Members of the medical team

Neurocritical care is a multi-disciplinary field comprised of a collaborative effort by:

Neurointensivists Nurse Practitioners and Physician Assistants

Rehabilitation Professionals

Neurosurgeons

Housestaff  Social Workers
Interventional / Endovascular Physicians

Pharmacists 
Other Professionals  
Nurses
 

Neurointensivists

Neurointensivists are physicians specially trained in neurocritical care. Their primary training may be in neurology, neurosurgery, anesthesiology or internal medicine, but they have undergone additional subspecialty training to care for the unique needs of neurocritically ill patients. Along with treating neurological injuries, neurointensivists also manage medical complications such as heart arrhythmias, lung or blood stream infections, blood clots, liver or kidney failure and a variety or respiratory disorders. Neurointensivists are able to provide complete care for patients by integrating and balancing the management of both the brain and the body. Neurointensivists provide medical management and perform many bedside invasive procedures (such as intubation, central line placement, and brain pressure monitor placement). In many facilities, neurointensivists are the leaders of the multi-disciplinary neurocritical care team.

Neurosurgeons

Neurosurgeons perform brain and spine surgery and are essential for the care of many neurologically ill patients. Typical operative procedures include the removal of brain tumors, obliteration of intracranial vascular abnormalities, and spinal surgery to name a few. Neurosurgeons and neurointensivists work closely in the daily decision making process for critically ill neurosurgical patients.

Interventional / Endovascular Physicians

Interventional endovascular physicians perform diagnostic and therapeutic angiographic procedures. An angiogram involves the placement of a catheter into the artery in the thigh with the injection of contrast into the arteries that enter the brain. Through minimally invasive techniques, these physicians can treat a variety of vascular problems such as injecting clot-busting medication into brain clots to treat stroke, coiling off aneurysms (abnormal ballooning of blood vessels that is prone to rupture) to treat subarachnoid hemorrhage or stenting of stenotic (narrowed) carotid arteries, among others.

Pharmacists

Pharmacists are an integral part of the neurocritical care team.  They work with the physicians and nurses to ensure safe and effective use of medications.  Pharmacists provide information on selecting the correct medications, proper dosing, and potential side effects. Pharmacists work with the team to monitor the impact of medications on the patient’s condition so that changed can be made if needed.

Rehabilitation Professionals

Most patients with neurological illness or injury require rehabilitation to prevent and treat long-term problems. This process begins early in the hospital stay, while the patient is still in the neuro-ICU. Examples of rehabilitation professionals include physical therapists, occupational therapists, and speech language pathologists. 

Nurses

Nurses provide bedside care for patients in the neuro-ICU and are invaluable members of the team.  Nurses are responsible for closely monitoring the patient’s condition, administering medications, performing treatments, and educating patients and families. Nurses ensure smooth and consistent patient care.  Nurses who care for critically ill neuroscience patients are specially trained to recognize subtle changes in patient condition so that the team can quickly intervene. Clinical Nurse Specialists are advanced practice nurses who work with patients, families, nurses, and other members of the health care team to improve outcomes for patients. 

Nurse Practitioners and Physician Assistants

Nurse practitioners (NP) and Physician Assistants (PA) work directly with the care team to deliver patient care.  NPs and PAs deliver medical care, perform procedures, write orders and help execute the daily plan of care for neuro-critical care patients.  NPs are advanced practice nurses who have undergone additional training to become nurse practitioners.  Physician assistants train for their role in working with physicians.  Many NPs and PAs undergo specialty training in neurocritical care.

Housestaff

Interns, residents and fellows are commonly referred to as housestaff.  They are all physicians who have earned their medical degrees, but are at varying stages of clinical training.  Interns are first year residents who have just graduated from medical school.  Residents are trainees focusing on a particular specialty (in the neuro-ICU they are typically training in neurology, neurosurgery, internal medicine or anesthesia) and fellows have completed residency and are training in specific medical sub-specialties.  Neurocritical care is a subspecialty with its own fellowship training process.  The housestaff work under the direction of the attending neurointensivist. 

Social Workers

Social workers provide additional support to guide families through the rehabilitation and discharge process.  Social workers can provide information on insurance coverage and home care, as well.  They are also available to provide spiritual and emotional support to families in need.

Other Professionals Who Provide Care in the Neuro-ICU

  • Respiratory therapists (RTs) work with the doctors and nurses to ensure that breathing is adequate using oxygen, a ventilator, and other treatments as needed.
  • Social workers provide emotional support. They may also address financial concerns and help patients and families prepare for discharge. Some hospitals have case managers or specially trained discharge planners for this purpose. 
  • Chaplains provide spiritual support throughout the patient’s hospital stay.