Transcranial Doppler (TCD) Course Part 1-4
Course Director: Aarti Sarwal, MD
This workshop offers four half-day sessions, equaling two full days of coursework and hands-on skills development for transcranial doppler. Credits can be obtained to count toward the total 40 hours required to qualify for the ASN Neurosonology examination (www.asnweb.org). The completion of all four courses will provide registrants with an in-depth review of applied principles of ultrasound physics, cerebral hemodynamics, critical review of clinical indications of transcranial Doppler, reading reports, billing tips and building a neurovascular program. Attendees will get hands-on experience in both imaging and non-imaging Doppler. Interactive case presentations can be credited toward the 100 total case interpretation experience required to take the TCD part of the ASN examination.
- Part 1- Monday 10/14, 8:00 AM - 12:00 PM
- Didactic session, TCD and clinical applications
- Part 2- Monday 10/14, 1:00 PM - 5:00 PM
- Hands-on training on performing TCD
- Part 3- Tuesday 10/15, 7:30 AM - 11:30 AM
Part 4- Tuesday 10/15, 12:45 PM - 4:45 PM
- Interactive review of clinical cases and writing reports
Basic Airway and Bronchoscopy
Course Director: Ines Koerner, MD, PhD
This is a hands-on workshop that teaches fundamentals of airway management and critical care bronchoscopy. Brief didactic sessions cover indications, techniques and devices in case-based reviews. Participants then get to practice fundamental intubation skills including the use of airway rescue devices at instructor led skill stations. Bronchoscopy stations provide opportunities to learn basic airway inspection and bronchoalveolar lavage. Pick up new skills, or practice existing ones — dynamic faculty will support individualized learning.
Bioinformatics and Machine Learning for Data-Driven Research
Rajat Dhar, MD, FRCPC
“Data” forms the bedrock of scientific discovery in the 21st century. Data-driven research has the potential to revolutionize the practice of neurocritical care, a discipline steeped in acquisition of multi-dimensional data on our patients with a variety of brain injuries. We now have the ability to collect and analyze data regarding not only clinical complications and outcomes but also physiology, imaging, and biologic data such as genetics and gene expression. This hands-on workshop will provide an opportunity for interactive learning to understand concepts of data science, as well as how to approach data manipulation and analysis. These concepts will be taught using real-world examples relevant to neurocritical care. Faculty are leading experts in data-driven research and machine learning. Attendees will have the chance to work with real de-identified data sets containing physiologic data, acute brain imaging, and patient genotypes. Attendees will learn the core principles of machine learning and how data science can be utilized to dissect patterns in data more deeply. The workshop will teach approaches on building platforms for data extraction, visualization, and analysis. Attendees will familiarize themselves with available image segmentation software and principles of computer vision in performing quantitative lesion analysis; attendees will also be acquainted with data analysis toolsets for association testing of patient genotypes and clinical phenotypes. Attendees are expected to bring a laptop and will receive data and links to download necessary software in advance of the workshop. Hands-on experience will be supplemented by interactive demonstrations by faculty of advanced principles.
Critical Care Ultrasound
: Jose Diaz-Gomez, MD
Neurocritically ill patients may have several cardiopulmonary morbidities requiring emergency intervention. Timely (noninvasive) diagnosis is key to prevention as well as effective management of such complications. Critical care ultrasound skills hence have become indispensable in the practice of intensive care. This workshop will provide participants with rigorous instruction in the acquisition and use of cardiopulmonary ultrasonography in the neurocritical care setting. Attendees will learn introductory knobology for imaging optimization using different ultrasound machines and perform heart and lung ultrasounds . Clinical algorithms using heart and lung ultrasound and case based reviews of use of ultrasound in the deteriorating patient will be presented via high quality didactics, followed by hands on skills stations.
