, Ianosi BA, et al. The Importance of PbtO2 Probe Location for Data Interpretation in Patients with Intracerebral Hemorrhage. Neurocritical Care . 2020 Sep 11:1-0.  Reviewed by Wazim Mohamed, MD Read the Article Background : Secondary brain injury after spontaneous intracerebral hemorrhage (ICH) continues to have a significant impact on long-term morbidity and mortality. Brain tissue oxygen tension monitoring (PbtO2) is an additional neuromonitoring modality that may provide insight into the extent of secondary brain injury after ICH, helping to identify targets to improve brain tissue hypoxia (BTH). One of the traditional arguments ...
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By Wade Smith, MD, PhD, FNCS COVID-19 Vaccinations: Hope Is on the Horizon Dear NCS Members, As hopeful news about COVID-19 vaccines spreads nationwide, we can start looking forward to a safe return to our regular lives. Rates of hospitalizations have fallen across the United States. All states are offering vaccinations to all people over 16 years old. With the Centers for Disease Control allowing domestic travel for those who are fully vaccinated, as well as following recommendations for international travel, many universities are relaxing restrictions on travel for vaccinated faculty and staff. I suspect this will allow for the potential of academic ...
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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.  Although all of us received extensive education and training in the care of neurocritical care patients, few if any of us received any training on the non-patient care aspects of our daily jobs. The goal of this series will be to increase your value as a neurocritical care provider to your organization while improving regulatory compliance and hospital-based metrics. Physician neurointensivists come from a variety of specialties and similarly are housed in a variety of hospital ...
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The Lancet Psychiatry (04/06/21) DOI: 10.1016/S2215-0366(21)00084-5 Taquet, Maxime; Geddes, John R.; Husain, Masud; et al. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00084-5/fulltext Approximately a third of people diagnosed with COVID-19 exhibited longer term neurological and psychiatric symptoms, a new study shows. For the retrospective cohort study, researchers from the University of Oxford examined the health records of 236,379 patients in the six months following their COVID-19 diagnosis and estimated the incidence of 14 neurological and psychiatric outcomes during that time. The estimated incidence of any neurological or ...
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Curing Coma Campaign Mission Control Keri S. Kim, PharmD, MS CTS Shraddha Mainali, MD Len Polizzotto, PhD Jose Suarez, MD, FNCS, FANA Claude Hemphill, MD, MAS, FNCS Daiwai Olson, PhD, RN, FNCS The Curing Coma Campaign (CCC) is a global public health initiative with an overarching goal of developing and implementing diagnostic, therapeutic and prognostic strategies to improve the lives of patients with coma and disorders of consciousness. World Coma Day, an initiative of the CCC was organized as a virtual event targeting a global audience and is a part of an ongoing clinical and scientific endeavor to improve ...
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J. Spencer Dingman, PharmD, BCCCP Neurocritical Care Pharmacy Specialist Wesley Medical Center, Wichita, KS James.dingman@wesleymc.com Brian W. Gilbert, PharmD, BCCCP, BCPS Emergency Medicine Pharmacy Specialist Wesley Medical Center, Wichita, KS Brian.gilbert@wesleymc.com With Sean Di Paola, PA-C, MPAS Emergency Medicine Physician Assistant Wesley Medical Center, Wichita, KS Sean.dipaola@carepointhc.com Christopher D. Cassidy, MD Emergency Medicine Physician Wesley Medical Center, Wichita, KS Christopher.cassidy@carepointhc.com Time-to-intervention has become well-recognized as an important quality measure in numerous areas of medicine, ...
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Dyan Fleming, PharmD, BCPS, BCCCPS Treating neurocritical care patients in Alaska, land of the midnight sun, comes with unique geographical, environmental, and seasonal challenges. Navigating these challenges requires careful planning coupled with complex coordination of medical care to minimize delays and optimize patient outcomes as much as possible through all transitions and levels of care.  Alaskans are resilient when it comes to dealing with crises in the harsh elements and sometimes “wild” remoteness.  Can you imagine for a minute- it’s January and 15° F.  You only have 4 hours of daylight, and you live in Akun, Alaska, an island which has no real ...
