NCS Roundup

By Jensen Ng, MBBS, MMed Tan Tock Seng Hospital (TTSH) was founded in 1844 and is the second largest hospital in Singapore with a capacity exceeding 1,500 beds. It is strategically located in Central Singapore, at the intersection of two major highways. The Neuroscience ICU (NICU) of TTSH has been in operation since the official opening of the current hospital premises in 2000. Since then, it has expanded to its current capacity of 14 Level 3 beds and four Level 2 Beds. The NICU functions as a single unit under the leadership of the NICU Director ...

By Catrice Nakamura, RN, MSN, CCRN-K, SCRN, and Diana Serondo, RN, NVRN-BC Mechanical thrombectomy in the setting of a large vessel occlusion has become a standard of care in the management of acute ischemic stroke. Despite the ample literature available to support care before and during these procedures, few publications focus on the details surrounding care of these patients in the immediate post-operative period. As mechanical thrombectomies are becoming more common, the argument could be easily be made for increased nursing education on the care ...

By Peter J. Papadakos, MD, FCCM, FAARC The last number of months has brought the issue of violence and sexual harassment into the news cycle. Employers and universities have rolled out programs to address discrimination and sexual harassment in the workplace. Health professionals and support staff are not immune from this issue. Media are full of reports of highly trained and educated healthcare workers assaulting each other, rising reports of sexual harassment and gender issues and assaults by patients and families on their health providers. The reasons ...

By Yasser B. Abulhasan, Chairman, Neurocritical Care-MENA Chapter of IPACCMS, and Hussain N. Al Rahma, President, IPACCMS It is a great pleasure to welcome you all to the first Regional Neurocritical Care Meeting in the Middle East and Africa, which was developed in partnership between the International Pan Arab Critical Care Medicine Society and the Neurocritical Care Society as part of the 15th Emirates Critical Care Conference (ECCC) on April 4-6, 2019, in Dubai, United Arab Emirates (www.eccc-dubai.com). There will be a highlighted full day neurocritical ...

By Jamil R. Dibu, MD, Section Head, Neurologic Critical Care Unit, Cleveland Clinic Abu Dhabi, United Arab Emirates Why is Cleveland Clinic in Abu Dhabi? As a direct expansion of the Cleveland Clinic model of care, Cleveland Clinic Abu Dhabi builds on almost 100 years of excellence at Cleveland Clinic, aligning its services to meet the specific needs of the United Arab Emirates population. The hospital is the result of an agreement signed in 2006 between Mubadala Investment Company and U.S.-based Cleveland Clinic, in support of the Abu Dhabi government’s ...

By Sara Hocker, MD; Shraddha Mainali, MD; and Andrew Naidech, MD The fifth Neurocritical Care Research Conference, “The Future of Neurocritical Care Research: Looking for a Blue Ocean,” was held in Boca Raton, Florida, on Sept. 25, 2018. The primary aim of this interdisciplinary scientific symposium was to bring together scientists and healthcare professionals from diverse fields with a common interest in understanding and advancing research in neurocritical care and to set the agenda for the future direction of the Neurocritical Care Research Network ...

By Wren Sherrill, MSN, ACNP, and Alexis Steinberg, MD, on behalf of the NCS Trainee Committee Mentorship is a time-honored practice of developing an individual’s skills, talents and experience. It refers to a special relationship in which someone with more experience helps guide a less experienced individual. A mentor refers to someone who positively impacts a protégé by providing guidance, fostering insight and encouraging growth. Mentorships can be formal or informal and can be found in academia, the medical field and corporations. Often, people ...

By Sang-Bae Ko, MD, PhD The Korean Neurocritical Care Society (KNCS) held the first regional Asian Chapter Neurocritical Care Society (NCS) Meeting in conjunction with KNCS Winter Symposium on Dec. 14-15, 2018 in Seoul, South Korea. The original idea for boosting quality of neurocritical care in Asia had been discussed with Dr. Gene Sung, and KNCS are lucky to have a chance to host the first Asian Chapter meeting in Seoul with a full support from Asian neighbors including Japan, Philippines, Nepal, India, Singapore, Indonesia and Australia. All Asian ...

