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.
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, intraventricular hemorrhage,
or subdural hematoma)
Seizure
Traumatic brain injury
Brain tumors
Hydrocephalus
Meningitis/encephalitis
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 the Neuroscience
Institute and Comprehensive Stroke Center from other hospitals.
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.
Neurocritical care team
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.
Neurology team
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
neurooncologist might discuss chemotherapy and radiation for your tumor.
Different members of the neurology team may follow you inside and outside
the hospital.
Neurosurgery team
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.
Hospitalist team
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.
Palliative care team
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.
Rehabilitation team
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 (PT and OT)
Physical and occupational therapists assess your degree of disability and
create a personalized plan to promote and monitor your recovery.
Speech and language pathology (SLP)
Speech and language pathologists assess any impairment in making and understanding
speech (aphasia and dysarthria) as well as swallowing fluid and food safely
(dysphagia).
Respiratory therapy (RT)
Respiratory therapists monitor your airway and breathing and plays a particularly
important role if you're on a ventilator.
Nutritionists
Nutritionists assess your nutrition on admission to the ICU and designs
a diet to enhance your recovery.
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.
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.
