Summary of key suggestions for neurocritical care resource utilization in pandemics

Key suggestions
Systems of care Emphasize continued appropriate triage of neurocritical care patients  – Transfer to higher level of care when required  – Utilization of telemedicine when available with patient retention at presenting hospital Develop screening and testing pathways for those with contagious illness and cohort early and accordingly Educate the public on infection control processes, and the need to seek care when required
Inpatient care Prioritize care of neurocritically ill patients by experienced teams Facilitate communications with patients’ families Avoid premature limitations on care
Neurocritical care unit staffing Neurocritical care experts can be leveraged to provide intensive care to patients without primary neurologic illness Implement interventions to prevent infections of health care workers:  – Minimize room entry  – Block scheduling  – Use of telemedicine to minimize physical contact Cross-train nurses, pharmacists, and other providers early to extend expertise
Pharmacy considerations Bundle medications and care interventions Place IV pumps outside patients’ rooms Strategize to mitigate medication shortages:  Early transition to enteral route  Judicious extension of expiration times
Education and training Utilize teleconferencing to minimize time spent at the hospital Promote “open-platform” venues to facilitate collaboration while recognizing limitations Facilitate disseminate of evidence-based practices