Acute Care Neurosurgery By Case Management

This book reviews the common clinical scenarios that might trigger emergent consultation for neurosurgical intervention, with attention to key components of the clinical interview and exam, optimal diagnostic evaluation, indications for and the goals of operative intervention, perioperative considerations, and strategies for complication mitigation. This is not a surgical atlas, but rather, a road map for the journey to the operating room door. The intent is to establish a systematic, evidence-based action plan for the patient presenting in neurologic crisis. Each chapter opens with a relevant case vignette and then unfolds through uniform sections to tell the story of how one might approach the disease entity in question, from initial request for consultation to definitive management, highlighting steps of the decision-making process: • What are the highest yield questions to ask during a focused interview? • What are the most pertinent objective exam findings? • What is the proper differential diagnosis? • What is the most appropriate and efficient plan for diagnostic evaluation – with respect to laboratories and imaging? • Does this patient have an indication for emergent or urgent neurosurgical intervention? • If so, what is the goal of that intervention? • What are the most common potential complications of the proposed procedure, and what steps might be taken to mitigate those risks? Each chapter is punctuated by 3-5 teaching pearls, summarizing these key elements. The overall goal is to create a framework for assessment that might be applied in the emergency department, the trauma bay, or the ICU when a neurologic emergency arises. The scope of the text encompasses not only cranial and spinal trauma, but also entities such as shunt failure, stroke, aneurysmal subarachnoid hemorrhage, pituitary apoplexy, cauda equina syndrome, and central nervous system infection that might require time-sensitive intervention. An additional section addresses issues requiring emergent neurosurgical response in the ICU setting, including sudden neurologic worsening, status epilepticus, and abnormal clotting/ coagulopathy. The text will not only serve as a valuable resource for those preparing to take the oral board exam, but will also provide a targeted refresher for clinicians taking general neurosurgical call in the community as well as an educational reference for mid-level practitioners and those in training who are serving as first responders on behalf of a neurosurgical service.

This book reviews the common clinical scenarios that might trigger emergent consultation for neurosurgical intervention, with attention to key components of the clinical interview and exam, optimal diagnostic evaluation, indications for and the goals of operative intervention, perioperative considerations, and strategies for complication mitigation. This is not a surgical atlas, but rather, a road map for the journey to the operating room door. The intent is to establish a systematic, evidence-based action plan for the patient presenting in neurologic crisis. Each chapter opens with a relevant case vignette and then unfolds through uniform sections to tell the story of how one might approach the disease entity in question, from initial request for consultation to definitive management, highlighting steps of the decision-making process: • What are the highest yield questions to ask during a focused interview? • What are the most pertinent objective exam findings? • What is the proper differential diagnosis? • What is the most appropriate and efficient plan for diagnostic evaluation – with respect to laboratories and imaging? • Does this patient have an indication for emergent or urgent neurosurgical intervention? • If so, what is the goal of that intervention? • What are the most common potential complications of the proposed procedure, and what steps might be taken to mitigate those risks? Each chapter is punctuated by 3-5 teaching pearls, summarizing these key elements. The overall goal is to create a framework for assessment that might be applied in the emergency department, the trauma bay, or the ICU when a neurologic emergency arises. The scope of the text encompasses not only cranial and spinal trauma, but also entities such as shunt failure, stroke, aneurysmal subarachnoid hemorrhage, pituitary apoplexy, cauda equina syndrome, and central nervous system infection that might require time-sensitive intervention. An additional section addresses issues requiring emergent neurosurgical response in the ICU setting, including sudden neurologic worsening, status epilepticus, and abnormal clotting/ coagulopathy. The text will not only serve as a valuable resource for those preparing to take the oral board exam, but will also provide a targeted refresher for clinicians taking general neurosurgical call in the community as well as an educational reference for mid-level practitioners and those in training who are serving as first responders on behalf of a neurosurgical service.

Prepare for a new career as a case manager—or just upgrade your skills to a whole new level—with the newly updated Case Management: A Practical Guide for Education and Practice, 4th Edition. Ideal for case management certification (CCMC) exam preparation, this is a thorough review of the case manager’s many roles and skills, from acute to post-acute care. Whether you are a nurse transitioning to case management or already active in it, this is your road map to coordinating successful patient care, from hospital to home. Build a strong case management career foundation, with expert, evidence-based direction: NEW chapter on case manager orientation programs that offers orientation checklists, competency assessment, and learning profiles, with available online tools NEW topics on current practice issues and developments, including the impact of the Patient Protection and Affordable Care Act and value-based care NEW content on experiential, problem-based learning—learning practices, training programs, case management team professional development Offers in-depth, evidence-based guidance on: The case manager’s roles, functions, and tasks Key concepts—quality management and outcomes evaluation, legal and ethical considerations, case management process, utilization management, transitions of care The role of the nurse case manager versus social worker role Strategies that ensure effectiveness of case management models Coordinating care, protecting privacy and confidentiality, health insurance benefit analysis, practice standards The Case Management Code of Professional Conduct, accreditation agencies and standards, specialty board certifications Management of resources and reimbursement concepts Case management in various settings—acute care, emergency department, admissions, perioperative services, disease management, insurance case management, palliative care, end-of-life care, hospice, home health care, physician groups, public health/community-based care, rehabilitation Ideal preparation for the CCMC exam—offers a large portion of CCMC exam content—and for Continuing Education Unit (CEU) for Case Management study A must-have desk reference that offers plentiful case studies—considered to be “the bible” of case management

