... the development of radiographic sinus opacification and pneumonia in the neurologicICU setting AbstractText: A retrospective review of head computed tomography or magnetic resonance imaging of 612 patients admitted to the neurocriticalcare unit at a tertiary care center from April 2013 through ... finds a strong relationship between worsening sinus opacification in the neurologicICU patient to the development of hospital-acquired pneumonia and increased ... Keyword: neurologicintensivecare unit.
Pneumonia (14), Sinusitis (5), Hospital Infections (1), more mentions
Emergencyneurology is a complex and rapidly changing field. Its evolution can be attributed in part to increased imaging options, debates about optimal treatment, and simply the growth of emergency medicine as a specialty. Every year, a number of articles published in emergency medicine or other specialty journals should become familiar to the emergency physician.
EmergencyNeurologic Life Support (ENLS) is an educational program designed to provide users advisory instructions regarding management for the first few hours of a neurologicemergency... Certification and training in ENLS is hosted by the NeurocriticalCare Society. This document introduces the concept of ENLS and describes revisions that constitute the third version.
Acute ischemic stroke is a neurologicalemergency that can be treated with time-sensitive interventions, including both intravenous thrombolysis and endovascular approaches to thrombus removal... For this reason, acute ischemic stroke was chosen as an emergencyneurological life support protocol. The protocol focuses on the first hour of medical care following the acute onset of a neurological deficit.
The need for a systematic evidence-based approach to the care of severe TBI patients within the emergency setting has led to its inclusion as an EmergencyNeurological Life Support topic. This protocol was designed to enumerate the practice steps that should be considered within the first critical hours of neurological injury from severe TBI.
... must have an organized approach to detect easily remediable causes, prevent ongoing neurologic injury, and determine a hierarchical plan for diagnostic tests, treatments, and neuromonitoring. Coma was chosen as an EmergencyNeurological Life Support protocol because timely medical and surgical interventions can be life-saving, and the initial work-up of such patients is critical to establishing a correct diagnosis.
... experience suggest that early and aggressive treatment of SE improves patient outcomes, for which reason this was chosen as an EmergencyNeurological Life Support protocol... as accelerated second line anticonvulsant drugs and induced coma when these fail, coupled with admission to a unit capable of neurologicalcriticalcare and electroencephalography monitoring.
Subarachnoid hemorrhage (SAH) is a neurologicalemergency because it may lead to sudden neurological decline and death and, depending on the cause, has treatment options that can return a ... be life-saving in the first few hours after onset, SAH was chosen as an EmergencyNeurological Life Support (ENLS) protocol.
... encephalitis, particularly herpes simplex encephalitis, are severe neurological infections that, if not treated promptly and effectively, lead to poor neurological outcome or death. Because of the value of early recognition and treatment, meningitis and encephalitis was chosen as an EmergencyNeurological Life Support protocol. This protocol provides a practical approach to recognition and urgent treatment of bacterial meningitis and encephalitis.
... neurological events that require immediate recognition and treatment to prevent irreversible injury and death. As in cardiac arrest, a brain code mandates the organized implementation of a stepwise management algorithm. The goal of this EmergencyNeurological Life Support protocol is to implement an evidence-based, standardized approach to the evaluation and management of patients with intracranial hypertension and/or herniation.
An organized bundle of neurocriticalcare interventions can improve chances of survival and neurological recovery in patients who are successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an EmergencyNeurological Life Support protocol. Key aspects of successful early post-arrest management include: prevention of secondary brain injury; identification of treatable causes of arrest in need ...
Furthermore, intubation, ventilation, and sedative choices directly affect brain perfusion. Therefore, Airway, Ventilation, and Sedation was chosen as an EmergencyNeurological Life Support protocol. Topics include airway management, when and how to intubate with special attention to hemodynamics and preservation of cerebral blood flow, mechanical ventilation settings and the use of sedative agents based on the patient's neurological status.
Urgent laboratory tests and neuroimaging are needed to confirm the diagnosis. Because acute weakness is a common presenting sign of neurological emergencies, it was chosen as an EmergencyNeurological Life Support protocol. Causes of acute non-traumatic weakness are discussed here by both presenting clinical signs and anatomical location. For each diagnosis, key features of the history, examination, investigations, and ...
Neurological and Central Nervous System Diseases (1) Muscle Weakness (1), Nervous System Diseases (1), more mentions
Traumatic spine injuries (TSIs) carry significantly high risks of morbidity, mortality, and exorbitant health care costs from associated medical needs following injury. For these reasons, TSI was chosen as an ENLS protocol. This article offers a comprehensive review on the management of spinal column injuries using the best available evidence. Though the review focuses primarily on cervical spinal column injuries, thoracolumbar injuries are briefly discussed as well. The initial emergency department (ED) clinical evaluation of possible spinal fractures and cord injuries, along with the definitive early management of confirmed injuries, are also covered.
... an adequate airway, proper diagnosis, and early management of several specific issues such as blood pressure, coagulopathy reversal, and surgical hematoma evacuation for appropriate patients. ICH was chosen as an EmergencyNeurological Life Support (ENLS) protocol because intervention within the first hours may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently.
The appropriate use of medications during EmergencyNeurological Life Support (ENLS) is essential to optimize patient care... article focuses on the important pharmacokinetic and pharmacodynamics characteristics, advantages and disadvantages and clinical pearls of these therapies, providing practitioners with essential drug information to optimize pharmacotherapy in acutely ill neurocriticalcare patients.
... outcomes for family members of patients discharged from the neurosciences intensivecare unit (neuro-ICU) AbstractText: We conducted a prospective, longitudinal cohort study in a single, thirty-bed neuro-ICU in a regional comprehensive stroke and level 1 trauma center ... One of two neuro-ICU services that admit patients to the same ICU on alternating days used a palliative care needs checklist during ... Keyword: Neuro-intensivecare unit.
Neuroscience (1), Cardiovascular Diseases (1) Depressive Disorder (1), more mentions
There are many causes of acute myelopathy including multiple sclerosis, systemic disease, and acute spinal cord compression (SCC). SCC should be among the first potential causes considered given the significant permanent loss of neurologic function commonly associated with SCC. This impairment can occur over a short period of time, and may be avoided through rapid and acute surgical intervention. Patients with SCC typically present with a combination of motor and sensory dysfunction that has a distribution referable to a spinal level. Bowel and bladder dysfunction and neck or back pain may also be part of the clinical presentation, but are not uniformly present. Because interventions are critically time-sensitive, the recognition and treatment of SCC was chosen as an ENLS protocol.
Immune System Diseases (1) Spinal Cord Compression (2), Multiple Sclerosis (1), Back Pain (1), more mentions
The aim of this study is to assess the relationship between ultrasound-based non-invasive ICP (nICP) and invasive ICP measurement in neurocriticalcare patients AbstractText: This was a prospective, single-cohort observational study of patients admitted to a tertiary neurocriticalcare unit. Patients with brain injury requiring invasive ICP monitoring were considered for inclusion.
Cardiovascular Diseases (3) Intracranial Hypertension (3), Craniocerebral Trauma (1), Coma (1), more mentions