Admission Criteria for NSCU

    • Neurovascular-Ischemic
      • Large hemispheric infarction defined as greater than 2/3 vascular territory and/or early signs of shift or impending herniation.
      • Cerebellar/posterior fossa infarction with threat of herniation or brainstem compromise
      • Cerebral edema requiring hyperosmolar (3% saline) therapy and/or ICP monitoring
      • Fluctuating exam suggesting of ongoing ischemia; induced hypertension
      • Status post interventional therapy
    • 2 Neurovascular-hemorrhagic
      • infra- or supra-tentorial spontaneous intracerebral hemorrhages that require ICU admission (refer to ICH Stroke Unit admission guidelines)
      • Aneurysmal/non-Aneurysmal subarachnoid hemorrhage
      • AVM post intervention/embolization and/or resection
      • Non-ruptured aneurysm coiling/clipping
    • Trauma
      • Patients with abnormal imaging and depressed GCS in setting of traumatic brain injury
      • Acute subdural/epidural hemorrhages
      • Chronic subdural hemorrhages > 10cm in thickness or <10cm in thickness in presence of neurological symptoms
    • Tumors
      • Evidence of vasogenic edema, shift with risk of herniation or neurological compromise
      • Osmotherapy/ICP monitoring for cerebral edema
      • Post-op craniotomy
    • Spine
      • Acute cord injury-trauma, malignancy
      • Post-operative cervical/thoracic fusion/lami with risk of respiratory decompensation
    • Status Epilepticus-convulsive or nonconvulsive
    • Neuromuscular disease
      • Guillain-Barre with change in VC and or NIF by 30% in a 24-hour period or a VC <20mg/kg or NIF <25cm H20 or evidence of autonomic instability
      • Myasthenic crisis
    • Other
      • Neurological patients with evidence of hemodynamic instability requiring vasopressor therapy
      • Neurological patients with evidence of respiratory compromise requiring mechanical ventilation
      • Neurological patients requiring invasive hemodynamic monitoring

REFERENCE:

NSUH Guidelines:  Neurosurgical Intensive Care Unit Admission Protocol.  11/18/2014

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