: Amedeo Merenda, MD
This hands-on workshop will focus on the fundamentals and beside implementation of both basic and advanced intracranial monitoring technologies for the goal of preventing or minimizing secondary brain injury. It is designed for health care providers in neurology, neurosurgery, emergency medicine and intensive care who care for patients with acute severe brain injury. The first hour of the course will be case-based, providing a review of guidelines on the indications and interpretation of intracranial monitoring technologies that can assist in clinical-decision making and optimization of care for patients with acute brain injury. The majority of the workshop will be a hands-on training session in which all attendees will learn and practice techniques on plastic skulls. Attendees will learn to insert, setup, manage, and remove intracranial monitoring devices including ventriculostomy, intraparenchymal ICP monitors, brain tissue oxygen probes, cerebral blood flow monitors and cerebral microdialysis. The workshop will enhance the participant’s practical utilization of these intracranial tools that have the potential to guide and fine-tune therapy during neurointensive care.
Neurocritical Care Pharmacotherapy
: Aaron Cook, PharmD
Expert faculty from across the country will cover new, controversial, and evidence-based pharmacotherapy strategies for the neurocritically ill in a case-based and interactive learning environment! This year’s topics include: unique monitoring strategies in anticoagulant/antiplatelet reversal, an update on paroxysmal sympathetic hyperactivity, neuro-specific issues in alcohol withdrawal, innovative medication use strategies, drug dosing & safety in plasmapheresis, and a contemporary discussion of newer/novel anti-epileptic agents in status epilepticus. Attendees are encouraged to bring their own cases/examples to the course for discussion.
: Christos Lazaridis, MD, EDIC
This workshop provides concise, clinically-oriented reviews of:
A) Basic and advanced pathophysiologic concepts including Shock physiology; cardiac output and venous return curves; fluid responsiveness; heart-lung interactions; assessment of organ perfusion; and review of vasoactive medications
B) Principles of “minimally invasive” hemodynamic monitoring modalities based on arterial pressure waveform, and pulse contour analysis, transpulmonary thermodilution, and thoracic bioreactance
C) Case discussions centered on the role for hemodynamic monitoring and optimization for the following clinical scenarios: 1. Severe TBI with monitoring of partial brain tissue oxygenation (± acute respiratory distress syndrome), 2. Aneurysmal Subarachnoid Hemorrhage with stress cardiomyopathy (± delayed cerebral ischemia), 3. Spinal cord injury with neurogenic shock, and 4. Management of the brain-dead organ donor.
Finally, attendees will have the hands-on opportunity to familiarize themselves with a variety of monitoring devices. Faculty comprises experienced intensivists from diverse backgrounds including medicine, anesthesia, and neurology.
Advanced Practice Providers
: Dea Mahanes, MSN, RN, CCNS, CCRN; Liz Fox, CNS, AGACNP-BC
Advance Practice Providers contribute to the care of critically ill neuroscience patients in many ways. This session focuses on both clinical care and role-specific professional issues. Specific clinical topics include the diagnosis and treatment of status epilepticus and concepts in targeted temperature management. Information will be presented using a case-based approach, allowing participants to apply diagnostic reasoning and management principles, integrating critical care concepts such as hemodynamic support, sedation/analgesia selection, and critical care EEG. Professional practice issues will also be addressed, focusing on topics such as APP team structure, ongoing development, and how to achieve satisfaction and purpose throughout your career.
: Soojin Park, MD
This workshop provides a stepwise approach to the practical implementation of managing and visualizing the data from a multimodal neuromonitored patient, established through real cases. You will learn the fundamentals of practical data acquisition and analysis. Finally, we will provide an overview of possibilities for research using high-resolution data.
Attendees will discover methods to acquire and process multimodality data for real-time management and research. Knowledge of programming and scripting languages, though welcome, is not required to successfully participate in this course. Required software and example data will be provided for the workshop. You will need to bring a laptop (with administrator access in order to be able to install the software) to fully benefit from this course.
