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Neurointensive Care Medicine as an Emerging ICU Subspecialty

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Textbook of Neurointensive Care

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Abstract

Critical care developed as a specialty in the 1800s. Its evolution has been facilitated by a recognition of the need for more intensive observation and nursing of sicker patients and by advances in technology starting with the ability to mechanically ventilate patients. Critical care specialty training began primarily in the postoperative setting with anesthesiologists and surgeons. Internal medicine and pulmonary medicine managed the medical patients with respiratory failure. Neurologists although initially involved with patients during the polio epidemic have traditionally had little to no training in managing critically ill patients and have been relegated to a primarily consultative and diagnostician role in the ICU. In the last few decades, however, acute stroke therapies and new research that increases the understanding of the pathophysiology of primary and secondary brain injury and the interplay of the neurological system and its disorders and other organ systems put neurologists into an active role in patient care in the ICU. Neurocritical care or intensive care neurology is a growing field with a growing body of knowledge that has shown to improve patient care. This chapter reviews the history of critical care as a subspecialty and the means for critical care certification both in the USA and internationally. It reviews the evolution of neurocritical care and the accreditation of training programs and certification of individuals, which currently is only available to North American candidates. With people living longer, the world has an aging population and faces a critical care workforce shortage. Neurocritical care is attracting a multiprofessional group of practitioners into this workforce. These individuals play an important role not only in the delivery of care to neurological critically ill patients but are key to the advocacy, education, prevention, and research to help improve outcomes.

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Authors and Affiliations

  1. Department of Medicine and Surgery, Neuroscience Institute/Neurocritical Care, The Queen’s Medical Center, University of Hawaii, John A. Burns School of Medicine, 1301 Punchbowl Street, QET 5, Honolulu, HI, 96813, USA

    Cherylee W. J. Chang MD, FACP, FCCM

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  1. Cherylee W. J. Chang MD, FACP, FCCM
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Correspondence to Cherylee W. J. Chang MD, FACP, FCCM .

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Editors and Affiliations

  1. Pulmonary and Critical Care Medicine, Geisinger Health System, Danville, Pennsylvania, USA

    A Joseph Layon

  2. Departments of Anesthesiology & Surgery, University of Florida College of Medicine, Gainesville, Florida, USA

    Andrea Gabrielli

  3. Department of Neurosurgery, University of Florida, Gainesville, Florida, USA

    William A. Friedman

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Chang, C.W.J. (2013). Neurointensive Care Medicine as an Emerging ICU Subspecialty. In: Layon, A., Gabrielli, A., Friedman, W. (eds) Textbook of Neurointensive Care. Springer, London. https://doi.org/10.1007/978-1-4471-5226-2_3

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  • DOI: https://doi.org/10.1007/978-1-4471-5226-2_3

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