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INTERNATIONAL NEUROCRITICAL CARE assessed by multidisciplinary teams which include respiratory 2) the unavailability of clinical pharmacists and specialized therapists, physical therapists, occupational therapists, and nurse practitioners, 3) restrained bed capacity, 4) confined use of nutritionists. The microbiology team also conducts their daily advanced multi-modality neuromonitoring as more complex cases rounds on ICU patients. On a weekly basis, multi-disciplinary are seen, and 5) possible funding constraints with the current cycle patient targeted meetings are conducted to discuss and approve of low oil prices. overall treatment plans. Ibn Sina ICU faced four exciting years of transition into the only All non-traumatic SAH cases in Kuwait get transferred to Ibn Neuro ICU in Kuwait. The paramount motivating factor for the Sina ICU with an approved protocol based treatment plan. perseverance that the team members graciously carried was the rise Around 80% of aSAH cases were treated with coiling in 2014 in the ICU stories of success and viewing a number of our patients which compares to a 20-30% coiling rate in previous years. An socially visiting the unit on a voluntary and independent basis aSAH database was created and the unit became a high volume after discharge. Overall, a sense of pride and morality got boosted aSAH center. among all ICU health care staff working in the unit yet it remains a work in progress. Invasive ICP monitoring and CT angiography and perfusion scans have become the standard of care. The use of Doppler sonography, extended EEG monitoring, minimally invasive cardiac output monitoring, point-of-care ultrasound assisted line insertions, advanced difficult airway equipment and fiberoptic bronchoscopy have flourished since 2012. Incorporation of further non-invasive neuromontoring devices is planned. As of late 2014, remote presence technology became a standard for the neurointensivist during the evening rounds and in emergencies. This technology introduced the possibility of international second opinions on interesting and challenging cases and bilateral teaching sessions. Current limitations in the workplace include: 1) a limited number of health care professionals with specialized expertise in neurocritical care in face of a rapidly expanding population, 19


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