Brain Death Determination
: David Greer, MD
Correct determination of brain death is an essential skill for anyone practicing neurocritical care. A full understanding of the principles, techniques and pitfalls is essential to good practice. This course will provide an in-depth educational experience for practitioners of all levels, providing a clear and comprehensive explanation of the principles of brain death, including prerequisites, avoiding confounders, proper examination technique, apnea testing procedures, and when to use ancillary tests. Participants will have hands-on experience using manikins, with bedside instruction from experienced senior clinicians. There will also be education regarding pediatric brain death determination, as well as how to perform effective communication about brain death, particularly what to do when families/surrogates challenge the diagnosis.
Building a Quality Improvement Program in the NICU
: Casey Olm-Shipman, MD; Debra Roberts, MD, PhD
The Quality and Performance Improvement Workshop (QPIW) will provide crucial concepts necessary for NCS leaders to develop effective multidisciplinary neurocritical care QI programs within their institutions. QPIW will enhance knowledge essential to improving process and outcome measures in neurocritically ill patients. Existing guidelines and performance measures will be reviewed as a foundation for development of QI projects. With these tools in mind, we will explore the nuts-and-bolts of building a comprehensive neurocritical care QI program, which include building a multidisciplinary QI team, garnering buy-in from institutional leadership and establishing administrative support, identifying and tracking neurocritical care QI metrics, and developing infrastructure for data collection and display.
The workshop will include case illustrations of how to design and implement QI projects. We will conclude with a discussion of pathways to scholarship in QI. Course participants will receive a valuable electronic guide describing useful resources pertinent to conducting QI in neurocritical care, including QI-relevant guidelines, databases, and project development materials.
Critical Care EEG
: Jan Claassen MD, PhD
This workshop will focus on the practical utilization of continuous EEG in the ICU with focus on challenging patterns such as the ictal interictal continuum. We will demonstrate rounding practices in the ICU with the benefit of EEG monitoring. We will discuss current and evolving approaches of quantitative EEG analysis. The workshop will provide a theoretical overview, interactive group discussion with audience participation, and a hands on skills station to familiarize participants with the use of the EEG software. The overarching goal will be to empower the attendees with knowledge about the current and future potential of EEG as a neuromonitoring tool.
Essentials of Neurocritical Care Certification Course (ENCC)
Essentials of Neurocritical Care Certification Course (ENCC) is designed to review and teach the essential topics of neurocritical care through a combination of on-line course material, in-person case discussions, and hands-on workshops. Prior to the live session, participants will be given access to the online course, which includes 15 required core modules with recorded lectures and examinations, and access to an additional 18 elective topic modules. Training will culminate at the live session with an intensive two days of case discussions and hands-on workshops, which will teach specific neurocritical care techniques.
The course requires pre-registration and an additional fee.
- Monday, October 14, 8:00 PM – 4:30 PM
- Tuesday, October 15 from 7:30 PM – 4:45 PM
Post-Meeting Workshop: ENLS Live Course
NCS is offering a post-meeting ENLS course on Friday, October 18 following the Annual Meeting. Please be advised that this course requires pre-registration and an additional fee.
The Emergency Neurological Life Support (ENLS) course is focused on improving care during the first hours of contact for patients with acute neurological emergencies. Special attention is placed on timely collection of relevant data which can be communicated effectively to consultants from the emergency department setting. The course consists of 14 ENLS modules that span a broad range of neurological emergencies and present a step-wise approach to early clinical care. Each module contains an initial algorithm, a checklist of important clinical points, and a list of information needed for communication to improve transitions across care settings.
The ENLS course undergoes a content update once every two years. ENLS Version 4.0 includes updated content with a new area of emphasis on patient transport. This revised version of ENLS continues to provide an algorithmic approach to the early stages of clinical care for patients with acute neurological emergencies. It also will serve as a springboard for ongoing education and improvements in the quality of clinical care for these patients.
Participants of this course will be given access to the online ENLS course. Successful completion of the online course grants participants two-year ENLS certification and 15 continuing education credits.
The ENLS 4.0 manuscript will also be available for purchase for $62.00. This popular course companion is a hardcopy of some of the online course materials. Highly recommended! Registrants who purchase the ENLS 4.0 Manuscript will be prompted to enter their shipping address, to receive this material via mail. Shipping is included in the price of the product