By Andrew Cheng, MD How do you measure neurological outcome after acute brain injury? What is the optimal dose and duration of targeted temperature management after cardiac arrest? How does this differ in traumatic brain injury? And how can this be best measured and monitored in the neuro-ICU? These were among some of the questions posed, discussed and debated at the recent seventh International Hypothermia and Temperature Management Symposium, held in Sydney, Australia, from Aug. 28-30, 2018. The Sofitel Darling Harbour, next to the new Sydney ...

By Jason Makii, PharmD, MBA, FCCM, FNCS, BCPS, BCCCP, Chair, Pharmacy Section Leadership Committee The pharmacy section continues to expand, and we have celebrated numerous successes this past year. Continued recruitment efforts have resulted in over 175 pharmacist members within the section, an increase from last year. Over 65 pharmacists attended the annual meeting in Florida last September with various members presenting their research, moderating sessions and speaking on various topics throughout the annual meeting. I would like to acknowledge ...

By Lauren Koffman This is the first installment in a Currents series that will feature neurocritical researchers who have been awarded career development awards, or K awards. Each person was asked to describe their research background, experience with the application process and a bit about their research project. Jonathan Elmer, MD, is at the University of Pittsburgh Medical Center and says that writing the first draft of the grant was a learning experience but fun. Dusting the application off a year later to revise and respond to the pink sheet ...

By Michel Torbey, MD, MPH, FNCS, FAHA, FCCM, FANA, Immediate Past President, NCS; Chair, NCS Global Partners Committee We finally have a Global Members Section! NCS leadership has been working on developing the section concept for the last two years. The new website changes finally made it a reality. Any NCS member can join the Global Member Section community. The goal is to make this a platform to exchange ideas, science and education across the globe. I encourage all members in the United States and internationally to join the section. In June, ...

By Yasser B. Abulhasan, MBChB, FRCPC, Chairman, Neurocritical Care-MENA Chapter of IPACCMS The International Pan Arab Critical Care Medicine Society (IPACCMS) and the Neurocritical Care Society (NCS) are partnering to develop the First Regional Neurocritical Care Meeting in the Middle East and Africa in conjunction with the upcoming 15th Emirates Critical Care Conference (ECCC) April 4-6, 2019, in Dubai, United Arab Emirates. This step was initially conceived during the 2018 ECCC because of the fruitful collaboration since 2011 and the success of ...

By Dheeraj Khurana, MD 1 (left); Kiran Jangra, MD 2 (center); and Gagandeep Singh, MD, DM 3 (right) Department of Neurology, Postgraduate Institute of Medical Education and Research Department of Neuroanesthesia, Postgraduate Institute of Medical Education and Research Department of Neurology, Dayanand Medical College & Hospital, Ludhiana Neurocritical care is a vast specialty that covers various subspecialities, including neurology, neurosurgery, neuroanaesthesiology and interventional neuroradiology. In India, this field is most developed ...

By Gentle Sunder Shrestha, MD, FACC, EDIC, FCCP, Neurointensivist, Assistant Professor, Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal Nepal is a landlocked South Asian nation, bordered by China on the north and India in the south, east and west. Nepal has the population of around 26.4 million, with the land area of 147,181 km2. The GDP of Nepal is USD 837 per capita. Countries like Nepal and other low- and middle-income countries (LMICs) have a high burden of neurological emergencies. The burden ...

By Masao Nagayama, MD, PhD, FACP, FAAN, FNCS, Professor, Department of Neurology, International University of Health and Welfare Graduate School of Medicine I am pleased to announce that the Japanese subsession titled “From Terrorism to Complementary Medicine,” will be held at the Neurocritical Care Society (NCS) 16th Annual Meeting. This session was made possible by Gretchen M. Brophy, president of NCS, and Jose I. Suarez, chair of the annual meeting, the theme of which is “Neurocritical Care Without Borders.” In this session, diverse topics are ...

By Pouya Ameli, MD-MS (left) ; Alexis Steinberg, MD (center); and Winnie Lau, MD (right) This year, the Resident and Fellow Committee (RFC) has organized several events for the 16th Annual Meeting in Boca Raton. Our committee’s goal is to help neurocritical care trainees with career advancement, including residents, fellows, junior attendings, APPs and pharmacists. To this end, we hope you find our events at the annual meeting helpful. All trainees and junior attendings are welcome to attend RFC events, which are summarized below, along with several ...

