This document is intended as an organisational framework to prepare and inform patients and their relatives. It is not intended as a substitute for informed discussion and consent between the patient and their clinical team.
It is recognised that accurate prognostication in life threatening brain injury is difficult, particularly at an early stage. This statement is intended to help consultants when making decisions on the management of patients admitted with a perceived devastating brain injury (DBI), and should not replace their clinical judgment. Endorsing organisations:
Faculty of Intensive Care Medicine (FICM)
Intensive Care Society (ICS)
Neuroanaesthesia and Critical Care Society of Great Britain and Ireland (NACCS) Royal College of Emergency Medicine (RCEM)
Society of British Neurological Surgeons (SBNS)
Welsh Intensive Care Society (WICS)
This guidance has been endorsed by the Intensive Care Society (ICS), the Neuro Anaesthesia
and Critical Care Society (NACCS), and the British Society of Neurological Surgeons (BSNS). The
guidelines have been approved by the Association of British Neurologists (ABN).
The resuscitation council have worked jointly with NACCS and SBNS to produce this guidance. This provides a useful overview of the issues and problems associated with a cardiac arrest occurring a spinal or neurosurgical procedure. It covers resuscitation according to patient position, as a well as dealing with such issues as defibrillation if the patient is in pins, managing an open head wound and air embolism. The document can be accessed here.
After requests from members of the society for the NACCS to take a view on standards for monitoring and calculating CPP, the following joint statement has been agreed with the SBNS: Joint position statement by the Councils of the Neuroanaesthesia and Critical Care Society of Great Britain and Ireland(NACCS) and the Society of British Neurological Surgeons (SBNS) with regards to the calculation of cerebral perfusion pressure in the management of traumatic brain injury.
The NACCS welcomes and fully supports this document as an important first step in introducing a standard of care for those patients who require urgent thrombectomy after failed thrombolysis for ischaemic stroke. Although thrombectomy is still not in itself a recognised standard of therapeutic intervention for stroke patients and large studies are still on going to look at this.
Joint Guidelines from the Association of Anaesthetists and the Society for Intravenous Anaesthesia.Guidelines are presented for safe practice in the use of intravenous drug infusions for general anaesthesia.
The Faculty of Intensive Care Medicine and the Intensive Care Society have published these guidelines in June 2019. GPICS has become the definitive reference source for the planning, commissioning and delivery of Adult Critical Care Services in the UK. Many units have found the standards and recommendations within GPICS invaluable in developing successful business cases to enhance their local services and improve patient care. NACCS is one of the endorsing societies.
Sepsis still kills far too many people each year, tens of thousands every year throughout
the UK and we know that if caught early, some cases of sepsis are preventable or
treatable. FICM established a cross-colleges group, led by Professor Julian Bion, Professor of
Intensive Care Medicine, University of Birmingham. This is a very significant piece of work that has already been very well received by a range of organisations; the list of those endorsing the guidance is set out at
the end of the report. The report has also been welcomed by all four of the UK
Health Departments.
Summary of major changes to the ACSA Standards document for Domain 5- Neuroanaesthesia.
A Consensus Guideline – January 2023
In 2021 the Faculty of Intensive Care Medicine (FICM) and the Intensive Care Society (ICS)
recommended that United Kingdom (UK) consensus guidance on ancillary investigations to support
the clinical diagnosis of death using neurological criteria (DNC) should be developed. In collaboration
with the British Society of Neuroradiologists, a consensus group has established a standardised
protocol for CT angiography (CTA) when used as an ancillary investigation to support the clinical
diagnosis of DNC
