The neurology department at Aster Hospitals has state-of-the-art specialized care units called High Dependency Units (HDUs). Neurointensivists in an HDU provide specialized, round-the-clock care to at-risk neurological patients after they have recovered from an acute episode, such as a stroke or head injury. The HDU at Aster Hospitals provides continuous specialized nursing care and immediate access to emergency treatment measures, thereby improving treatment outcomes after an emergency episode or post-surgery.
After recovering from the first ICU episode, some patients are still at risk of deterioration or developing complications. They need 24-hour specialized nursing care and immediate access to emergency treatment measures. Neurology HDUs serve as intermediary units for the patients discharged from ICU, but need more care than that given in a general ward. HDUs are also called step-down units or intermediary care areas.
Benefits of neurology HDU
Neurology HDUs are essential in managing severe neurological conditions admitted in the emergency and ICUs, specifically after recovery from an initial episode.
Neurology HDUs benefit people as they provide the following:
- Round-the-clock specialized nursing care
- Invasive monitoring care
- Facilities of short-term emergency treatment equipment, such as a mechanical ventilator, oxygen supply, and many more
- Facilities for frequent interventions and therapies that are not available in the general wards
- Support for patients who continue to be at high risk for deterioration, even after initial recovery in ICU
- Higher nursing care due to a higher nurse-to-patient ratio
- Sharing the burden of ICU while providing short-term emergency facilities similar to ICU
- Increased patient satisfaction due to the level of care given
- Lesser postoperative infections
- Cost-effective for the hospital as well as the patient
- HDUs close to the ICU hold additional advantages, as the ICU staff can attend to a repeat emergency episode or acute complications without delay.
Who needs neurological HDU care?
Acute neurological conditions are complex and often require long-term observation and monitoring. The acute stage neurological critical care and treatment is provided in the intensive care units. Doctors may still want to monitor them round the clock, beyond the recovery from an acute episode of medical or surgical conditions. Here, HDUs are the best option, offering round-the-clock intense observation and monitoring of high-risk neurology patients
Shifting from ICU to HDU involves two approaches:
- The step-up approach involves transferring the patient from the general neurology ward to a neurology HDU on the development or predictability of complications. If needed, a step-up approach can also be employed to transfer from HDU to ICU.
- The step-down approach is when the patient is shifted to HDU from ICU as the condition improves and is not in a critical state. But there is a predicted risk of another episode or complications. The criteria for the step-down approach include clinical stability for at least 24 hours in ICU.
HDUs are unsuitable for admission if more than one body organ has a problem. Chronic neurological conditions without an acute episode do not need care in HDUs.
The main difference between ICU, HDU, and general ward care is the ratio of the nurse to the patient. In the ICU, it is one-to-one; in the HDU, it may be two-to-one in the general ward, and it may be two nurses for 30 patients.
The criteria analyzed by the doctors before discharging the patient from the ICU and shifting to HDU runs as follows:
- Checking for any physical or psychological problems
- Predictability of risks
- Control of acute conditions, such as convulsions
- Haemodynamics stability
- Breathing stability
- Bleeding control
- Consciousness status
- Intracranial pressure maintained
- Brain perfusion
Once the condition becomes stable in HDU and the risk predictability is low, doctors transfer them to the general ward for further care and treatment.
Health Conditions Treated
- Severe brain injury
- Spinal cord injury
- Brain hemorrhage
- Stroke
- Seizures
- Paralysis or paraplegia
- Impaired consciousness like coma or semi-comatose condition
- Acute respiratory failure in neurological disease
- Peripheral neuropathies such as Guillain Barre syndrome
- Post-operative care after intracranial surgery.
FAQs
At Aster Hospitals we provide the highest quality of care and a transformative experience for all your healthcare needs. With our network of multi-speciality hospitals, specialised doctors, and world-class technology, we bring global standards of medical care to our patients.
Why are patients shifted to high-dependency units from the ICU?
Although you may not need critical care, you still need to be kept under observation for 24-48 hours. Hence patients are shifted to high-dependency units from the ICU.
Should I think my recovery is good if I am transferred from ICU to a neurological HDU?
After you have recovered from a critical condition in the ICU, if doctors shift you to an HDU, it means that you still need intense observation and monitoring. However, it also means that you are on your road to recovery and you should be better soon with some extra care and observation.
What is meant by nosocomial infection?
Sometimes, patients acquire infections in the hospital after being admitted and treated for other illnesses. These are called nosocomial infections.
What is meant by the step-up approach?
When the level of monitoring and care increases due to risk and complications, the patients are shifted back from HDU to ICU or from the general ward to HDU. This is called a step-up approach.
Are nurses always available in HDUs?
Yes. Nurses are available round the clock in HDUs, and the nurse-patient ratio is higher than in the general ward.
Will I get good nursing care in a neurological HDU?
Yes. The nurse-to-patient ratio is higher in HDUs than in general wards. You will be looked after round the clock.
How much will I be at risk of getting an infection in HDU?
In HDUs, standard operating procedures are strictly followed to prevent hospital-induced infections. So, your risk of getting an infection in an HDU is reduced.
Why are neurology HDUs called step-down areas?
HDUs are also called step-down areas as the level of care needed by the patients in HDUs is lesser than that needed in an ICU.
Do all patients admitted to HDU come from the ICU?
No. In addition to the ICU, doctors admit patients to the HDU immediately after surgery for intense nurse observation and monitoring.
What facilities are available in HDUs?
HDUs are equipped with all short-term emergency care instruments and machines. The nurses are specialized and monitor you around the clock. In some hospitals, HDUs are close to the ICU, so in case of need, you can be quickly transferred to the ICU.
Advanced Technology & Facilities
Diagnostics
The facilities for diagnostic tests are available all day, 24 hours. A few of the essential tests done at neurology HDUs include:
Complete blood count
- Arterial blood gas analysis
- Electrolytes
- Blood urea
- Blood sugar
- Serum creatinine
- ECG
- EEG
- X-ray
Facilities
HDUs provide specialized intense care, such as:
- Round-the-clock monitoring of vital signs
- Delivering oxygen with a face mask without the need for endotracheal intubation
- Delivering oxygen with an adult mechanical ventilator
- Oxygen supply
- Intracranial pressure monitoring
- EEG
- ECG
- Disinfection
- Fluid management
- Intense monitoring
- Optimal pain relief
The neurology HDU in Aster Hospitals offers the best round-the-clock care by specialized nurses. The nurse-to-patient ratio is high to provide intense care and close monitoring.
The neurology team in HDU at Aster Hospitals is multi-professional, involving neurologists, specialized nurses, intensivists, and anesthetists. Moreover, HDU equipment, devices, and rooms are regularly sterilized, and strict management protocols are followed to ensure an infection-free neurological HDU facility.
