PROPOSAL FOR STARTING PDF IN NEUROCRITICAL CARE BY Neurocritical care society of India (NCSI)

As per the request of the Executive Body, the education committee of NCSI discussed the issue of starting a one year PDF (Neurocritical Care) course.

Now it is well established that many acute neurological conditions are eminently treatable provided correct principles are understood by the treating team and the care is delivered expeditiously. To achieve these goals a specialised training is required for physicians managing these cases. Considering the need of trained professionals of neurocritical care in the country, NCSI has initiated this proposal

The institutions providing such a course should be well-equipped, must have a good patient load and must have competent teaching staff. With that idea the following recommendations are made with respect to the hospitals which can offer this course:

1. The hospital must have active Neurology and Neurosurgery Departments
2. Neurointerventional procedures should also be performed in the centre
3. Anaesthesia department should have designated Neuroanaesthetists
4. The hospital must have an exclusive Neurocritical Care Unit of not less than 6 beds
5. The critically ill patients requiring mechanical ventilation for > 48 hrs has to be at least 40-50 patients in a year.
6. It is preferred to have a full-time consultant in charge of the NeuroICU. The consultant should have an experience of at least 5 years in managing Neurocritical care patients.
7. At least two faculty members should be available for starting the course. One consultant/senior consultant and at least one junior consultant.
8. There should be adequate number of ventilators and monitors to monitor ECG, blood pressure, SpO2, capnometry and invasive blood pressure.
9. There must be a blood gas analyser.
10. There must be a round the clock biochemistry laboratory, and CT scanning facility
11. Facilities to monitor Intracranial pressure, Transcranial blood flow velocity and EEG monitoring must be present.
12. Cardiac output monitoring, Near-infrared spectroscopy, brain tissue oxygen tension monitor, cerebral microdialyis, evoked potential monitor, and jugular venous oximetry are desirable.
13. In case of any shortfall in the parameters, the inspectors should take a final call based on all the facilities and parameters available.