Neurology
TITLE:
NEUROCRITICAL CARE (NCC) -ICE
This course will introduce the student to the medical management of life-threatening neurological and neurosurgical conditions in the Neuroscience ICU. This clerkship will also involve exposure to vascular neurology (stroke) and neuroendovascular therapies.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP), 26931373 (INTERNAL MEDICINE CORE CLKSP), 26940373 (NEUROSCIENCE CORE CLKSP), 26940373 (NEUROSCIENCE CORE CLKSP)
Recommend completing one (1) Year III Clinical
Neuroscience-related rotation prior to taking this elective.
expand all
GENERAL INFORMATION
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
STATUS:
Full-Time
OFFERED AS FULL-TIME AND PART-TIME:
NO
ALLOWS OVERLAP:
NO
DIRECTOR:
Katrina Peariso, MD, PHD
medonestop@uc.edu
ADMINISTRATIVE SUPPORT PERSON:
Carol Wullenweber
wullencj@ucmail.uc.edu
513-558-1059
MSB, 7109
ROTATIONS:
Rotation |
Dates |
Max |
1 |
05/06/2024 - 05/31/2024 |
0 |
2 |
06/03/2024 - 06/28/2024 |
0 |
3 |
07/01/2024 - 07/26/2024 |
2 |
4 |
07/29/2024 - 08/23/2024 |
2 |
5 |
08/26/2024 - 09/20/2024 |
2 |
6 |
09/23/2024 - 10/18/2024 |
2 |
7 |
10/21/2024 - 11/15/2024 |
2 |
8 |
11/18/2024 - 12/13/2024 |
2 |
9 |
12/16/2024 - 01/10/2025 |
2 |
10 |
01/13/2025 - 02/07/2025 |
2 |
11 |
02/10/2025 - 03/07/2025 |
2 |
12 |
03/10/2025 - 04/04/2025 |
0 |
13 |
04/07/2025 - 05/02/2025 |
0 |
NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
6:30 a.m. - 6:30 p.m. Monday - Friday; includes 5 consecutive night coverage 6:30 p.m. - 6:30 a.m.
REPORT 1ST DAY:
Report the first day to the NSICU (Main Hospital 4th Floor) at 6:30 a.m. and ask HUC for the NCC APP or Fellow for patient sign-out.
You will receive an email with detailed information and instruction the week prior to this elective. In-person/Virtual orientation to this course ***.
INSTRUCTION
LEARNING ACTIVITIES:
- Case-Based Instruction/Learning
- Clinical Experience - Inpatient
- Conference
- Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
- Discussion-Small Group (Small Group (=12)
- Journal Club
- Lecture
- Patient Presentation--Faculty
- Patient Presentation--Learner
- Research
- Self-Directed Learning (Learners take initiative for their own learning; diagnosing needs; formulating goals; identifying resources; implementing appropriate activities; and evaluating outcomes.)
- Simulation
- Ward Rounds
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.
The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
50% |
Attending Physician |
10% |
Junior Resident |
15% |
Other Allied Health Professional(s) |
25% |
Fellow Physician |
ASSESSMENT:
Weekly attending completion of the "UC COLLEGE OF MEDICINE - M4 EVALUATION" per week, in addition to the required topic presentation and structured journal club/critical reading of literature presentation given once during this 4-week rotation.
ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Oral Patient Presentation
Participation
FINAL GRADE:
GRADE ASSIGNED BY:
Course director
OBJECTIVES
Curricular Resources :
**PLEASE SEE COURSE DIRECTOR FOR MORE REFERENCES**
TEXTS:
- The Neuro ICU, Second Edition, McGraw-Hill Education 2018, Editor: Kiwon Lee, M.D.
- The ICU Book, Fourth Edition, Wolters Kluwer Health/Lippincott Williams & Wilkins 2014, Editor: Paul L. Marino, M.D.
- CONTINUUM: Lifelong Learning in Neurology https://journals.lww.com/continuum/pages/default.aspx
WEBSITES:
- Neurocritical Care Society
- American Heart Association / American Stroke Association
- American Epilepsy Society
- American Clinical Neurophysiology Society
- American Academy of Neurology
- American Association of Neurological Surgeons
- Society of Critical Care Medicine
- Pulmonary Critical Care Medicine
- Taming The SRU / Taming the Neuro ICU
Instructional Methods:
Daily NSICU rounds with the NSICU Attending, direct patient care, and lectures/conferences. Required topic presentation and structured journal club/critical reading of literature presentation.