By Jennifer Kim, MD, PhD (left); and Michael Diringer, MD (right) Publishing is often a major part of advancement in an academic career. Clinicianscientists, including nursing and pharmacy, work throughout their careers to bring their research to the world through publications such as the Neurocritical Care journal. The peerreview process often seems daunting and clouded in mystery. However, as one begins to advance in their career, they may find they are now asked to serve as a reviewer themselves. Most do not undergo any formal training to take on ...

By PJ Papadakos, MD, FCCM, FAARC Over the last decade, I have observed the rapid growth of our society as we have progressed into a worldwide professional organization advocating for state-of-the-art care of critically ill patients suffering from neurological conditions. This growth has led to the widespread availability of neuro- ICUs staffed by dedicated professionals in many communities. However, often rapid growth leads to confusion in the community regarding exactly what it is we do. How have we added to the care of patients, and what has the ...

By Shaheryar Hafeez, MD 1 (left); Michel T. Torbey, MD, MPH, FNCS, FAHA, FCCM, FANA 2,3 (center); and Diana Greene-Chandos, MD 2,3 (right) Department of Neurosurgery, UT Health Science Center San Antonio Department of Neurology, The Ohio State University College of Medicine Department of Neurosurgery, The Ohio State University College of Medicine The aim of neurocritical care fellowship training, as outlined by the UCNS, is to “prepare the physician for the independent practice of Neurocritical Care 1 .” The way to achieve this objective is ...

By Lauren Koffman, DO, MS Natalie Kreitzer completed an emergency medicine residency and neurocritical care fellowship at the University of Cincinnati. Her fellowship was a combined stroke/ research/neurocritical care T32 fellowship. After training, she stayed at the University of Cincinnati as faculty with a combined role in working in emergency medicine and neurocritical care. In her free time, she stays busy with her two sons, Jackson and Tyler. She is now working on developing a research-oriented career, specifically in helping guide care ...

The NCS Pharmacy Committee is excited to receive applications for the Invited Clinical Pharmacist (ICP) Program annually starting this November. The purpose of this program is to promote and increase the practice of neurocritical care pharmacy by sending qualified neurocritical care pharmacists to selected institutions that wish to expand or initiate neurocritical care pharmacy services. The invited clinical pharmacist is expected to interact with the pharmacy and neuro-ICU teams, provide lectures, attend rounds or perform other relevant activities that ...

The American Board of Medical Specialties (ABMS) adopted a new Neurocritical Care (NCC) Subspecialty involving the American Board of Psychiatry and Neurology (ABPN), American Board of Anesthesia (ABA), American Board of Emergency Medicine (ABEM) and American Board of Neurosurgery (ABNS). The new NCC subspecialty will allow for uniformity in the training and skill sets of  neurointensivists  through ACGME-accredited fellowship training. 1. How did this certification come about? The NCS first reached out to the ABPN in late 2016 about the possibility ...

By Stefanie Amelung, RPh, Dipl.-Pharm. 1,2  (left), and Carina Hohmann, RPh, PhD 3  (right) Affiliations: 1 Pharmacy Department, Heidelberg University Hospital, Heidelberg, Germany 2 Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany 3 Department of Pharmacy, Klinikum Fulda gAG, Fulda, Germany Clinical Pharmacy Practice in Germany Drug therapy of patients is becoming more complex, thus making drug prescribing more challenging. In clinical practice, a wide range of drug-related ...

By Faheem Sheriff, MD, and Hamisi K. Shabani, MD The Muhimbili National Hospital is the largest referral hospital in Tanzania, handling a broad spectrum of pathology, including critically ill neurologic and neurosurgical cases of the highest complexity. It is affiliated with the Muhimbili Orthopedic Institute (MOI), which is the only tertiary center for neurosurgery and orthopedics in Tanzania. The World Health Organization recommends that all countries have one neurosurgeon for each 100,000 residents. In Tanzania, the ratio is 1 to 13 million. ...

