NeuroAnaesthesia and Critical Care Society NACCS

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NACCS is a membership society, and our purpose is to improve the quality and safety of patients by promoting education, research, information and collaboration.

NACCS at Brain Conference 2025 – LondonWe are delighted to announce that Dr. Timothy Faccini, NACCS Council Member and A...
01/12/2025

NACCS at Brain Conference 2025 – London
We are delighted to announce that Dr. Timothy Faccini, NACCS Council Member and Anaesthetic Registrar, will be presenting his multicentre SSNAP-shot of anaesthesia for Mechanical Thrombectomy at the upcoming Brain Conference 2025 in London.
This important work highlights current practices and provides valuable insights into anaesthetic management for MT across the UK.
We look forward to engaging with colleagues, sharing knowledge, and advancing neuro-anaesthesia excellence.

30/11/2025

⏱️ Thrombectomy Timing vs. Arterial Lines – What Matters More?
During the recent NACCS webinar, a question came up: “With time to get to the IR suite being highly variable, is saving 3 minutes by skipping an arterial line worth the possible reduced detection of hypo/hypertension?”
Dr. Rebecca Campbell answered:
“If a patient medically requires an arterial line—like if they’re cardiovascularly unstable—then absolutely, place it. But the vast majority of patients don’t need one. Our data shows arterial lines didn’t reduce hypotension or other complications.
Improving pathway timings is a team effort—think Dave Brailsford’s marginal gains. To hit the 60-minute goal safely, we all need to move as quickly as possible. Every hour of delay means 7 fewer patients benefit from thrombectomy. Every 10-minute delay reduces disability-free survival and increases NHS costs.”
💡 Takeaway: Prioritize patient safety, but avoid unnecessary delays—time is brain in thrombectomy.

30/11/2025

🧠 Thrombectomy Q&A from the NACCS Webinar
A participant shared:
"In my centre, we audited thrombectomies over 4 months and found door-to-puncture (DTP) times particularly long at ~120 mins. Is this the national picture? And will DTP and door-to-door (DTD) times be recommended at 60 mins?"
Dr. Campbell responded:
✅ The national average (SSNAP) for clock start to puncture is 2h17m, up from 2h6m in 2023/24.
✅ For transferred patients, it’s 3h57m from arrival at the first hospital.
✅ New target: 60 mins for directly admitted patients.
✅ Across London, centres have been running QI projects since May. Some, including Dr. Campbell’s, have achieved

30/11/2025

💡 Thrombectomy in Critical Care: Data Insights
From the recent NACCS webinar: “What data is currently collected on patients admitted to critical care post-mechanical thrombectomy?”
Dr. Rebecca Campbell shared:
“Within SSNAP, data is collected on whether a patient was admitted to HDU or ITU and the reason for this. However, the question regarding reasons for ITU admission is poorly written, and we often struggle to find the appropriate answer.”
📊 This highlights ongoing challenges in capturing accurate post-thrombectomy critical care data—an important step for improving patient outcomes and quality reporting.

30/11/2025

💉 NACCS Webinar Insight 💉
Question: "Are colleagues performing RSI inductions for thrombectomy in general? If so, with TIVA, how are they doing this?"
Dr. Rebecca Campbell:
"It depends on the patient’s fasting status and other individual factors. I only perform RSI if I believe there’s a high risk of aspiration. Interestingly, our local and national data suggest that a non-TIVA anaesthetic may be faster for these patients."
🔹 Key takeaway: Choice of induction should be individualized, balancing aspiration risk and procedural efficiency.

30/11/2025

💡 NACCS Webinar Insight:
Q: Is there strong evidence for etomidate use in thrombectomy GA inductions to try to avoid hypotension?
Dr. Campbell:
"I don’t personally think so. With careful and judicious use of our existing induction agents and vasopressors, we can avoid significant hypotension. In complex patients, it’s especially important to use agents we are most familiar with."
✅ Takeaway: Familiarity and careful titration of induction agents matter more.
# thrombectomy # Stroke Care

30/11/2025

Two weeks ago we ran our webinar, and we’ve had some excellent follow-up questions since. One common question was:
“Which vasopressor or antihypertensive do you use in your practice during thrombectomy?”
Here’s the response from Dr. Rebecca Campbell, who presented the thrombectomy session:
👉 Vasopressors:
“In our institution, we generally use metaraminol infusions, with ephedrine boluses when needed.”
👉 Antihypertensives:
“Our most commonly used agent is labetalol, which is also the first-line antihypertensive recommended by our stroke physicians.”
Beccy also pointed out that the SPRINT audit mentioned magnesium as an antihypertensive used in several centres. In our dataset, 5.6% of patients received an antihypertensive.
Thanks again to everyone who attended and continues to engage!
# Beccy Campbell

14/11/2025

🩺 NACCS Webinar Q&A Spotlight
Predicting ICU outcomes is never easy. If we try to prognosticate for too long, our intensive care beds may become stretched: an unsavoury reality, but sometimes unavoidable in a resource-limited system.
Early pessimistic predictions might free beds but at what cost? Modern data show patients can wake far beyond day 2–3, even after weeks. ⏳
When prognosis is uncertain, giving time can save lives.
💭 The question for clinicians and policymakers: Do we prioritize empty ICU beds… or unexpected survivors?

14/11/2025

📢 NACCS Neuroanaesthesia & Neurocritical Care Webinar — Audience Q&A
❓ Question for Dr. Susanne Muehlschlegel:
What strategies help keep shared decision-making genuinely “shared” when the clinical team and family begin with different expectations?
💬 Dr. Muehlschlegel’s answer:
To keep shared decision-making truly shared, clinicians must step away from telling families what they “should” do. These choices are value-based, and families may prioritise differently — sometimes choosing options we wouldn’t choose for our own loved ones. ❤️
Provide a balanced outlook with best/worst/most-likely scenarios 📊, be mindful of personal biases 🧠, and avoid clinical nihilism 🚫. Respect when families value outcomes differently — including prioritising life over predicted QOL. ✨ Shared decision-making means giving a balanced outlook, avoiding nihilism, and respecting when families’ values differ from ours — even if they prioritise life over predicted QOL.
📚 For deeper insight, read: “Clinical Nihilism in Neurological Emergencies.”

Happy Monday 🌟Don’t forget, the NACCS Webinar is happening this Friday, Nov 14th! 🎓✨It’s going to be a great educational...
10/11/2025

Happy Monday 🌟
Don’t forget, the NACCS Webinar is happening this Friday, Nov 14th! 🎓✨
It’s going to be a great educational program, full of learning and inspiration! If you haven’t signed up yet, what are you waiting for? 💻
Let’s kick off this beautiful week by registering today! 🙌
👉 https://zurl.co/YFFpu
’tMissOut

🔥 We are so excited! Just over a month before our Autumn CPD Webinar!!! 🔥 🤓 Have you registered yet? ⏰ Hurry! Register n...
09/10/2025

🔥 We are so excited! Just over a month before our Autumn CPD Webinar!!! 🔥

🤓 Have you registered yet?

⏰ Hurry! Register now and save the date: 14th November 2025

https://zurl.co/YFFpu

Save the date!The NACCS CPD Webinar is coming: 14th of November 2025!
11/07/2025

Save the date!

The NACCS CPD Webinar is coming: 14th of November 2025!

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