Page 33

ezMag_277323_SmithBucklin_NCS_March_Currents_3

Neurocritical Care at the Cleveland Clinic - A Truly Multidisciplinary Approach Organized in institutes and centers, the Cleveland Clinic structure is centered around specific diseases, which allows the close interaction of physicians with different training backgrounds to better achieve the common goal of improving patients’ outcomes. To that end, the Cerebrovascular Center houses vascular neurologists, neurointensivists, vascular neurosurgeons and neurointerventionalists under the same roof and fosters a collegial and constant exchange of ideas that blur traditional lines of medical specialties and has led to improved outcomes, novel research ideas and unique educational experiences for trainees. Cleveland Clinic’s main campus has a 24-bed neurointensive care unit that cares for some of the sickest patients in the nation, many of whom have complex medical and surgical pathologies. A total of five board-certified neurointensivists, two vascular neurosurgeons, six neurointerventionalists, seven vascular neurologists, dedicated pharmacists and various acute care nurse practitioners contribute to the clinical management of patients with neurovascular disorders requiring critical care. We also have close collaborations with general neurologists and neurosurgeons and engage in a very active continuous EEG monitoring program in the NICU, which is the source of several research projects that will help define its role in the care of this complex patient population. Dedicated ICU-EEG and neuro-infectious diseases expertise is just one of the many unique features of our program. Neurointensivists and nurse practitioners, along with trainees, provide high-intensity staffing for 12 hours during daytime. After 7 p.m., nurse practitioners and fellows are available on-site, while neurointensivists are available via tele-medicine and general intensivists ready to respond to emergencies if required. Besides tele-ICU, other medical technologies available include portable CT scanner, invasive means of intracranial pressure, cerebral blood flow and partial pressure of brain oxygen determination, as well as a certified transcranial Doppler program available seven days a week, focused cardiac ultrasound, fibreoptic bronchoscopy and non-invasive cardiac output determination. 33


ezMag_277323_SmithBucklin_NCS_March_Currents_3
To see the actual publication please follow the link above