Good morning everyone, we are the group 5 and we are to talk about the Neuro-ICU.

1. Neuro ICU is the intensive care unit for patients with life-threatening neurological
(nervous system) diseases. It is a specially designed section of the hospital where patients
with acute life-threatening organ that concerns the brain, spinal cord and nerves that are
damage due to a disease or injury are given more effective and individualized treatmen t.

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2. Developed in the 1980's as a subspecialty of intensive care, and have evolved from
larger multidisciplinary ICUs into freestanding unit, not limited only to
postoperative neurosurgical patients but also involving integrated management of
other conditions of the central nervous system and their complications.

So meaning, working in a hospital’s neurointensive care unit treat patients suffering

from everything from stroke to traumatic brain injuries.

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3. Now, let’s talk about the Setting and Organization of a Neurocritical Care Unit
An NCCU is considered to be a level III ICU, and should serve as a tertiary referral unit for intensive care
patients, capable of providing comprehensive critical care for an extended period of time. The unit
should preferably be a closed ICU headed by an intensivist who specializes in neurocritical care. The aim
should be to provide long-term care of highest standards with defined protocols and policies. There
should be a sufficient clinical workload and variety of patients to provide the requisite level of clinical
expertise and education of staff, including trainees

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4. These are the commonly admitted patients in a NCCU
(basaha ang naa sa PPT)
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5. Who Works in a Neuro-ICU?
Neuro-ICUs are very multi-disciplinary in nature. Neurologists, neurosurgeons, intensive
care specialists, and anesthesiologists often work very closely with teams of highly trained
nurses, respiratory therapists, nutritional experts, and more.
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6. Policies and guidelines are formed by a committee comprising the medical
superintendent, neurosurgeon, neurointensivists, neurologist, and nursing superintendent
of the institute. Such a committee will appropriately define the critical care burden of the
hospital, type and size of unit; appoint the unit in-charge, and form guidelines and policies.
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7. Moving forward, here are the procedures and interventions done inside the Neuro-ICU
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Nurses working in a hospital’s neurointensive care unit treat patients suffering from
everything from stroke to traumatic brain injuries. They must vigilantly monitor their
patients, watching for neurological decline and intervening as soon as possible.
Neuro-ICU nurses’ jobs are to monitor the patient’s condition, administer medication, and
also help educate patients and their families who are dealing with a potential life-altering
event.
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8. Neuro assessment and evaluation
- Neurologic assessments by neurology-trained, intensive care physicians and staff in a NICU
determine the severity of the Traumatic Brain Injury (TBI) have been proven benefit for
minimizing in-hospital mortality and length of stay. 
What is done during a neurological exam?
During a neurological exam, the healthcare provider will test the functioning of the nervous
system. The nervous system is very complex and controls many parts of the body. The nervous
system consists of the brain, spinal cord, 12 nerves that come from the brain, and the nerves that
come from the spinal cord. The circulation to the brain, arising from the arteries in the neck, is
also frequently examined. The following is an overview of some of the areas that may be tested
and evaluated during a neurological exam:
 Mental status. Mental status (the patient's level of awareness and interaction with the
environment) may be assessed by conversing with the patient and establishing his or her
awareness of person, place, and time.

 Motor function and balance. This may be tested by having the patient push
and pull against the healthcare provider's hands with his or her arms and legs.
 Sensory exam - The patient's healthcare provider may also do a sensory test that
checks his or her ability to feel.
 Evaluation of the nerves of the brain. - There are 12 main nerves of the brain,
called the cranial nerves. During a complete neurological exam, most of these
nerves are evaluated to help determine the functioning of the brain.
  The Glasgow Coma Scale (GCS) is the most common scoring system
used to describe the level of consciousness in a person following
a traumatic brain injury . Basically, it is used to help gauge the severity
of an acute brain injury. The test is simple, reliable, and correlates
well with outcome following severe brain injury.

Intubation and mechanical ventilation- maintains an open airway and helps prevent

suffocation. This will decrease the work of breathing until patients improve enough to no longer
need it, and ensure that the body receives adequate oxygen and that carbon dioxide is removed.

