Our immediate objectives are:

 

● Establishing and implementing a well-integrated and cohesive multidisciplinary approach in the Acute Neurosciences Critical Care Program that would entail support jointly from the Departments of Neurology, Neurological Surgery, Anesthesiology, Critical Care Medicine, the Stroke service and Neuroradiology.  Faculty members in the program are fully trained neurointensivists and critical care physicians from the Departments of Neurology, Anesthesiology and Peri-Operative Medicine and Pulmonary/Critical Care.

 

 

Patient population in the Acute Neurosciences Unit include:

·         subarachnoid hemorrhage

·         patients undergoing elective vascular surgery,

·         post-operative care of patients with brain tumors,

·         spine surgery

·         and any patient that requires continuous neuromonitoring for the assessment and management of elevated intracranial pressure.  

 

Neurological patients include:

·         ischemic strokes following systemic or local thrombolytic therapy or selective angioplasty,

·         large hemispheric infarctions requiring continuous neuromonitoring, intraparenchymal and intraventricular hemorrhages,

·         status epilepticus, encephalopathies,

·         meningitis, encephalidities,

·         neuromuscular disorders in crisis (myasthenia gravis, Guillain-Barre syndrome) and acute myelopathies. 

 

A step-wise expansion plan over the next five years depending on need and dictated by patient census/bed occupancy.

 

● Development of a referral base from surrounding private and city hospitals for the specialized care of patients requiring acute neurological and neurosurgical critical care with teaching and outreach programs for regional Emergency Room physicians, internists, general neurologists, Emergency Medical Team (EMT) personnel to enhance response time in thrombolytic therapy for ischemic strokes and other acute brain injuries.  Developing outreach programs to affiliate hospitals and other primary and secondary regional medical care centers for Stroke/acute brain injury awareness through invited lectures and seminars. 

 

● Participation in ongoing multi-center clinical trials funded by National Institutes of Health, Pharmaceutical companies and the institutional GCRC and the Department of Epidemiology/Biostatistics for outcomes research.  Themes would include neuromonitoring techniques, neuroprotective agents in ischemic brain injury and other therapeutic strategies in ameliorating brain injury. 

 

● Education and training: Overall goal is to develop a two-year combined clinical and research fellowship training program to develop Clinician-Scientists in the field of Neurocritical Care who will eventually be leaders in the field.  Residents from the departments of Neurology, Neurosurgery, Anesthesiology and Peri-Operative Medicine, Pulmonary/Critical Care and Emergency Medicine will have structured curriculum during their rotations in the Neuro-ICU.  Nursing education and training of Physician Assistants is to be an integral part of the program.