COVID-19 Neurocritical Care Survey
In many hospitals, patients with serious neurologic illnesses that require intensive care are placed in a dedicated Neurocritical Care Unit (NCCU) and are cared for by a neurointensivist along with neurocritical care-trained nurses. This care team is important and has been shown to improve neurological outcomes in patients with brain and spinal cord injuries (Jeong, 2019) (Kim, 2020). This changed after a large number of people tested positive for the COVID-19 virus in 2020. Many of these “pre-vaccine” cases required hospitalization along with the utilization of intensive care units and critical care teams. Hospitals around the country experienced maximum ICU bed capacity and there was even a projected link between limited ICU availability and an increase in COVID-19 deaths (Zebrowski, 2020). Hospital leadership looked for solutions to open up as many ICU beds as possible. For Tufts Medical Center in Boston, MA, a decision was made to displace the NCCU and convert it into a COVID-19 specific unit. As a result, dedicated neurocritical care nurses were re-located to other units and patients in the NCCU were moved to different floors around the hospital.In addition to respiratory symptoms, COVID-19 can be associated with neurological symptoms such as impaired consciousness (Laurent, 2020). Patients who had a neurologic complaint and were COVID-19 positive would have been admitted to a separate locationthan a COVID-19 negative neurocritical care patient. Separating neurocritical COVID-19 positive and negative patients is not known to be beneficial or necessary.
Disinformation circulated by media outlets regarding COVID-19 transmission played a role in keeping patients away from hospitals in 2020. Even though ICUs around the country were at maximum capacity, there were significant reductions in stroke hospital admissionsand delays in emergency care for stroke patients (Wu, 2020). The delay in care could have negatively impacted neurocritical care patient outcomes during this time.
The Tufts Medical Center study team has developed the hypothesis that other hospitals around the world had similar experiences during 2020. They also hypothesize that decentralizing care for these patients may have led to more negative patient outcomes than previous years. In combination with the existing Tufts Medical Center NCCU database, this survey will provide insight into how other hospitals handled the first COVID-19 wave and could provide guidance to hospital leadership for future pandemic waves.
Target Audience: All Members
Duration: 5 minutes
Contact: Deborah Green-LaRoche, MD
Survey closes: June 31, 2023
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