Useful information about working in Neurosurgery

Who to call

Information to have when calling the Registrar

1. Name and age

2. Brief history

3. GCS (broken down into 3 parts)

4. Focal neurological deficit

5. Basic observations (BP, HR, oxygen saturation)

6. Significant medical comorbidities

7. Medications (especially those with anticoagulant and antiplatelet properties)

8. Blood results (especially Na+ and coagulation)

9. ECG (acute ischaemic changes often present in SAH)

10. CXR

11. Imaging results

General points

• There is a folder of guidelines kept in the Neurosurgical Intensive Care (NIC) office outlining management of common problems

• Patients who deteriorate acutely in the NIC should be urgently assessed by the House Officer and immediately discussed with either the Registrar for the team or the on-call Registrar

Do not give glucose + sodium chloride as it may exacerbate cerebral oedema; use sodium chloride 0.9%

Do not give any medications with anticoagulant properties (including aspirin) without discussion with the Neurosurgical Registrar

Ring on-call Neurosurgical Registrar if GCS declines ≥2 points or there is evolution of focal deficit