By Halinder S. Mangat, MD My wife and I both lived in Africa at different stages of our lives, so there was no hesitation when opportunity arose via the Global Health Department at Weill Cornell Medicine to return to this enigmatic continent. In addition to teaching the curriculum in neurology at the second biggest university hospital, Weill Bugando Medical Center, Mwanza, from 2012, I joined an international collaborative effort in neurotrauma, led by Dr. Roger Härtl, professor of neurosurgery at Weill Cornell. The neurotrauma project includes ...

By Joanne B. Robles, MD and Geraldine Siena L. Mariano, MD (pictured) In the Philippines, cerebrovascular diseases rank as the second most common cause of mortality in the National Statistics Office epidemiological reports in 2017. Other neurological diseases that require intensive care management like status epilepticus and traumatic brain injury are unfortunately underreported leading to a lack of epidemiologic data. As technological advances moved us further into discovering more efficient and expedient means of preventing and protecting the injured ...

By Yasser B. Abulhasan, MBChB, FRCPC, Chairman, Neurocritical Care-MENA Chapter of IPACCMS The International Pan Arab Critical Care Medicine Society (IPACCMS) and the AsianAfrican Conference of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) conduct their annual meeting in conjunction with the Emirates Critical Care Conference (ECCC) around the first weekend of April in Dubai, United Arab Emirates. Since 2011, the Neurocritical Care Society (NCS) has endorsed and participated in the full day neurocritical care track ...

By Lauren Koffman and Starane Shepherd Drs. Starane Shepherd and Lauren Koffman, neurointensivists, from Rush University Medical Center, located in Chicago, Illinois, recently spent several days in the capital of the Dominican Republic, Santo Domingo, kicking off a series of educational conferences being offered to local physicians and trainees. The Global Health Department at Rush Medical College has a longestablished relationship with a local nonprofit organization, Community Empowerment, in providing healthcare to those in need in the Dominican ...

By Andrew Udy, BHB, MB, ChB, PGCert(AME), FCICM, PhD A History of Intensive Care Training in Australasia  The body responsible for vocational training in intensive care medicine in Australia and New Zealand is the College of Intensive Care Medicine (CICM). CICM was established in 2008 and formally took over the responsibility for training and certification of intensive care specialists from the Joint Faculty of Intensive Care Medicine on Jan. 1, 2001. Prior to 2001, two training programs in intensive care medicine were available in Australia and ...

By Michel Torbey, MD, MPH, FNCS, FAHA, FCCM, FANA; Immediate Past President, NCS; Chair, Global Partners Committee Neurocritical Care Society continues to work on promoting education with our global partners. Dr. Katja Wartenberg directed our second ENLS course in Dubai. The course was part of the 14th International Pan Arab Critical Care Medicine Society Meeting. During the meeting, neurocritical care was well represented. Faculty included: Gene Sung, Kiwon Lee, Gretchen Brophy, Michel Torbey, Susan Yeager, Katja Wartenberg and Yasser Abulhassen. ...

By Shraddha Mainali (left), Sara Hocker (center), Andrew Naidech (right), NCS Research Operations Sub-Committee We recently asked the NCS Research Training Fellowship Grant recipients Dr. David Hwang (2015) and Dr. Edilberto Amorim De Cerqueira Filho (2016) to share their experience regarding the fellowship grant. How did you learn about the grant? Dr. David Hwang (DH) : NCS did a great job advertising this grant via emails. Dr. Edilberto Amorim De Cerqueira Filho (EA) : I found out about the grant when Dr. David Hwang received the award ...

By Kassi Kronfeld (left) and Alexis Steinberg (right) The Neurocritical Care Society made a strong showing once again at this year’s AAN Annual Meeting in Los Angeles, with several events and lectures featuring NCS members. The Resident and Fellow Committee, in conjunction with the support of the executive board and Drs. David Hwang and David Freeman, helped to coordinate and publicize these events, allowing for the strong neurocritical care presence at AAN. The highlighted NCS sponsored event at the AAN was the Neurocritical Care Society Mentorship ...

