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)
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 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.
Neurocritical care
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
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.
Neurosurgery
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
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
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
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
Respiratory Therapy (aka RT) monitors your airway and breathing and plays
a particularly important role if you are on a ventilator.
Nutrition
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.
