Inpatient Advanced Clinical Focus Session: More Than a Disposition: Critical Care Rehabilitation Medicine-Session Recording

Video Transcription

Video Summary

The session featured Dr. Mary Russell, Dr. Rashi Krishnan, and Dr. Marilyn Pacheco, focusing on neurocritical care and rehabilitation in acute medical settings. Dr. Krishnan emphasized "time is brain," highlighting early diagnosis and treatment of neurocritical emergencies like strokes and brain injuries to reduce long-term damage. She presented case studies, including a stroke patient who improved significantly after timely intervention with thrombolysis and thrombectomy. The discussion on managing intracranial pressure introduced a tiered approach involving various therapeutic measures like hyperosmolar therapy and surgical interventions. Dr. Pacheco discussed management strategies for high cervical spinal cord injuries within ICU settings, addressing challenges such as bradycardia, secretion management, and bladder care. She provided practical advice for preventing complications, such as using theophylline to manage vascular tone and bradycardia. Dr. Russell outlined the role of physiatry in ICU consults, stressing the benefits of physiatrist involvement in early rehabilitation for improved functional outcomes and reduced hospital stays. She shared her experience in enhancing consulting services for neurologic patients, highlighting the importance of interdisciplinary collaboration and effective communication with teams. Dr. Russell also discussed the BRAINS (Bridging Resources After Inpatient Neurologic Stay) initiative, targeting patients with poor social determinants of health to improve care continuity and reduce readmissions. The session underscored the critical role of timely interventions and multidisciplinary approaches in acute neurologic care, with a strong focus on improving patient outcomes and supporting complex discharge planning.

Keywords

neurocritical care

rehabilitation

stroke

intracranial pressure

thrombolysis

spinal cord injuries

physiatry

interdisciplinary collaboration

acute medical settings

BRAINS initiative

neurocritical emergencies