Description

Physiatrists who work in neuro-rehabilitation settings perform consults in acute care settings. The consulting teams often ask for recommendations regarding rehabilitation needs, including the most appropriate post-acute care setting for patients recovering from brain injury, spinal cord injury, and stroke. For patients who are still critically ill, the consult questions can also include request for assistance with management of various medical issues. These include paroxysmal sympathetic hyperactivity (neuro- storming), autonomic dysreflexia, agitation, and potential options for neurostimulation medications.

Physical medicine and rehabilitation physicians with expertise in neuro-rehab are in a unique position to help facilitate high- quality care in the ICU. Providing appropriate care to patients recovering from brain injury, spinal cord injury, and stroke while they are still in the ICU can have significant benefits for their eventual course in acute rehabilitation and beyond. Physiatrists can also provide crucially important education to the ICU teams and families about prognostication of these complex diagnoses. This session will provide participants with a review of frequently encountered ICU issues by patients with brain injury, spinal cord injury, and stroke. We will have a panel discussion, with some cases to review, and with time for questions and answers. This discussion will be based on current literature regarding these important clinical issues

Learning Objectives

Learning Objective 1: Review general principles for PM&R consultant's role in the critical care setting.
Learning Objective 2: Discuss common PM&R principles for medical management of patients with brain injury and stroke in the
ICU.
Learning Objective 3: Discuss common PM&R principles for medical management of patients with spinal cord injury in the ICU.
Learning Objective 4: Understand approaches of facilitating discussions related to functional prognosis of these conditions in
patient's post-ICU clinical course.

Member Community
Central Nervous System
Brain Injury Medicine Current Fellows and Future Candidates
Spinal Cord Injury Medicine

Accreditation Statement
The American Academy of Physical Medicine and Rehabilitation is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation of Credit
The American Academy of Physical Medicine and Rehabilitation (AAPM&R) designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.  

Financial Disclosures
AAPM&R requires all individuals who are in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest, which is any entity producing, marketing, re-selling or distributing health care goods or services consumed by, or used on, patients. Disclosures are made in written form prior to the start of the educational activity and any potential conflicts of interest that exist are resolved prior to the start of the activity through AAPM&R’s Conflict of Interest Disclosure and Resolution Policy Process. Individuals in a position to control content and their disclosed financial relationships are listed below.

Faculty
Yi (Dan) Zhou, MD: Disclosed no relevant financial relationships.
Kian Nassiri, DO: Disclosed no relevant financial relationships.
Matthew Puderbaugh, DO: Disclosed no relevant financial relationships.

AAPM&R Medical Education Committee
John C. Cianca, MD: Ownership or partnership with Musculoskeletal Ultrasound Consultants, LLC.
Karen P. Barr, MD: Disclosed no relevant financial relationships.
Rachel A. Brakke Holman, MD: Disclosed no relevant financial relationships.
Joseph E. Burris, MD: Serves on the Speakers Bureau for, and received clinical research grants from Allergan.
David S. Cheng, MD: Disclosed no relevant financial relationships.
Theresa A. Gillis, MD: Disclosed no relevant financial relationships.
Kevin N. Hakimi, MD: Disclosed no relevant financial relationships.
Matthew T. Haas, MD: Disclosed no relevant financial relationships.
R.Samuel Mayer, MD: Royalties from Demos Medical Publishing.
Ameet S. Nagpal, MD MS MEd: Disclosed no relevant financial relationships.
Sunil Sabharwal, MD: Royalities from Demos Publishing; board member, American Board of Physical Medicine and Rehabilitation.
Sarah M. Smith, MD: Disclosed no relevant financial relationships.
Stephanie Tow, MD: Disclosed no relevant financial relationships.
Kevin R. VIncent, MD, PhD: Disclosed no relevant financial relationships.

AAPM&R CME Committee
Karen P. Barr, MD: Disclosed no relevant financial relationships.
Cherry C. Junn, MD: Disclosed no relevant financial relationships.
Sheryl R. Levin, MD: Disclosed no relevant financial relationships.
Kentaro Onishi, DO: Disclosed no relevant financial relationships.
Evan R. Peck, MD: Disclosed no relevant financial relationships.
Cynthia G. Pineda, MD: Disclosed no relevant financial relationships.
Patricia T. Tan, MD: Disclosed no relevant financial relationships.
Brionn K. Tonkin, MD: Disclosed no relevant financial relationships.
Kristin A. Wong, MD: Disclosed no relevant financial relationships.

No other planners, faculty or other individuals in control of content disclosed any relevant financial relationships.

FDA Disclosures
All faculty members for this activity have disclosed they do not intend to discuss or demonstrate any pharmaceutical or medical device for which FDA clearance has not been approved.