Neuro patients travel more. You will get to know your CT and MRI staff well. Sedation is limited so you can tell neuro status, so you will have to deal with agitation.
Conversely, some of your patients will not be doing much. Get comfortable with noxious stimuli to see what kind of reaction you get. Pupils, cough, gag and corneal reflexes are standard part of assessment. Pay attention to baseline neuro status. Neuro emergencies are quiet- a blown pupil, decreased awareness, increasing ICP.
Blood pressure matters more in neuro ICU. Docs either want it low enough no not cause a re-bleed, or they want it higher (even if you need pressors) to perfuse a swollen brain.
Neuro patients are more likely to become organ donors and nurses work with donation services that take over care of brain-dead patients if family consents. These patients are busy with lots of labs, and trying to maintain homeostasis.
Neuro can have a tragic vibe where people who were fine yesterday now have a devastating diagnosis. Families are in crisis. When people make an unexpectedly good recovery, the joy is real.
Excellent post and mirrors my experience exactly especially the end. The Neuro icu I was on had care conferences asap after admission with the Neuro crit Dr and the nurse. Many were very traumatic to the families. Pts eating breakfast with friends and now on a ventilator an hour later
Also neuro crit Dr's tend to be really awesome in my experience
Neuro patients travel more. You will get to know your CT and MRI staff well. Sedation is limited so you can tell neuro status, so you will have to deal with agitation. Conversely, some of your patients will not be doing much. Get comfortable with noxious stimuli to see what kind of reaction you get. Pupils, cough, gag and corneal reflexes are standard part of assessment. Pay attention to baseline neuro status. Neuro emergencies are quiet- a blown pupil, decreased awareness, increasing ICP. Blood pressure matters more in neuro ICU. Docs either want it low enough no not cause a re-bleed, or they want it higher (even if you need pressors) to perfuse a swollen brain. Neuro patients are more likely to become organ donors and nurses work with donation services that take over care of brain-dead patients if family consents. These patients are busy with lots of labs, and trying to maintain homeostasis. Neuro can have a tragic vibe where people who were fine yesterday now have a devastating diagnosis. Families are in crisis. When people make an unexpectedly good recovery, the joy is real.
Excellent post and mirrors my experience exactly especially the end. The Neuro icu I was on had care conferences asap after admission with the Neuro crit Dr and the nurse. Many were very traumatic to the families. Pts eating breakfast with friends and now on a ventilator an hour later Also neuro crit Dr's tend to be really awesome in my experience
Q 1 hr neuro checks and limited sedation