Neuro ICU patient population?

[Chaserr]

Out of curiosity, what kind of patients are seen in Neuro ICU? Most common diagnosis?

[Esme12, ASN, BSN, RN]

depending on the facility.....CVA, head bleeds, aneurysms, invasive neurological procedures for aneurysms/brain, seizures/status....some neurological disorders....MS, ALS etc.

[Mully]

depending on the facility.....CVA, head bleeds, aneurysms, invasive neurological procedures for aneurysms/brain, seizures/status....some neurological disorders....MS, ALS etc.

A couple not mentioned here... Guillain barre, Traumatic brain injury/poly trauma.

[ninja-nurse, BSN]

My facility mostly sees SDH's, SAH's, CVA's and the occasional tumor. Of course, we ARE in Florida, so the majority of our patients are "grandma/grandpa fell and hit their head". In the 2 years I've worked here I think I've seen 3 Myasthenia Gravis, 1 Guillain Barret and 1 MS.

[amajeste]

I agree with the above. We see a lot of CVAs and TIAs especially if the patient got TPA our standard is Neuro ICU for at least 24 hours. We see a lot of SAH and they stay in the Neuro ICU forever because of the risk of vasospasims, at least 2 weeks. Also see a lot of TBIs. I am in New Orleans so I see a lot of people who were drunk and fell or got into bar fights. We occasionally will get overflow from the MICU and CCU. We get a lot of neurosurgery patients but it's mostly the craniotomies. We don't get many spinal surgeries because they'll go to the step down unit. Also Neurogenic Shock and Brain death patients who are donating their organs. Neuro ICU can be very sad because our patients tend to not have the best outcomes.

[nurseactivist]

Trauma centers/public hospitals have GSWs, MVAs with TBIs.

[TWD_RN]

I'm sure it depends on the facility. I work in a level 2 trauma hospital that is also stroke certified on a NICU/Trauma ICU. We get all the above brain injury, stokes bleeds, tumors, MSE, SIADA, and potential organ donors. We also get thoracotomies, MVA, GSW, crush injuries, and complicated spinal cord surgeries (usually back and neck SX go our stepdown unit where I use to work). We have a lot of poor outcomes and patients tend to be there for a while. You will get use to death (or switch to another specialty), but the good cases are really something, and when you catch a slight neuro change and save someone it is the best feeling imaginable. Tension with families get high and I swear some days it's like an episode of Jerry Springer just to watch them.

[Natasha A., CNA, LVN]

I'm sure it depends on the facility. I work in a level 2 trauma hospital that is also stroke certified on a NICU/Trauma ICU. We get all the above brain injury, stokes bleeds, tumors, MSE, SIADA, and potential organ donors. We also get thoracotomies, MVA, GSW, crush injuries, and complicated spinal cord surgeries (usually back and neck SX go our stepdown unit where I use to work). We have a lot of poor outcomes and patients tend to be there for a while. You will get use to death (or switch to another specialty), but the good cases are really something, and when you catch a slight neuro change and save someone it is the best feeling imaginable. Tension with families get high and I swear some days it's like an episode of Jerry Springer just to watch them.

Nice! You must have some great assessment skills :)

[TWD_RN]

Yah, I guess good assessment come with practice, like q1h Neuro checks ;-)

[TWD_RN]

@Mully, I'm sure they just forgot, Gillian Barre is so rare, but yes, we do also see them on the unit. I once had a patient with West Nilewwhich was interested, especially because he survived with little deficits. I think he was 70 or 80 ish, so it was a real supprise how well he did after.