Ebook: Neurocritical Care: A Guide to Practical Management

Neurocritical Care: A Guide to Practical Management provides clear and concise guidelines for the clinician, on the management of adult brain injured patients. It steers the clinician through the complicated decisions that are demanded in these cases, involving initial assessment, interpretation of radiological investigations, referral to a Regional Neurosurgical Center, prevention of secondary brain injury and the management of complex clinical scenarios such as Status epilepticus. This book will prove an indispensible aid for making these critical decisions.

Including tried and tested proformas for swift and accurate communication of information to Regional Neurosurgical Centers, this book equips the clinician to get the most out of these specialist services. This book also addresses the difficult area of defining futility and withdrawal of care, ranging from the role of neuro-radiological imaging in aiding these decisions to a discussion of the complex ethical dilemmas that the clinician is inevitably faced with.

A comprehensive easy-reference, Neurocritical Care is essential reading for those working within the primary referring centre in Emergency Medicine, Anesthesia, Intensive Care and Surgery.

John P. Adams, MB ChB MRCP FRCA ATLS PGD – MedSch (Anesthesia) is Consultant Anesthetist with an interest in Neuroanesthesia and Anesthesia for Endocrine Surgery at Leeds Teaching Hospitals NHS Trust, UK.

Dominic Bell, FFA.RCS MB ChB MPhil is Consultant in Intensive Care and Anesthesia at Leeds Teaching Hospitals NHS Trust, UK.

Justin McKinlay, MA (Oxon) BM Bch FRCA is Consultant Anesthetist and Honorary Senior Lecturer at Leeds Teaching Hospitals NHS Trust, UK.

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Traumatic brain injury is the leading cause of death in young people in the UK and USA. The vast majority of these patients will be initially managed outside the teaching hospital environment and many will remain there for the duration of their treatment. As clinicians, what happens during the first hours and days after injury can have a huge influence on the patient’s chance of survival and also their quality of life after the injury. Results of a recent national survey have highlighted 2 main areas of major concern. Firstly, there are far too few specialist neurosurgical beds in out tertiary referral centers, which means that District General Hospital Intensive Care Units are frequently having to manage very seriously brain injured patients. Secondly, many clinicians do not know when they should be speaking to their Regional Neurosurgical Centre, do not fully understand how they should be managing these patients, do not know how to interpret the relevant physiological and radiological data, and have difficulty identifying when to escalate treatment and when the situation has become futile. Lives could therefore be saved and outcomes improved with the introduction of common treatment pathways and better defined lines of communication between referring hospitals and specialist centers.