Emergency Neurosurgical Procedures Protocol Template

1. Initial Response Protocol

Emergency Classification

• Level 1: Immediate surgical intervention required (<1 hour)
• Level 2: Urgent intervention required (<4 hours)
• Level 3: Semi-urgent intervention required (<12 hours)

Activation Criteria

• Acute subdural/epidural hematoma with midline shift >5mm
• Deteriorating GCS score
• Acute hydrocephalus
• Spinal cord compression with neurological deficit
• Penetrating head/spine trauma

2. Resource Mobilization

Personnel Requirements

• Lead neurosurgeon
• Assistant surgeon
• Anesthesiologist
• OR nursing team (minimum 2)
• Neuromonitoring technician

Equipment Checklist

1. Cranial Procedures:

   • Craniotomy set
   • High-speed drill system
   • Microscope
   • Neuronavigation system

2. Spinal Procedures:

   • Spine instrumentation set
   • C-arm/fluoroscopy
   • Microscope
   • Spinal cord monitoring equipment

3. Documentation Requirements

Pre-Procedure

• Emergency assessment form
• Informed consent (if possible)
• Pre-op imaging review documentation
• Time-out checklist

Post-Procedure

• Operative report
• Post-op orders
• Family notification documentation
• Transfer of care documentation

4. Quality Metrics

Time Targets

• Door to OR time
• Procedure initiation time
• Total procedure duration

Outcome Measures

• 24-hour mortality rate
• Complication rates
• Unplanned return to OR
• Length of ICU stay

5. Contact Protocol

Emergency Response Team

• Primary neurosurgeon: [Insert contact]
• Backup neurosurgeon: [Insert contact]
• OR coordinator: [Insert contact]
• Anesthesia lead: [Insert contact]

6. Review and Update

• Protocol review frequency: Every 6 months
• Last update: [Insert date]
• Next review due: [Insert date]