Knowledge/Skills:
Gain / Display knowledge in:
· Acute management of neurological/neurosurgical emergencies· Indications for neurosurgical procedures
· Indications for thrombolytic therapy
· Identification of complications from life-threatening neurological conditions
· General management of the critically-ill patient
· Discuss ethical and end-of-life issues involving neurological conditions
· Cost effectiveness of diagnostic studies and procedures
Main Course Topics :
· Acute Ischemic Stroke (AIS)
· Acute Hemorrhagic Stroke (ICH/IPH)
· Subdural Hemorrhage (SDH)
· Subarachnoid Hemorrhage (SAH)
· Traumatic Brain Injury (TBI)
· Elevated Intracranial Pressure (ICP Crisis)
· Status Epilepticus (CSE/NCSE)
· Acute Spinal Cord Injury (ASI)
· Acute Complications of Neuromuscular Disorders (NMD)
· Autoimmune/Paraneoplastic Neurological Disorders (AIDP/GBS; CIDP; PNP)· Meningitis/Encephalitis/Rhombencephalitis/Ventriculitis
· Targeted Therapeutic Management and Post-Cardiac Arrest (TTM)
· ICU Ethics
· End-Of-Life Topics
· General Critical Care Medicine
Procedures:
NSICU procedures permitted for students to perform include OGT, NGT, ABG, Blood Draws, Point of Care Ultrasound, and PIV placement under direct supervision and after discussion with the NCC APP, Fellow and/or Attending.
Arterial line placement is permitted if:
1. NSICU Attending has been informed and is in agreement of the medical student performing this procedure.
2. Radial placement ONLY.
3. Observe/Assist FIRST, then the student may perform under DIRECT OBSERVATION.
Medical students are NOT to place central lines or perform endotracheal intubation in the NSICU.
Remediation Plan:
Refer to the medical student course guidelines.
SAMPLE WEEK
Monday:
6:30AM |
7:00AM |
Night Coverage Sign-Out |
7:00AM |
8:30AM |
Patient Data Collection Student Pre-Rounding |
8:30AM |
12:00PM |
PATIENT ROUNDS |
12:00PM |
1:00PM |
Lunch Break |
1:00PM |
5:30PM |
Patient Care |
5:30PM |
6:00PM |
Patient Sign-Out |
Tuesday:
6:30AM |
7:00AM |
Night Coverage Sign-Out |
7:00AM |
8:30AM |
Patient Data Collection Student Pre-Rounding |
8:30AM |
12:00PM |
PATIENT ROUNDS |
12:00PM |
1:00PM |
Lunch Break |
1:00PM |
2:00PM |
Patient Care |
2:00PM |
4:00PM |
Patient Care |
4:00PM |
5:30PM |
NeuroImaging Conference |
5:30PM |
6:00PM |
Patient Sign-Out |
Wednesday:
6:30AM |
7:00AM |
Night Coverage Sign-Out |
7:00AM |
8:30AM |
Patient Data Collection Student Pre-Rounding |
8:30AM |
12:00PM |
PATIENT ROUNDS |
12:00PM |
1:00PM |
Neurology Grand Rounds |
1:00PM |
2:00PM |
Multidisciplinary Critical Care Lecture Series |
2:00PM |
5:30PM |
Patient Care |
5:30PM |
6:00PM |
Patient Sign-Out |
Thursday:
6:30AM |
7:00AM |
Night Coverage Sign-Out |
7:00AM |
7:30AM |
Patient Data Collection |
7:30AM |
8:30AM |
NeuroVascular Imaging Conference |
8:30AM |
12:00PM |
PATIENT ROUNDS |
12:00PM |
1:00PM |
Lunch Break |
1:00PM |
2:00PM |
Patient Care |
2:00PM |
3:00PM |
ICU EEG / Journal Club / M&M Conference (alternating) |
3:00PM |
5:30PM |
Patient Care |
5:30PM |
6:00PM |
Patient Sign-Out |
Friday:
6:30AM |
7:00AM |
Night Coverage Sign-Out |
7:00AM |
8:30AM |
Patient Data Collection Student Pre-Rounding |
8:30AM |
12:00PM |
PATIENT ROUNDS |
12:00PM |
1:00PM |
Lunch Break |
1:00PM |
2:00PM |
Patient Care |
2:00PM |
3:00PM |
NCC Resident/Faculty Education |
3:00PM |
5:30PM |
Patient Care |
5:30PM |
6:00PM |
Patient Sign-Out |
SCHEDULE NOTE:
- You must also attend the following (date/time will be provided):
TBI MMM Conference
- Meeting(s) with Course Director for required topic presentation and structured journal club/critical reading of literature presentation (often in the last week of clerkship rotation).
ATTENDANCE AND ABSENCE POLICY
Session Attendance for M4 Students
- Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
- Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
- AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
- Excused Absences - The following will be considered excused absences:
- Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
- Personal illness, accident or a major catastrophic event
- Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
- Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
- The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
- The following items are explained in detail in the Medical Student Handbook:
- Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work
See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.