By Jennifer A. Kim While career advice is often geared toward the training and early job stages, the roadmap to success throughout the remainder of one’s career is often not much clearer. Here, Dr. Wendy Wright, director of the Neuroscience Intensive Care Unit at Emory University and chair of the Fellow of Neurocritical Care Committee, provides insight into making the most of your mid-career, getting promoted, taking on leadership roles and becoming a Fellow of Neurocritical Care (FNCS). Even for those of us early in our careers, Dr. Wright provides ...

By Jennifer A. Kim Securing one’s first job as an attending is an exciting time! The first few years of being an attending form a crucial foundation for success throughout the remainder of your career. For those who choose to enter academics, we interviewed Dr. Thomas Bleck, founding chair of the Neurocritical Care Society and director of clinical neurophysiology at Rush University Medical Center; Dr. Jonathan Rosand, chief of neurocritical care and emergency neurology at Massachusetts General Hospital; and Dr. Jose Suarez, director of neurosciences ...

By Jennifer A. Kim After putting in so many years of studying, then blood, sweat and tears into residency and fellowship, it’s finally time to apply for a job! But, having only experienced life transitions in applications and matches, the job search process is daunting. Despite having extensive training, the logistics and “business” of job hunting can feel mysterious. To help alleviate those anxieties, Dr. Karen Hirsch, medical director of neurocritiacal care at Stanford, shares her advice. (Note: The interview has been paraphrased for brevity.) ...

By Anand Venkatraman and Alexis Steinberg Applying for your fellowship can be one of the most stressful times during residency. If it weren’t hard enough to have to navigate a busy program, family life and keeping up with your reading, now you have to send out emails, set up interviews and book flights around the country. The process of fellowship applications has certainly become easier since NCC joined SF Match. A match provides structure, while also taking out the stress of deciding when to accept an offer. That said, it is still a process that ...

By Jennifer A. Kim In this issue of Currents, I am very excited to share a four-article series offering career advice, from applying to fellowship to becoming a leader in neurocritical care. With the assistance of guest writers Dr. Anand Venkatraman, fellow at Massachusetts General Hospital, and Dr. Alexis Steinberg, resident at University of Pittsburgh Medical Center, we have had the great opportunity to interview a few of the leaders in our field, who offer advice to physicians in training and throughout their careers. 1. Forging Ahead: Tips ...

By Aarti Sarwal (left) and Soojin Park (right) NCS 15th Annual Meeting theme was “It Takes a Village.” We saw the theme coming in action as it literally took a village to pull through 12 workshops at the beautiful Waikoloa Beach Resort. Preconference workshops are an important part of our members’ learning experience and require a year-long preparation of multiple teams coming together. Workshops receive immense positive feedback due to their hands-on nature and ability to receive up-close learning experience from experts about practical management ...

By Jose I. Suarez, MD The fifth Neurocritical Care Research Conference: The Future of Neurocritical Care Research—Looking for a Blue Ocean will be co-located with the 16th annual meeting of the Neurocritical Care Society (NCS) at the Boca Raton Resort & Club in Boca Raton, Florida, on Sept. 25, 2018. The Neuroscience Center at the CHI Baylor St Luke’s Medical Center in Houston, Texas, has committed funds to partially support this symposium. The symposium is unique in that it will provide a forum to present and discuss the problems and opportunities ...

By Satoshi Egawa 1 , Nobuhiro Narabu 2 , Satomi Yamagata 2 , Ryosuke Okada 2 , Minoru Fukuda 2 , Hidetoshi Nakamoto 3  and Yuichi Kubota 3  (from left) 1. Neurointensive Care Unit, TMG Asaka Medical Center 2. Pharmacy, TMG Asaka Medical Center 3. Stroke and Epilepsy Center, TMG Asaka Medical Center Excellent activity of any hospital demands effective teamwork of its medical staff, especially in the intensive care unit (ICU). Since Jan. 1, 2018, TMG Asaka Medical Center has been operating the neuro ICU in complete collaboration ...

By Jose I Suarez, MD The Tower of Babel, as described in Genesis, was built in the land of Shinar (Babylonia) sometime after the Great Flood. This biblical myth, an attempt to explain the existence of diverse human languages, has fascinated humankind for millennia. Accepted modern vernacular translations indicate that the Babylonians wanted to make a name for themselves by erecting a mighty city and a tower that could reach the heavens. God punished the builders for their presumption by so confusing the language of the workers that they could no longer ...

