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What to do in the Critical First Hours of a Neurological Emergency

The Emergency Neurological Life Support (ENLS) course is designed to help healthcare professionals improve patient care and outcomes during the critical first hours of a patient’s neurological emergency.  Now in its third version, ENLS demonstrates a collaborative, multi-disciplinary approach and provides a consistent set of protocols, practical checklists, decision points, and suggested communication to use during patient management.  This activity is designated for a maximum of 15 AMA PRA CME, ANCC, ACPE and CECBEMS credits upon completion. For detailed information on continuing education credits and NCS's joint provider accreditation, please click here.



Course Options    ENLS is a versatile course that can be taken either online or in a live course format. 

Online: ENLS is perfect for the busy healthcare provider. Individuals or organizations can purchase the course online, and participants can progress through the modules at their own pace. 

Live: The live ENLS course is a great addition to a conference or healthcare institution's continuing-education offerings. The course is conducted by certified ENLS trainers. Once the live course is complete, students access the ENLS course online to complete the certification process. Click here for more information about hosting a live course.
Group Purchases   For both online and live courses, healthcare facilities and medical schools can take advantage of reduced group pricing rates by purchasing a bundle of 25 or more ENLS course access codes. Click here for more information on group purchases.
Individual Purchases   ENLS is perfect for the busy healthcare provider. Individuals can purchase the course online, gain access to their own ENLS accounts and course materials, and progress through the modules at their own pace. Click here to purchase a course and get started.
Accreditation   NCS's ENLS courses have been planned and implemented by Ciné-Med and the Neurocritical Care Society. Click here for more information about accreditation, including the number of credits and/or hours are awarded for both ENLS and ENLS Recertification.
Certification   To gain ENLS certification, the online portion of the course must be completed. This involves passing the 14 exams with a score of 70% or higher. ENLS certification is valid for two years, during which an individual retains access to their ENLS account and course materials.

Note: NCS does not mail certificates. Rather, you will be able to download your own certificate once the course is complete. If you are unable to access the certificates, it is likely that you have not fully completed the course. Please review each module to verify you have passed each exam.
Recertfication   ENLS certification is valid for two years. Certification can be renewed by completing the ENLS Recertification Course. This course includes medical updates and module additions to the original course's manuscripts and protocols. To gain ENLS recertification, the online portion of the course must be completed. Click here for more information about ENLS recertification. 


Info GuideThe ENLS Informational Guide is a comprehensive tool for anyone interested in learning more about ENLS. Topics range from course overview and continuing education credits to becoming a certified ENLS trainer and how to host a live course. FAQ sections address common questions related to individual online registration and the Train-the-Trainer course, while ACGME-ENLS Residency Milestone Tables help residents chart ENLS course topics to ACGME milestones. The ENLS Information Guide is a valuable resource for anyone interested in taking the course, hosting a course, becoming a trainer, or simply learning more.

Price: $10 / $8 for purchases of 25 or more

Click here to purchase the ENLS Informational Guide.


What Others Are Saying About ENLS

“I thought the ENLS course was fantastic.  The course covers a broad range of material and is extremely clinically oriented.   The faculty were great and were free of obvious commercial bias.  In addition they gave the current consensus about protocols of care for patients and were able to highlight areas of controversy and/or ongoing research.  This course has tremendous value.”
~ Frank M O’Connell, MD, FACP, FCCP, Atlanticare Regional Medical Center

“We had a great turnout for our ENLS event. This course really served to coordinate our departments and provide useful information for both our nurses and providers. We look forward to offering the course again in the near future!”
~ Tara D. Box, RN, BSN, CNOR, Clinical Education Supervisor, Crouse Hospital

“ENLS was tough and useful. It is an amazing compilation of important and succinct information, with practical implications. Many primary specialty textbooks do not contain the information provided by ENLS, especially up-to-date details that guide fast-paced management decisions from the first encounter with the neurological or neurosurgical patient in the ED to his/her long-term NICU stay. Despite the fact that I am a mid-career neurointensivist with years of experience, I found few module questions quite challenging. I have definitely learned something new.”
~ Panayiotis Varelas, MD, Henry Ford Hospital
“The ENLS course is a great nursing tool. The course covers all the important aspects of early care and treatment for neuro patients; and the opportunity to complete the course online - at my own pace - is a perfect fit for busy neurocritical care nurses who want to advance their knowledge and skill.” 
~ Dai Wai M. Olson, PhD, RN, University of Texas Southwestern

"Mercy Health St. Vinvent Neuroscience Institute has used ENLS to train, certify and educate their Mobile Stroke Unit paramedics, nurses and others providers (NP, EM residents, EM attending and all Neuro residents, fellows and attending). Great course for any provider on the frontline of neuro-related emergencies and critical care."
~Daniel Crots, MA, IC-P, FP-C, NRP Paramedic Instructor Coordinator Mercy Health Life Flight Network


ENLS Protocols

ENLS consists of 14 protocols. Each protocol was designed and written by neurointensivists and emergency medicine physicians.  These protocols are designed to provide the same advice an expert in neurocritical care would provide if you called the physician for a consult and asked, “What should I do in the first hour to best help this patient and hand them off to you?” The 14 ENLS protocols are:

  • Acute Non-Traumatic Weakness
  • Acute Ischemic Stroke
  • Airway, Ventilation and Sedation
  • Approach to the Comatose Patient
  • Intracerebral Hemorrhage
  • Intracranial Hypertension and Herniation
  • Meningitis and Encephalitis
  • Pharmacotherapy
  • Resuscitation Following Cardiac Arrest
  • Spinal Cord Compression
  • Status Epilepticus
  • Subarachnoid Hemorrhage
  • Traumatic Brain Injury
  • Traumatic Spinal Cord Injury


  • Baylor College of Medicine - Houston, TX
  • Faxton St. Luke's Healthcare - Utica, NY
  • Indian Society of Neuroanaesthesiology and Critical Care - India
  • JFK Medical Center - Edison, NJ
  • Kalispell Regional Medical Center - Kalispell, MT
  • St. Vincent Mercy Medical Center - Toledo, OH
  • Mission Hospital - Mission Viejo, CA
  • Neurological Society Argentina - Argentina
  • Sri Lankan Society of Critical Care and Emergency Medicine - Sri Lanka
  • SUNY Upstate University Hospital - Syracuse, NY
  • Tribhuvan University Teaching Hospital - Nepal
  • UC Davis - Davis, CA (new residents)

ENLS Courses Around the World

CritiCon Colombo



General ENLS questions? Please email ENLS@neurocriticalcare.org. Thank you!