Emergency Neurologic Life Support (ENLS): Evolution of Management in the First Hour of a Neurological Emergency
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Emergency Neurologic Life Support (ENLS): Evolution of Management in the First Hour of a Neurological Emergency Chad M. Miller1 • Jose Pineda2 • Megan Corry3 • Gretchen Brophy4 Wade S. Smith5
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Ó Springer Science+Business Media New York 2015
Abstract Emergency neurological life support (ENLS) is an educational program designed to provide users advisory instruction regarding management for the first few hours of a neurological emergency. The content of the course is divided into 14 modules, each addressing a distinct category of neurological injury. The course is appropriate for practitioners and providers from various backgrounds who work in environments of variable medical complexity. The focus of ENLS is centered on a standardized treatment algorithm, checklists to guide early patient care, and a structured format for communication of findings and concerns to other healthcare professionals. Certification and training in ENLS is hosted by the Neurocritical Care Society. This document introduces the concept of ENLS and describes the revisions that constitute this second version. Keywords Emergency Algorithm Neurocritical care Resuscitation Critical care
& Chad M. Miller [email protected] 1
Neurocritical Care and Cerebrovascular Diseases, OhioHealth, Columbus, OH, USA
2
Departments of Pediatrics and Neurology, Washington University School of Medicine, St. Louis, MO, USA
3
City College of San Francisco Paramedic Program, San Francisco, CA, USA
4
Departments of Pharmacotherapy and Outcomes Science and Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA
5
Department of Neurology, University of California, San Francisco, CA, USA
Background Emergency neurologic life support (ENLS) was created upon the principle that efficient and appropriate management of the early stages of a neurological emergency has substantial impact on patient outcome. Despite an appreciation for this association, the medical community had not historically had standardized approaches to neurologic injuries similar to those developed for trauma and cardiac arrest. The inconsistencies in the methodologies of neurologic resuscitation have been further multiplied by the diversity of expertise of individuals who participate in the initial care of these patients. Few of these providers possess specific training in the neurosciences and, therefore, may struggle to deliver care focused on the neurologic needs of the patient. ENLS was designed to focus on the fundamentals of acute management of patients suffering a range of neurologic emergencies. The treatment algorithms were devised to be simple, able to be administered across a spectrum of care environments, and clinically applicable for medical care givers of a variety of backgrounds. The basic structure of ENLS education was created by its inaugural chairs, Dr. Wade Smith and Dr. Scott Weingart. They observed a dualistic template for construction of the materials where each of the 13 topics was co-chaired by a practitioner from a critical ca
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