By Mona Kumar, MD, FNCS (left), and Molly McNett, PhD, RN, CNRN The development of evidence-based clinical practice guidelines(CPGs) is one of the most valuable and visible functions of the Neurocritical Care Society (NCS). As such, development of scientifically sound CPGs is central to the mission of the society. Development of quality CPGs follow structured frameworks, which include a formalized needs assessment, identification of relevant topics, balanced writing groups, rigorous evaluation of the scientific literature, utilization of a systematic ...

By Neha S. Dangayachm, MD, Aarti Sarwal, MD, and Vineeta Singh, MD The Neuroscience Section of the Society of Critical Care Medicine was well-represented at the 47th Critical Care Congress in the program, honors and attendance. The SCCM now has 16,000 critical care professionals in more than 100 countries, and, like previous years, this meeting has continued to be the largest event to bring together attendees from several specialties, providers and practitioners of critical care teams striving to provide the “Right Care, Right Now.” The theme for the ...

By Jason Kurian, PharmD and Salia Farrokh, PharmD, BCCCP For secondary stroke prevention, the 2013 American Heart Association (AHA) and American Stroke Association (ASA) joint guidelines recommend aspirin within 24 to 48 hours after stroke onset for most patients and state that the use of clopidogrel is not well established. The 2012 American College of Chest Physicians (ACCP) guidelines recommend treatment with aspirin, clopidogrel or aspirin/dipyridamole extended-release (ER) over no antiplatelet therapy or the combination of clopidogrel plus aspirin. ...

By Jo Ann Soliven, MD The Philippines consists of more than 7,000 islands with a current population of about 104 million living mainly in 10-11 islands. Geography, location and growing population challenge both healthcare and economic reforms. Healthcare expenditure is heaviest on a self-pay system. The fragmented healthcare delivery consists of the national government, local government units relying on revenue shares from the national government and the private sector. Health workforce consist of doctors concentrated on National Capital Region and ...

By Michel Torbey, MD, MPH, FNCS, FAHA, FCCM, FANA, Immediate Past President, NCS, Chair, NCS Global Partners Committee In 2018, the Neurocritical Care Society has several successful international collaborations. Dr. Shaheen Shaikh directed an ENLS course at the 19th Annual Conference of the Indian Society of Neuroanesthesia and Critical Care in Mumbai, India. Course faculty included: Michel Torbey, Abhijit Lele, Richard Moser and Letha Mathews. The course was well attended and was a success by all metrics thanks to the efforts of Dr. Shaikh and our ...

By Sara Hocker, MD, Andrew Naidech, MD and Shraddha Mainali MD The newly organized Neurocritical Care Research Central (NCRC) is pleased to announce that Drs. Javier Provencio and Paul Vespa have been appointed as its co-directors. The selection process, previously outlined in the December 2017 issue of Currents , began with the convening of a five-member task force supervised by the Research Operations Subcommittee (ROS) tasked with selecting nominees. Fifteen nominees were selected based upon pre-specified criteria. Criteria included a track record ...

By Sarah L. Livesay, DNP, RN As the Neurocritical Care Society (NCS) grows as an international organization, NCS members have worked hard over the past year to support neurocritical care nurses across the globe. To highlight a few key initiatives to offer support and education to nurses, NCS nursing members have participated in a number of international meetings and Emergency Neurologic Life Support (ENLS) courses, and represented NCS on several international nursing boards. In late 2017, NCS became an official member of the World Federation of Neuroscience ...

By the iCSD2018 Scientific Committee The first annual meeting of the Neurocritical Care Society was held in Phoenix, Arizona, in February 2003. In November of the same year, a small group of neurologists and neurosurgeons gathered in Copenhagen, Denmark, for the first annual meeting of what would be known as the Co-Operative Studies on Brain Injury Depolarizations (COSBID). After 15 years of cultivating their missions and expanding their reach, NCS and COSBID will come together this September for affiliated annual meetings in Boca Raton, Florida. ...