Curriculum Reference

13.11.7 – Manages the resuscitation, stabilisation and transfer of patients with acute neurological deterioration.

15.9.2 Delivers safe peri-operative anaesthetic care to adults for emergency intracranial surgery, CSF diversions, spinal surgery and endovascular thrombectomy.

HiLLO 12: Doctors specialising in Intensive Care Medicine understand the special needs of, and are competent to manage patients with neurological diseases, both medical and those requiring surgery, which will include the management of raised intracranial pressure, central nervous system infections and neuromuscular disorders.

Review Articles

Surgical Decision Making in Brain Hemorrhage New Analysis of the STICH, STICH II, and STITCH(Trauma) Randomized Trials

Further Reading (incl. Key Trials)

Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage

Rapid blood-pressure lowering in patients with acute intracerebral haemorrhage

Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial

National Guidance/Standards

European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral haemorrhage

Online Resources

The Neurocritical Care Society

RCoA Audit Compendium or FICM GPICS

FICM Standard

Previously fit adults, admitted to critical care following a primary intracerebral haemorrhage, must be referred to specialist neurosurgical centres for consideration of surgical evacuation.

FICM Recommendation
Intracerebral haemorrhage should be managed in accordance with international guidance with particular attention to the reversal of anticoagulation and acute control of blood pressure.

Hypoxic Encephalopathy

Further Reading (Key Trials)

Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia (2002)

Targeted temperature management at 33°C versus 36°C after cardiac arrest (2013)

Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest (2021)

Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm

Increasing survival after admission to UK critical care units following cardiopulmonary resuscitation

National Guidance/Standards

European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care

Prognostication in comatose survivors of cardiac arrest: An advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine

RCoA Audit Compendium

FICM Standard

FICM recommendation
Protocols should be available to deliver post-resuscitation care to comatose survivors following cardiac arrest as per the Resuscitation Council (UK) guidelines.

NACCS Video