I hope you find these materials useful. Please don’t hesitate to get in contact if you have any feedback/suggestions.

Dr Andrew Hitchings – ahitchin@sgul.ac.uk

Functional neuroanatomy. Dr Maresa Santi. (Link to participation/reflection form.)

Post-operative care following elective neurosurgery. Dr Anne Garner. (Link to participation/reflection form.)

Agitation in neurocritical illness. Dr Yun Mak. (Link to participation/reflection form.)

Human factors in ICU – Error and biases. Dr Andrew Hitchings. (Link to participation/reflection form.)

Human factors is a scientific discipline concerned with the interactions between people, the tasks they do, and the context in which they do them. By understanding and manipulating these factors, it aims to improve the reliability, safety and productivity of the systems in which we live and work. This is crucially underpinned by an understanding that humans make errors. This 16-minute session discusses how error can arise, and in particular, how we are cognitively biased to make certain types of error. This is illustrated with reference to a real adverse incident.

Human factors in ICU – Work procedures and ergonomics. Dr Andrew Hitchings. (Link to participation/reflection form.)

In this 18-min session, I discuss how an understanding of human factors can inform the development of guidelines, protocols and pathways (collectively termed ‘work procedures’ in this session). I also briefly touch on the physical aspects of our work environment, and how this can be engineered to optimise reliability, safety and productivity (‘ergonomics’). (

Status epilepticus – Initial management. Dr Andrew Hitchings. (Link to participation/reflection form.)

This 17-min session covers the management basics of early and established status epilepticus.

Status epilepticus – New-onset refractory status epilepticus (NORSE). Dr Andrew Hitchings. (Link to participation/reflection form.)

This 20-min session discusses the management of refractory status epilepticus, and specifically the syndrome of new-onset refractory status epilepticus. This condition is uncommon, but we see several cases a year in this unit, and they can present significant management challenges.

IV fluids – Core concepts. Dr Andrew Hitchings. (Link to participation/reflection form.)

This 20-min session is about the concepts that crucially underpin the use of IV fluids – namely their composition and how they distribute through body water compartments. 

IV fluids – Fluid resuscitation. Dr Andrew Hitchings. (Link to participation/reflection form.)

This 25-min session provides an introduction to the principles and practicalities of fluid resuscitation in a critical care environment, with particular emphasis on assessment of response to a fluid challenge.

IV fluids – Assessing fluid responsiveness without fluid. Dr Andrew Hitchings. (Link to participation/reflection form.)

This 17-min session builds on the Fluid resuscitation session to discuss the methods of assessing fluid responsiveness without giving fluid. Methods discussed include the passive leg raise test, stroke volume variation / pulse pressure variation, and the end-expiratory occlusion test.

Hyponatraemia- Pathophysiology. Dr Andrew Hitchings. (Link to participation/reflection form.)

A 20-min session discussing the core pathophysiological concepts that underpin the understanding of hyponatraemia. The mechanisms of the main causes of hypotonic hyponatraemia are covered, together with the less common but important mechanisms of non-hypotonic hyponatraemia.

Hyponatraemia – Evaluation and Differential Diagnosis. Dr Andrew Hitchings (Link to participation/reflection form.)

A 22-min session setting out a practical approach to the evaluation of a patient with hyponatraemia to elucidate the diagnosis. Presented from a general perspective (i.e. not neuro ICU specific).

Hyponatraemia – Management. Dr Andrew Hitchings (Link to participation/reflection form.)

An 8-min session discussing the acute management of hyponatraemia, according to whether or not the patient has acute and/or severe symptoms. Presented from a general perspective (i.e. not neuro ICU specific), with a focus on the acute/critical care considerations.

Hyponatraemia – NeuroICU perspective. Dr Andrew Hitchings (Link to participation/reflection form.)

A 17-min session that builds on the others by discussing the causes, evaluation and management of hyponatraemia in the setting of a specialist neurointensive care unit. This session draws on material from the others sessions, but could be viewed on a stand-alone basis if you already have good general working knowledge of the topic.

Police Powers – Mrs Shanti Kelly (Legal Services St. George’s Hospital)

A 30-min presentation on police requests and law around patient confidentiality and sharing information with the police. Q&A follows. This was an invited presentation in June 2021, and presented to our M&M meeting. No patient identifiable information was shared.