Return to Main Menu

NSICU specializes in acute brain injuries by Heather Woolwine Public Relations The neuro-intensive care unit not only recently changed its name to the Neurosciences Intensive Care Unit (NSICU), but underwent a shift in attitude too.   From left: Ray Lorenz, Pharm.D., Dr. Julio Chalela and Raigan Vardon, R.N., discuss changes in the course of a patient's treatment during rounds Monday morning. With the arrival of Julio Chalela, M.D., NSICU director, and a dedicated staff, the NSICU now boasts a truly multidisciplinary approach to intensive care for patients suffering neurologic injury.   With very few specialized neuro-intensive care units in the country, Chalela is the only fellowship-trained neuro-intensivist to direct a unit of this type in South Carolina. In the adult-only unit, Chalela and his team monitor physiological parameters that other units, similar to the NSICU, do not; including intracranial pressure, EEG activity, and cerebral venous oxygen saturation monitoring (SjO2).   “Several studies have shown that admitting a patient with an acute brain injury into an NSICU leads to a better outcome than admitting them to a general ICU,” Chalela said. “In the last 10 years, the treatment of severe neurological disorders has evolved dramatically and those disorders are best treated by those who specialize in neurocritical care.”   Having only arrived at the medical center six  months ago, Chalela has already made an impact with his patients, as well as staff. “We have a lot more educational opportunities now that Dr. Chalela is here,” said Cindy Steffen, R.N., NSICU. “He’s made it so that more people want to come up here to work because of the environment that he helped create.”   “The NSICU staff is a group of dedicated, professional, concerned, and caring individuals that together form a great team,” Chalela said. “We’re all committed to a multidisciplinary approach to rounding and managing the unit. Everyone is involved in the patient’s treatment plan. It makes sense to involve the nurses closely; they have minute-to-minute contact with patients and know them better. The input from dieticians, pharmacists, respiratory therapists, and consultants is invaluable. The literature suggests that multidisciplinary approaches to patient treatment results in better outcomes.”   The NSICU’s patients include just about any and every brain or spine injury from head traumas and strokes to a variety of tumors and diseases affecting the nervous system.   One of the procedures that Chalela really values in the new NSICU is discharge planning with a social worker and case manager. “This has always been overlooked in other ICUs I’ve worked in, but it makes absolute sense to get plans ready before the patient leaves the hospital for potential rehabilitation services and placement of those services.”   The future for the NSICU holds additional beds, taking the newly renovated seven-bed unit to a 16-bed unit in the coming years. Chalela and his staff echoed the importance of having a neurological intensive care unit, as unique individuals with unique diseases or conditions require complex care best provided in a specialized unit. “Our patient satisfaction scores are up since Dr. Chalela came to our unit,” Steffen said. “Having a neuro-intensivist in the unit makes the physician more accessible to the staff and patients. We have a really good mix of nurses and the synergy up here with Dr. Chalela is very good.”   A myth surrounds acute neurological injury, namely that those who suffer from it always have a dismal prognosis. To judge by the enthusiasm and teamwork in the NSICU, this thought may be exposed for what it is…a pessimistic notion clearly not based on the commitment and dedication of MUSC’s highly specialized NSICU staff. How do you catch a stroke? Many of the patients seen in the NSICU are stroke victims, and it’s a well known fact that South Carolina sits at the buckle of the national stroke belt. Below are some tips to help recognize when someone is having a stroke, and what to do.   By asking three simple questions, anyone can recognize a stroke. If someone stumbles unexpectedly, seems dazed, or just in general seems like something is wrong, ask him or her: 1.    To smile. 2.    To raise both arms. 3.    To speak a simple sentence, like “It is sunny outside today.”   If the person has trouble with any of these, call 911 immediately.     Friday, Jan. 20, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778, ext. 201.