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JAMA Neurology (03/01/21) DOI: 10.1001/jamaneurol.2021.0023 Wilcock, Andrew D.; Schwamm, Lee H.; Zubizarreta, Jose R.; et al. https://jamanetwork.com/journals/jamaneurology/article-abstract/2776793   Patients with ischemic stroke who received care at hospitals with telestroke services are more likely to receive reperfusion therapy, and their 30-day mortality rate is lower than that for patients treated at hospitals without telestroke capacity, according to a large study. The study, which include 153,272 patients treated for stroke, found that increases in reperfusion treatment were highest among smaller hospitals, among rural residents, and among individuals ...
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JAMA Neurology (04/05/21) DOI: 10.1001/jamaneurol.2021.0520 Guterman, Elan L.; Betjemann, John P.; Aimetti, Alex; et al. https://jamanetwork.com/journals/jamaneurology/article-abstract/2777805 Highly refractory status epilepticus (SE) is associated with increased hospitalization costs and worse outcomes, according to new research. The cross-sectional study evaluated 43,988 hospitalizations related to SE from 2016 through 2018 in the United States. Patients were categorized by the administration of antiseizure drugs given while hospitalized: low refractoriness (treatment with none or one intravenous antiseizure drug), moderate refractoriness (more than ...
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Recommendations for Regional Stroke Destination Plans in Rural, Suburban, and Urban Communities From the Prehospital Stroke System of Care Consensus Conference: A Consensus Statement From the American Academy of Neurology, American Heart Association/American Stroke Association, American Society of Neuroradiology, National Association of EMS Physicians, National Association of State EMS Officials, Society of NeuroInterventional Surgery, and Society of Vascular and Interventional Neurology: Endorsed by the Neurocritical Care Society Stroke (03/11/21) DOI: 10.1161/STROKEAHA.120.033228 Jauch, Edward C.; Schwamm, Lee H.; Panagos, Peter D.; et al.   https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.033228 ...
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By Wade Smith, MD, PhD, FNCS, and Paul Nyquist, MD/MPH, FANA, FCCM, FAAN Introducing the Neurocritical Care Foundation Dear NCS Members, It was wonderful to engage with you all during World Coma Day on March 22. I am proud to lead a society that prioritizes raising awareness of coma as a treatable and recoverable clinical entity. Thank you to all who made the inaugural World Coma Day a success. World Coma Day is not the only new initiative 2021 is bringing our society. I am thrilled to announce that the NCS Board of Directors approved the founding of the Neurocritical Care Foundation (NCCF) during our March board meeting. The NCCF is a significant ...
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Bindi Parikh, MD, Neurology Resident, University of Minnesota Christine Yeager, MD, Assistant Professor of Neurology, University of Minnesota     Section Editor Lauren Koffman, DO, MS One Thursday, amidst the peak of the COVID-19 pandemic, Naema had been working from home as a student advisor and was carrying out her usual activities. Though she did not feel quite herself, she drove herself to take care of errands and later went outside for a run. She recalls, “I was feeling off, my appetite was off. I didn’t know at the time that I was walking off to the left.” Naema recalls a visit with an ENT for ear pain the week prior and states “they ...
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Circulation (03/08/21) DOI: 10.1161/CIR.0000000000000958 Dezfulian, Cameron; Orkin, Aaron M.; Maron, Bradley A.; et al. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000958 Opioid-associated out-of-hospital cardiac arrest (OA-OHCA) is clinically different from other types of cardiac arrest and more education is needed for people to recognize signs of an overdose, the American Heart Association (AHA) says in a new scientific statement. The "distinct features of OA-OHCA demand a critical appraisal of education and policy decisions to improve outcomes," according to the AHA. More than 2 million Americans have opioid use disorder, and opioid overdose ...
