Copyright 2014 Neurocritical Care Society

Neurocritical Care Society

What to do in the first critical hour of a neurological emergency

ENLS is a collection of suggested approaches to the management of common neurological emergencies within the first hour of onset. ENLS was created by neurointensivists and emergency physicians on a volunteer basis and improved by feedback from physicians and nurses worldwide. Use of ENLS is intended for all medical professionals and is provided free on-line.

The goals of ENLS include

ENLS was created by members of the Neurocritical Care Society in cooperation with leaders from Emergency Medicine. These topics are simply practical guides that should not dictate care in any particular patient. See our legal disclaimer.

We ask that you provide feedback to any part of ENLS by using the "feedback" button within the topic or you may email comments directly to the ENLS chairs shown to the right.

These comments are useful to the topic co-chairs who are charged with authoring and maintaining these protocols. It is our hope that by making these protocols public domain it will lead to wider and faster adoption of treatments for these complex patients, and build international consensus on a consistent approach.

Duplication or representation of ENLS without the authorization of the Neurocritical Care Society is prohibited. If you would like such permission please email The Neurocritical Care Society.

ENLS was created by the collaborative efforts of many individuals. The chairs solicited topics that are common concerns for emergency neurological situations and charged a neurointensivist and an emergency physician to create a practical approach to the condition using evidence-based guidelines where available. These were reviewed by members of the Neurocritical Care Society between 2010 and 2011 and these suggestions were incorporated as necessary. ENLS Beta went live April 15, 2011. Anyone who wishes to provide input can make anonymous or named comments using the feedback feature at each node in the topics. We wish to keep track of those who wish credit for their comments so let us know who you are.

ENLS Chairs:
Scott Weingart, MD Wade Smith, MD,PhD
Topic Co-chairs:
Emergency Physicians Neurointensivists
Brad Bunney, MD J. Claude Hemphill, MD, MAS
Jan Claasen, MD Peter Le Roux, MD
Jon Edlow, MD Bart Nathan, MD
David Gaieski, MD Kristine O'Phelan, MD
Harmut Gross, MD Kees Polderman, MD
Andy Jagoda Owen Samuels, MD
Ed Jauch, MD David Seder, MD
John Marx, MD Deborah Stein, MD
Jon Rittenberger, MD Robert Stevens, MD
Robert Silbergleit, MD Gene Sung, MD
Stuart Swadron, MD Eelco Wijdicks, MD
(Emergency Physicians) (Neurointensivists)
ENLS Advisors
E. Sander Connolly, MD Neurosurgeon
William Coplin, MD Neurointensivist
Daryl Gress, MD Neurointensivist
Arthur Pancioli, MD Emergency Physician
Allan Ropper, MD Neurointensivist
Edward Sloan, MD Emergency Physician