
It Took a Village: Highlights of the Workshops at the
NCS 15th Annual Meeting and What You Can Expect
This Year
By Aarti Sarwal, Soojin Park and Jordan Winn
NCS 15th Annual Meeting theme was “It Takes a Village.” We
saw the theme coming in action as it literally took a village to
pull through 12 workshops at the beautiful Waikoloa Beach
Resort. Pre-conference workshops are an important part of our
members’ learning experience and require a year-long preparation
of multiple teams coming together. Workshops receive immense
positive feedback due to their hands-on nature and ability to
receive up-close learning experience from experts about practical
management issues. The 2017 conference was no different. The
pre-conference workshops were again a success, with over 230
people participating. Facilitators were applauded for excellent
teaching and knowledge skills, and hands-on sessions were
reported to be extremely helpful in the feedback received from
attendees. What follows is a brief synopsis to make our members
aware of the learning opportunities available through these
sessions. Please make sure to mark your calendars for this year’s
Annual Meeting, Sept. 25-28 in Boca Raton, Florida.
David Hwang directed “Prognostication, Communication and
Shared Decision Making: Palliative Care in ICU.” He was joined
by a unique group faculty from a wide range of backgrounds. The
group covered palliative care needs in severe acute brain injury,
pitfalls in neuro-ICU prognostication, discussing prognosis with
surrogates and shared decision making in the neuro-ICU. This
workshop provided a live session with a “patient’s family” that
was deemed invaluable in the feedback provided by the attendees.
There were both didactic and interactive sessions focused on
incorporating principles of palliative care and shared decision
making into neurocritical care focusing on proper timing and
triggers for palliative care consultation, common pitfalls when
formulating and discussing prognosis for patients, and the use of
formal decision aids. While this workshop is rotating off this year,
look for this topic to be covered in the conference symposiums
and in future years’ workshops.
Eric Rosenthal and Brad Kolls led two workshops on critical
care EEG to cover basic and advanced interpretation of EEG
in the neuro-ICU. Eric was joined by teaching faculty who
covered Normal and Interictal EEG, Quantitative Basis of EEG
Trend Monitoring, Ictal-Interictal Continuum and Ictal Patterns
in Seizures and Status Epilepticus. This ICU EEG workshop
taught fundamentals through didactic sessions and hands-on
experience on normal, ictal, interictal, status epilepticus and
artifactual EEG patterns. The faculty taught the American College
of Neurophysiology Society Critical Care EEG Terminology and
quantitative EEG trends to screen for seizures and ischemia.
Participants then placed this knowledge into action, rotating
through workshop stations to get hands-on experience reviewing
case studies. Experts went over practical implementation of
quantitative EEG monitors, prognostication using EEG, new
standards for continuous monitoring of delayed cerebral ischemia
in subarachnoid hemorrhage, and emerging applications of ICU
EEG. They expanded the scope of learning to quantitative EEG
methods, depth EEG recording, cortical spreading depolarization,
and management of complex ICU cases including refractory status
epilepticus. Attendees got a hands-on opportunity to explore ICU
EEG devices and quantitative EEG systems and ask questions of
the faculty who use these systems on a daily basis. This workshop
was supported by Corticare, Moberg ICU Solutions Nihon Koden
and Persyst Inc. This year, the critical care EEG workshops will
merge under the directorship of Eric Rosenthal.
The Transcranial Doppler offering was incorporated into the
workshops last year, and was expanded to offer hands-on skills
sessions in addition to two full days of coursework in preparation
for board certification. This workshop was expertly directed by
Andrei Alexandrov. The didactic portion provided a review of
applied ultrasound physics principles, cerebral and systemic
hemodynamics as used in transcranial ultrasound assessment
in critical care. The faculty helped attendees navigate through
challenges of setting up a neurosonology program in the neuro-
ICU, reviewed complete TCD protocols for SAH and stroke, and
discussed the evidence supporting TCD monitoring for various
clinical indications. There were interactive case presentations
of TCDs in the ICU. The four-part session was designed so that
participants could take them separately or sequentially; taking
all four half-day sessions provided credits required for the ASN
Neurosonology certification. This workshop was supported by
Rimed and Compumedics DWL, Andrei Alexandrov will be
bringing this workshop back this year with hopes of strengthening
the educational opportunities for neurosonology education for
our members.
Critical care ultrasound has become a required skill in the modern
ICU. An industrious group of faculty led by director Aarti Sarwal
came from a wide range of backgrounds helped attendees get
exposure to learning point of care ultrasound (POCUS) as part of
the Critical Care Ultrasound workshops. This daylong workshop
taught skills using ultrasound in the clinical evaluation and
management of a critical care patient. High-yield didactics and
faculty supervised hands-on scanning stations with live models
trained attendees to perform POCUS independently. Attendees
learned the finer points of ultrasound knobology, point of care
echocardiography, lung ultrasound, abdominal exam using the
FAST protocol, inferior vena cava measurements, optic nerve
sheath sonography, and review of resuscitation and evaluation
algorithms for shock, respiratory distress and volume assessment.
The afternoon workshop built on the basic ultrasonography skills
to learn clinical goal directed scanning with review of pathology.
This workshop was supported by Fujifilm Sonosite Inc., which
provided machines for skill stations. This workshop will return
this year under the directorship of Jose Diaz-Gomez.
Aarti Sarwal Soojin Park Jordan Winn
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