Sarah E. Nelson - Neurointensive Care Unit: Clinical Practice and Organization

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The field of neurocritical care is expanding. Presently, an understanding of its basic principles is essential for the appropriate care of patients requiring intensive care. In addition to understanding the basics of neurocritical care, it is also important to have an understanding of how a neurocritical care unit (NCCU) is structured and how the services paramount to its operation are accessed and organized. The goal of this book is to go beyond the management of neurocritical care-related illness by providing guidance to intensivists and providers from all backgrounds with regard to perspectives on how to organize and manage the challenging environment that is the NCCU. The first chapters in this book are dedicated to describing the current evidence-based management of key neurological emergencies, from beginning to end, across the timeline of care. We have included information about triaging decisions, from admission to discharge, as well as the use of pharmacologic agents unique to neurocritical care conditions. In the second section, we examine organizational principles of the NCCU including neurointensivists training, telemedicine and telestroke, and the responsibilities of key personnel in the NCCU. This includes the special roles and training requirements of nurses, advanced practice providers, residents, fellows, and attendings. We further delve into the use of specialty services such as ultrasound, electroencephalography, angiography, and multimodal monitoring all of which are necessary to support an NCCU. We also discuss the important issue of prognostication in neurocritical care patients. It is our goal to provide a textbook that is helpful to those aspiring to plan and build an NCCU as well as to those seeking a comprehensive review of neurocritical care management.

Neurointensive Care Unit: Clinical Practice and Organizationedited by Sarah Nelson and Paul Nyquist continues a tradition of books concerning neurocritical care that has appeared in Springers Current Clinical Neurology series over the past 15 years. These includeCritical Care Neurology and Neurosurgeryedited by Jose Suarez and two editions of theHandbook of Neurocritical Careedited by A Bhardwaj, MA Mirski, et al. These volumes were designed to detail the array of patients with acute, life-threatening neurological and neurosurgical illnesses encountered in intensive care units.Section 1of this volume expands upon these conditions providing much information that has appeared in the past 15 years concerning newly described acute and severe neurological conditions and the scientific basis of many new treatments and interventions that have become available in this area. There are ample numbers of tables and figures throughout the book that very nicely illustrate the issues presented.Section 2contains a newer body of information that reflects the widespread growth of neurocritical care units as free-standing hospital facilities staffed by certified professionals with a primary interest in neurocritical care. Special training and certification of neurointensivists, remote diagnosis by the use of telemedicine and telestroke, and the utilization of physician extenders such as nurse practitioners, physician assistants, nurses, residents, and fellows have allowed for the increased growth of specialized neurointensive care units. These personnel have been increasingly assisted by sophisticated ancillary services such as multimodal neuromonitoring; brain metabolism, blood flow, and intracranial pressure monitoring; and ultrasound, which have become essential to support the care of patients in neurointensive care units. In the future, this will continue to be a rapidly growing field that is now very effectively brought up to date by this well-organized and instructive volume.