An authoritative and comprehensive review of the most important clinical issues facing critically ill neurologic and neurosurgical patients. The authors provide pertinent basic, clinical, diagnostic, and management guidelines for all the conditions commonly encountered in the neurocritical care unit, including the management of autonomic disorders that require critical care, postoperative management, and endovascular treatment. The authors also discuss the latest developments in the monitoring of different body systems, emphasizing the management of cardiorespiratory complications and other medical conditions that may threaten the patient's life. Also detailed are the concepts of intracranial physiology and current neuromonitoring techniques, subjects whose understanding is basic to effective management of critically ill neurologic patients. Numerous tables, figures, diagrams, and radiographs simplify and explicate both the diagnostic and therapeutic processes.

Brain injury is a worldwide leading cause of mortality and morbidity and requires early and appropriate management to minimize these adverse sequelae. Despite such needs, access to specialist centers is limited, forcing both immediate and secondary care of these patients onto generalist staff. These responsibilities are made more problematical by differences in patient management between and even within specialist centers, due in part to an insuffcient evidence-base for many interventions directed at brain injury. This book is borne out of the above observations and is targeted at em- gency and acute medicine, anesthetic and general intensive care staff caring for brain injury of diverse etiology, or surgical teams responsible for the inpatient care of minor to moderate head trauma. Although explaining the various facets of specialist care, the book is not intended to compete with texts directed at neurosciences staff, but aims to advise on optimal care in general hospitals, including criteria for transfer, by a combination of narrative on pathophysiology, principles of care, templates for documentation, and highly specifc algorithms for particular problems. It is intended that the content and structure can form the basis of guidelines and protocols that refect the needs of individual units and that can be constantly refned. Our ultimate goal is to promote informed, consistent, auditable, multidisciplinary care for this cohort of patients and we hope that this text contributes to that process.

Neuromonitoring is the tool of trade in intensive care, and should incorporate cutting edge technology with patience, repeated clinical observation, careful identification of neuroworsening. The aim of the book is to be of practical use, and to assist the clinical practice of the busy physician. The clinical examination belongs to the introductory section of the book, and an abundance of technology, with specific emphasis on the importance of intracranial pressure, comes in the following parts. Since the patient with an injured brain can have chances only if other organs and systems (as the lungs, and the acid-base equilibrium etc.) are preserved, a section of the book covers the interactions between the affected brain and other organs. The way the brain reacts to different insults has common aspects, as inflammatory responses, edema etc., but also specific features. Sections five to nine summarize the most relevant pathologies, from ischemic to hemorrhagic lesions, trauma, tumors etc. and also mentions new‑comers, as the specific problems related to the expanding field of neuroradiological interventions. Finally, neurointensive care does not exist without knowledgeable nurses. The intracranial pressure measurement starts (or unfortunately ends) with a catheter well maintained, and that becomes vital when the drainage of hydrocephalus is concerned. Dealing with patients with severe brain damage has plenty of ethical implications, up to the problems related to brain death and organ donation. This book is published in two volumes.

An authoritative pocket-sized guide on the medical and surgical management of neurosurgical intensive care patients Decompression is still the mainstay of surgical intervention for neurosurgeons treating neurocritical care patients. However, during the last 20 years, an evolution away from a mechanistic approach has transformed neurocritical care into an increasingly multidisciplinary field. Neurosurgical Intensive Care, 2nd Edition reflects this new paradigm, authored by a neurosurgeon with contributions from experts in the fields of neurology, vascular neurology, interventional neuroradiology, anesthesiology, critical care, traumatology, nutrition, and advanced practice nursing. Neuromonitoring advances have enabled customized interventions tailored to each patient's unique circumstances. The critical care of neurosurgical patients has evolved from an emphasis on pulmonary care (ventilation and oxygenation) to a more nuanced understanding of cerebral protection measures required to manage a disrupted blood-brain-barrier. This edition encompasses advances in the use of ICP monitors, external ventricular devices, brain tissue oxygen monitoring devices, cerebral microdialysis, fluid and electrolyte correction, as well as the increasing use of continuous EEG in the ICU. Key Features Straightforward summaries for each stage of patient care including bedside exams, neuroimaging, lab work, triage procedures, sedation and pain management, neuropharmacology, nutritional needs, administration of fluids, and more. 159 tables and figures facilitate rapid evaluation and decision making. Clinical pearls on a wide range of ICU scenarios - from pathophysiology and management of coma - to interventions for spinal cord injury, multisystem injuries, acute ischemic stroke, and pediatric cases. Insights on how to handle family communication and spiritual needs, medical-legal issues, and discharge planning This compact, highly practical handbook provides a stellar reference for managing critically ill neurosurgical patients in the ICU. It is a must-have resource for nurses, medical students, residents, fellows, and attending physicians who treat these patients.