Approximately 1,300 patients each year are admitted to the Neuroscience Intensive Care Unit (NSICU) at the University of Cincinnati Medical Center. All are cared for by a Neurocritical care physician (neurointensivist) who is assisted by a team of specially trained nurse practitioners, residents, and nurses. Some patients are admitted under the care of the Department of Neurosurgery.
Nurse practitioners, fellows and resident physicians and neurointensivists provide 24-hour patient care. A neurosurgical physician is onsite 24 hours a day and able to intervene immediately in the event of a neurosurgical emergency.
The neurointensivist makes daily rounds with the rest of the neurocritical care team to review laboratory data, medical literature, imaging results, medications, and to design a daily plan of care for each patient. All patients are visited and examined on daily rounds during which the questions and concerns of patients and family members are addressed.
Caring for patients in the NSICU is a multidisciplinary effort that involves the active participation of neurologists, neurosurgeons, neurointervantionalists, neuroradiologists, neuropathologists, specialized pharmacists, PT/OT, SW and Dietitians/Nutritionists.
Our neuroscience nurses are specially trained to care for neurological patients. Nurses are assigned to one or two patients in order to provide a constant, high level of care.
Neuroscience Intensive Care Unit (NSICU)
The NSICU is designed to provide round-the-clock care for critically ill patients with neurological or neurosurgical disorders. UC Medical Center has the largest and most technologically advanced ICU in our region devoted to patients with disorders of the brain and spinal cord. The best care of patients with life-threatening neurological disorders requires teamwork among a variety of related specialties. UC Medical Center has the necessary manpower with the most board-certified neurointensivists, the largest neurosurgery department, the largest number of stroke and endovascular specialists, the largest number of epilepsy specialists, the most neuroradiologists, and the highest number of neuroscience nurses in our region. UC Medical Center is the only certified Comprehensive Stroke Center in the region.
The NSICU comprises 20 beds but is divided into two parts (South and North), separated by a short hallway. The amount of time a patient stays in the NSICU varies according to his or her medical condition. Patients recovering from surgery who experience few complications may spend only a couple of days in the NSICU. Patients who have suffered an intracranial hemorrhage or have serious medical complications have a longer stay. The average patient spends about five days in the NSICU before moving to a step-down unit, neuroscience floor bed, or transferred to another facility.
The Family’s Role
Having a serious neurological and neurosurgical illness can be frightening for both patients and their family members. Our staff works closely with patients and their families to reduce anxiety as much as possible by providing medical information and treatments in a supportive and caring environment. Family member presence in the ICU is welcomed to reduce the stress of illness for both patients and their loved ones. The NSICU staff is always available to inform and educate about particular aspects of neurological and neurosurgical disease and treatment. In addition to the NSICU team, social workers, care coordinators and chaplains, there are patient representatives whose role is to meet with families on a regular basis to address any unmet needs.
Advanced Technology
Our NSICU is the largest and most technologically advanced neuroscience ICU in our region. We routinely employ an array of advanced sensor technologies to monitor a variety of brain functions and attributes. Our capabilities include:
- Brain tissue oxygen monitoring
- Measuring brain electrical activity via implanted electrodes
- Brain tissue temperature measurement and management
- Continuous brain blood flow measurements
- Continuous video/EEG monitoring
- Drainage of ventricular and lumbar cerebrospinal fluid
- Intracranial pressure monitoring
Many of these techniques can be employed simultaneously, and the results are fed into specially designed workstations so trends and correlations can be tracked and acted upon.
In addition, a variety of advanced imaging technologies are available to us at the UC Medical Center including biplane and rotational cerebral angiography, 3T MRI imaging, MR spectroscopy, PET imaging, nuclear blood flow studies, CT angiography, and intraoperative MRI.
Comprehensive Stroke Program
Ischemic stroke and intracranial bleeding are the two most common disorders among patients admitted to our NSICU. UCMC has the only certified Comprehensive Stroke Center in our region. This capability includes the 24/7 availability of skilled neurointerventionalists who can remove clots causing ischemic strokes from brain arteries, administer thrombolytic therapy (tPA) intravenously or directly into the brain’s arteries, occlude aneurysms using coils or other techniques, or open narrowed arteries in the neck and brain using stents or other devices.
Neurosurgery
Our Neurosurgery department includes nationally known surgeons who are capable of performing a wide range of complex procedures including back/spine operations, clipping of aneurysms, obliteration of arteriovenous malformations, cerebral bypass operations, removal of benign and malignant brain tumors, drainage of abscesses and hematomas. UC Medical Center neurosurgeons routinely implant devices to treat Parkinson’s disease and control seizures as well. As a Level I trauma center our neurosurgeons commonly manage complex traumatic injuries of the brain and spine.