Lately, I’ve thought about ICP monitors, and how much they are used. There is a Pubmed article http://www.ncbi.nlm.nih.gov/pubmed/23025964 comparing the rates of use of ICP monitors and differences in injury severity and mortality among level I trauma centers and level II trauma centers. I guess I spent most of my time at Children’s Hospital of the Kings Daughters, 15 days or so in the Pediatric Intensive Care Unit, along with 34 days in a regular hospital room. Part of the time, I had an ICP monitor placed, so that they could track the pressures. There is probably a sharing agreement where some neurosurgeons from Norfolk General are available to come over when needed. I am not sure how all of that process worked. I am fortunate that I had a very supportive family, and that my treatments were handled in timely manners, and that I was transported by the Nightingale’s helicopter transport service. Something about that golden hour, the first segments of time following an accident which can impact prognosis. Optimism is important.
I did ask a couple of folks at work if they knew how many times ICP monitors are used, and one Nurse Practitioner said that they’d have to ask a neurosurgeon, and I later found out that Tampa General averages about 10 ICP placements per month. Tampa General is a level I trauma center, as is Shands in Gainesville and Jackson Memorial in Miami. There are probably more level I trauma centers in Florida. But being generous and assuming 30 per month, and 360 per year just from Florida shows how relatively rare it is. Of course, this doesn’t take into account the level II trauma centers which might not see the volume of incidents that the level I trauma centers see. There probably are not the same level of 24 hour staff availability as the level I trauma centers have with various specialties.
Other cities probably see different mixes of complex cases as well.