Artificial nutrition and hydration- allow patient to receive nutrition and hydration when they
are no longer able to take them by mouth.
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9. Vasoactive support/medication therapy. A vasoactive substance is an endogenous agent or
pharmaceutical drug that has the effect of either increasing or decreasing blood pressure and/or
heart rate through its vasoactivity, that is, vascular activity (effect on blood vessels).
Bedside chemical analysis – defined as chemical diagnostic testing at or near the point of care,
it utilizes microchemistry instruments potentially offers physicians the opportunity to evaluate
urgent blood test results rapidly and reliably using only drops
Continuous electroencephalographic (EEG) monitoring – allows uninterrupted assessment of
cerebral cortical activity with good spatial resolution and excellent temporal resolution. This, this
procedure provides a means of constantly assessing brain function in critically ill obtunded and
comatose patients.

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10. Neuro ICU nurses frequently perform delicate procedures such as

 inserting central lines

 pulmonary artery catheters.

They might also assist physicians with bedside procedures such as

 inserting a drain in the patient’s skull to reduce pressure.

11. basahon ra nimo the last slide

Before we finish our presentation please allow us to present a 2 min video presentation.

Thank you and goodbye….

Neuro assessment and evaluation- Neurologic assessments by neurology-trained, intensive care
physicians and staff in a NICU determine the severity of the Traumatic Brain Injury (TBI) have
been proven benefit for minimizing in-hospital mortality and length of stay. 

CT scan – (of the head) should be performed as soon as possible to detect any condition that
requires immediate neurosurgical intervention.

Intubation and mechanical ventilation- maintains an open airway and helps prevent

suffocation. This will decrease the work of breathing until patients improve enough to no longer
need it, and ensure that the body receives adequate oxygen and that carbon dioxide is removed.

Artificial nutrition and hydration- allow patient to receive nutrition and hydration when they
are no longer able to take them by mouth.

Vasoactive support/medication therapy. A vasoactive substance is an endogenous agent or

pharmaceutical drug that has the effect of either increasing or decreasing blood pressure and/or
heart rate through its vasoactivity, that is, vascular activity (effect on blood vessels).

Bedside chemical analysis – defined as chemical diagnostic testing at or near the point of care,
it utilizes microchemistry instruments potentially offers physicians the opportunity to evaluate
urgent blood test results rapidly and reliably using only drops (250 microL) of whole blood.
Continuous electroencephalographic (EEG) monitoring – allows uninterrupted assessment of
cerebral cortical activity with good spatial resolution and excellent temporal resolution. This, this
procedure provides a means of constantly assessing brain function in critically ill obtunded and
comatose patients.

Neurosurgical Procedures:

Craniotomy for trauma- performed after a traumatic brain injury. It is done to remove a part of
the skull in order to relieve pressure in the area of the brain that swells.
Carotid artery surgery- removal of blockages to retain the normal flow of blood and to
minimize the risk of a stroke. It also helps prevent a transient ischemic attack (TIA).

Major spine surgery/spinal fusion- surgery to permanently connect two or more vertebrae in
the spine, eliminating motion between them. Spinal fusion involves techniques designed to
mimic the normal healing process of broken bones.

Craniofacial and transsphenoidal surgery – a type of surgery in which instruments are

inserted through the nose and sphenoid sinus (a hollow space in a bone in the nose) to remove
tumors that are in or near the pituitary gland. A common surgery used to remove pituitary
tumors.

Supra- and infratentorial craniotomy for tumor or aneurysm – is a lateral skull base
approach suitable to access the parasellar, parachiasmatic and intrasylvian space. This approach
attempts to minimize brain retraction, an important consideration for surgeons attempting to
reach deep lesions, especially underneath the dominant hemisphere. It may be done for a variety
of reasons, including but not limited to, the following: Diagnosing, removing, or treating brain
tumors.

Cerebral aneurysm repair or tumor resection – used to treat a bulging vessel in the brain that
is at risk of rupturing or tearing open.

Laminectomy – procedure that is used to treat spinal stenosis or pressure on the nerves of the
low back. The surgery involves an incision on the back of the spine that allows the surgeon to
remove bone spurs and thickened ligaments that are pressing on the nerves of the low back.