What is Neurocritical care?
Our Neurocritical care service is dedicated to the care of the sickest patients with diseases of the brain, spine, or nerves. Our specially trained, board-certified team serves to support the efforts of your neurosurgeon and neurologist, as well as the needs of you and your family as you recover.
What is the Neurocritical Care Unit?
The Neurocritical Care Unit (NCCU) is an intensive care unit devoted to the neurologically injured patient. You may be admitted to the NCCU for severe neurologic disease, including:
- High-risk brain or spine neurosurgery
- Stroke after surgery
- Bleeding in the brain (Intracerebral, Subarachnoid, and Intraventricular hemorrhage, or Subdural hematoma)
- Traumatic brain injury
- Brain tumors
- Spinal cord injury
- Neuromuscular respiratory failure
NCCU is more than just a room label; clinical research has shown that patient outcomes are better time and again if you receive dedicated care in a NCCU. The NCCU is one characteristic that distinguishes a Neuroscience Institute and a Comprehensive Stroke Center from other hospitals.
Where is the Neurocritical Care Unit?
The NCCU at LCMC Neuroscience Institute is an intensive care unit on the second floor of West Jefferson Medical Center.
Who cares for you in the Neurocritical Care Unit?
Many providers may see you in the NCCU, including attending physicians, resident physicians, medical students, and advanced practice providers. The major teams are Neurocritical care, Neurology, and Neurosurgery. In some cases, heart, lung, kidney, infection, and blood specialists and other surgery teams may be asked to see you.
The Neurocritical care team sees every patient in the NCCU. The team is led by a board-certified, neurointensivist assisted by residents, advanced practice providers, and a pharmacist. The neurointensivist is a physician, often a neurologist or neurosurgeon, with specialized training in Neurocritical care, airway management, and life support. The Neurocritical care team cares for every organ in your body, particularly your brain, heart, lungs, and kidneys, and performs many procedures in the NCCU. The Neurocritical care team rounds in the mid-morning. A member of the Neurocritical care team is always in the NCCU. The Neurocritical care team does not see you after you leave the NCCU or the hospital.
The Neurology team provides extra insight on the brain, spine, and nerves and includes many subspecialties. The Stroke specialist might discuss the cause of your stroke and how to prevent future strokes. The Epilepsy specialist might read your brain waves on an EEG. The Neuromuscular specialist might examine the electrical function in your nerves and muscles. The Neuro-Oncology specialist might discuss chemotherapy and radiation for your tumor. Different members of the Neurology team may follow you inside and outside the hospital.
The Neurosurgery team sees anyone who has surgery or may need surgery. The team is led by an attending surgeon assisted by the chief resident and junior residents. The Neurosurgery team rounds in the early morning, and a team member is always rapidly available if you have any surgical needs. The Neurosurgery team may follow you inside and outside the hospital.
The Hospitalist team sees every inpatient in the hospital. The team is composed of internal medicine physicians. Each physician sees a number of different patients day after day. The Hospitalist team sees you inside and outside the NCCU but does not follow you outside the hospital.
The Palliative Care team supports you and your family through your stay. They focus on quality of life and control of symptoms to ease suffering. They assist your other teams to discuss goals of care at end of life.
The Rehabilitation team helps to plan the next steps of your recovery and may see you near the end of your stay in the NCCU.
Physical and Occupational Therapy
Physical and Occupational Therapy (aka PT and OT) assess your degree of disability and create a personalized plan to promote and monitor your recovery.
Speech and Language Pathology
Speech and Language Pathology (aka Speech, SLP) assesses any impairment in making and understanding speech (aphasia and dysarthria) as well as swallowing fluid and food safely (dysphagia).
Respiratory Therapy (aka RT) monitors your airway and breathing and plays a particularly important role if you are on a ventilator.
Nutrition assesses your nutrition on admission to the ICU and designs a diet to enhance your recovery.
What is a day in the Neurocritical Care Unit like?
While the NCCU provides 24-hour care with a clinical provider immediately available at all times in the event of a change in a patient’s health. In general:
- In the early morning, the Neurosurgery team sees patients and discusses plans for the day
- In the mid morning, the Neurocritical care team discusses or “rounds” on each patient. The team reviews the overnight events, labs, radiology, and procedures that were performed. The overall plan for the patient’s care is then established for the day with the physicians, nurses, pharmacist, and non-clinical coordinators.
- In the afternoon, families are contacted with updates and to answer any questions. Additional procedures and studies are performed at this time.
- Overnight, patients are continually reevaluated for any changes in health. Patients are prepared for any procedures to be performed the next day.
What can I expect from my time in the Neurocritical Care Unit?
At the start of your illness, every minute might be an emergency. Doctors and nurses are frequently in and out to examine you, start medicines, and discuss surgery. After your problem is diagnosed, every hour may still be critical, and you are admitted to the NCCU. When the tempo of changes in your condition slows to days or weeks, you will be transferred out of the NCCU to another floor or another facility. Leaving the NCCU may be frightening if you have been very sick, but it is always a good sign! If you are going home, congratulations. If you are going to acute rehabilitation, you have a lot of work and potential for recovery. If you are going to a subacute rehabilitation or long-term acute care hospital, you will need more time and care to strengthen.