New Grad Neuro ICU

[29Nurse]

Any advice for a new RN graduate starting out in the Neuro ICU?

Things I should look up and familiarize myself prior to a residency program?

Any procedures, common dx, common meds, and so on?

Any advice would be helpful!

Thanks! :)

[nrsang97, BSN, RN]

Be familiar with external ventricular drains (EVD's), drainage and using to monitor ICP (this can do both). You will see lots of them and help put them in at the bedside. Know the signs and symptoms of increasing ICP. Know how to treat.

Know about subarachnoid hemorrhages (SAH), traumatic and non traumatic (ruptured aneurysm). Know about treatment, risk for vasospasam, know treatment for vasospasam. Know the risk window.

Know you seizure medications like Dilantin, Keppra, Depakote (valproaic acid), Vimpat.

Know about ischemic stroke and treatment, Know about using TPA. Signs and symptoms of stroke.

Know the medications nimodipine, nicardipine. Learn about vasopressors.

Know about triple H therapy (Hypervolemic, hypertensive, hypernatremic) treatment for vasospasam.

Also know about Gullian Barre, and Myesthenia Gravis as well.

Also know about spinal cord injuries.

Learn about the subarachnoid bolt (Camnio Bolt) for monitoring ICP as well. You will also assist in putting these in at bedside as well.

The neuro ICU I worked in also put in trachs and pegs at the bedside as well. Know brain death criteria. Know when to refer to your organ procurement agency.

Know your normal measurements for ICP.

Learn your ventilator settings.

Good luck. You can do it, but it will be daunting.

[29Nurse]

Thank you for your response! This is incredibly helpful!

[nrsang97, BSN, RN]

No problem. I worked in a neuro ICU for 6 years. I haven't done that in about 4 years now but I still remember it. Good luck to you.