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Deepa Malaiyandi MD, Hana Nobleza MD, Marin Darsie MD, H.E. Hinson, MD Welcome to the new Inclusion in Neurocritical Care (INCC) Corner of Currents .  Our Editorial Board Members Drs. Hana Nobleza (WINCC Subcommittee Co-Chair) and Deepa Malaiyandi (INCC Chair) are excited to be able to bring the membership curated content on all things highlighting the diversity, equity and inclusion efforts and opportunities within NCS. The INCC Corner is authored by the new INCC Committee and INCC Section,which are all expansions of the previous WINCC Corner and Section to serve the membership more broadly.  INCC has a number of goals which include: Establishing ...
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The Lancet Neurology (02/01/21) Vol. 20, No. 2, P. 117 DOI: 10.1016/S1474-4422(20)30406-3 Badhiwala, Jetan H; Wilson, Jefferson R; Witiw, Christopher D; et al. https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(20)30406-3/fulltext Recovery of sensorimotor function was greater among patients who underwent surgical decompression within 24 hours of acute spinal cord injury (SCI), a new study shows. The pooled analysis used data from more than 1,000 patients between December 1991 and March 2017. At one year after spinal injury, the patients who underwent early surgical decompression — within the first 24 hours — had improved recovery compared ...
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JAMA Neurology (03/01/21) DOI: 10.1001/jamaneurol.2021.0084 Kowalski, Robert G.; Hammond, Flora M.; Weintraub, Alan H.; et al. https://jamanetwork.com/journals/jamaneurology/article-abstract/2776794 Most patients who became comatose after moderate or severe traumatic brain injury (TBI) recovered consciousness during rehabilitation — and nearly half regained functional independence, according to new research. The cohort study involved 17,470 patients with TBI who were enrolled in the Traumatic Brain Injury Model Systems National Database. The patients had experienced moderate or severe TBI and were discharged from acute hospitalization and admitted to ...
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By Sana Alkhawaja, MD, CABEM; Nehad Al Shirawi, MD, MRCP; Hasan Mohammed Naser, MBBS, Najat S. Hameed Naser, RN; Asrar A. Majeed Al Asheeri, RN; Redha Abdulla Al Hammam, RN; Amina Maki Husain, RN  The Kingdom of Bahrain, home of the ancient Dilmun civilization, is a Middle Eastern island situated in the Arabian Gulf. Bahrain is made up of an archipelago of 33 natural islands. The capital city of Manama lies in the heart of the island, the most densely populated area, with over two thirds of Bahrain’s 1.7 million people residing there. The total land area is 760 Km 2 (293 sq. miles) which makes it the third-smallest country in Asia after Maldives and Singapore. ...
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By Wade Smith, MD, PhD, FNCS Education and Certification Dear NCS Members, Can you believe that it has already been a year in terms of the pandemic? Over the past year, each of us has had to change our lifestyles and adapt to our circumstances and environment. Whether that has meant staying home, wearing masks or social distancing, we’ve all adapted to make the most of an unprecedented and unpredictable year. NCS also has spent the last year adapting to the pandemic and our changing landscape. Online, digital education has become more important than ever — and we know that educational products and the Emergency Neurological Life Support ®  (ENLS) certification ...
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By Peter J Papadakos, MD, FCCM, FCCP, FAARC, FNIV During the worldwide COVID-19 pandemic, critical care practitioners throughout the United States and the world were instructed by health agencies, government leaders and hospital administration to ban family members from visiting critically ill patients.  The question I ask, along with many of my critical care peers, is - did we do more harm than good to our patients and their families?  How did the rush to deal with this pandemic and flatten the curve affect our bedside care?  Did what these leaders suggest and mandate create a new standard of care that was followed by us, without weighing the accumulated ...
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