Emergency Neurology Prerequisites for Incoming PGY2 Residents

In order to help ensure that incoming residents have a good foundation for handling medical and neurological emergencies, we require incoming residents to complete several training modules prior to September 1 of the PGY-2 year:

  • ACLS Many residents will have obtained this training during the PGY-1 year.
  • Lumbar Puncture / Atraumatic Needle Use- Please view the following training video regarding proper LP technique
  • NIHSS The NIH Stroke Scale is the most widely-used measure of stroke severity. Knowing how to administer the NIHSS exam prior to the beginning of the PGY-2 year will facilitate your running of stroke codes.

ASPECTS scoring. The Alberta Stroke Program Early CT Score is a validated way to assess the extent of early infarction visible on non-contrast head CT. It plays a role in patient selection for acute endovascular therapies and so having some familiarity with it will, like the NIHSS, help the incoming resident become prepared to run stroke codes. There’s no formal certification for ASPECTS, but incoming residents are encouraged to peruse the website and work through the training materials.

  • ENLS certification. Emergency Neurology Life Support is a new program loosely modeled on ACLS. It focuses on the first few hours of neurological emergencies such as:
    • Acute ischemic stroke
    • Intracerebral hemorrhage
    • Subarachnoid hemorrhage
    • Status epilepticus
    • Bacterial meningitis
    • Acute non-traumatic weakness (Guillain-Barre syndrome)

ENLS training is composed of ~ 14 modules on these topics, each of which consists of a short review article, some slides, and a management algorithm. It is a very interesting (for neurologists!) and worthwhile course—a good way to get up to speed on neurological emergencies so that when you start encountering these problems as PGY2s, you’ll have a good foundation from which to start learning and caring for patients. We’ll register each incoming resident for the course and pay the fee on your behalf.

Latest revision: 12-15-2015
Justin A. Sattin, MD