Examining Very Short Antibiotic Courses

Many patients started on antibiotics for possible ventilator-associated pneumonia (VAP) do not have pneumonia. Patients with minimal and stable ventilator settings may be suitable candidates for early antibiotic discontinuation. Therefore, Klompas et al set out to compare outcomes amongst patients with suspected VAP but minimal and stable ventilator settings treated with one to three versus more than three days of antibiotics.

Very short antibiotic courses (one to three days) were associated with outcomes similar to longer courses (more than three days) in patients with suspected VAP but minimal and stable ventilator settings.

Read the full Concise Critical Appraisal by logging into the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

Stay Up to Date on the Latest SCCM Guidelines with Free Access

Help ensure that critical care patients are receiving consistent, evidence-based care by staying up-to-date on the latest Society of Critical Care Medicine (SCCM) guidelines.

Members and nonmembers alike can access the SCCM guidelines for free by visiting www.sccm.org/guidelines and Critical Care Medicine online or by downloading the Guidelines App.

SCCM’s guidelines cover a variety of topics including family-centered care, sustained neuromuscular blockade, reversal of antithrombotics in intracranial hemorrhage, and the management of sepsis and septic shock. View the complete list online.

Register for Ultrasound Courses

Registration is now open for the Society of Critical Care Medicine’s (SCCM) summer 2017 Critical Care Ultrasound courses. These courses will be held at the Loews Chicago O’Hare Hotel in Rosemont, Illinois, USA.

The comprehensive, two-day Critical Care Ultrasound: Adult and Critical Care Ultrasound: Pediatric and Neonatal courses will be held July 30 to 31, 2017. The ultrasound courses will provide the ability to:

  • Immediately integrate learned skills into your clinical practice
  • Increase your diagnostic skills and scanning proficiency
  • Earn continuing medical education credit hours available to physicians and nurses
  • Learn from field experts on the latest strategies in ultrasound image interpretation and diagnostic challenges, as well as new innovations and procedures
  • Experience high-quality education from prominent faculty, including nurse practitioners, physician assistants and more
  • Receive a significant hands-on experience, ensured by a five-to-one learner-to-faculty ratio

Expand your fundamental echocardiographic skills and knowledge with the one-day Advanced Critical Care Ultrasound: Adult course, which will follow on August 1, 2017. This course will focus on the specialty-specific use of echocardiography in the management of the critically ill patient, and participants will explore the noninvasive management of the hemodynamically unstable patient. New this year, expert faculty will provide hands-on training in the use of transesophageal echocardiography (TEE).

Registration for the ultrasound courses includes a complimentary copy of SCCM’s Comprehensive Critical Care Ultrasound eBook, which covers the entire body and encompasses various views and diagnoses that clinicians will encounter at the bedside in both adult and pediatric populations.

Register online today for Critical Care Ultrasound: Adult, Critical Care Ultrasound: Pediatric and Neonatal and Advanced Critical Care Ultrasound: Adult using your customer ID and password, or contact SCCM Customer Service at +1 847 827-6888.

Alarm & Alert Fatigue Webcasts

Register today for the upcoming two-part webcast series on alarm and alert fatigue from the Society of Critical Care Medicine (SCCM). This series is held in collaboration with the Surgery Section Patient Safety Committee. Registration is complimentary for all participants.

The first session, Alarm Fatigue: Evidence and Management Strategies, will take place on Thursday, March 30, 2017, at 1:00 p.m. Central Time. During this session, Maria M. Cvach, DNP, RN, FAAN, Director of Policy Management and Integration at The Johns Hopkins Health System, and Bradford D. Winters, MD, PhD, FCCM, Associate Professor, Anesthesiology and Critical Care Medicine and Surgery at The Johns Hopkins Hospital, will discuss how alarm fatigue has become a health technology hazard and will offer strategies for management. Missed alarms have resulted in patient injury and death; this hazard has been listed on the Emergency Care Research Institute’s Top 10 Health Technology Hazards list since its inception in 2007. The Joint Commission instituted a National Patient Safety Goal on Alarm Management in 2014 with a requirement that hospitals fully implement it by January 2016.

Learning Objectives

  • Discuss clinical alarm hazards and The Joint Commission’s National Patient Safety Goal on Alarm Management
  • Rate available evidence regarding alarm fatigue literature
  • Identify gaps in knowledge and research needs
  • Discuss alarm management strategies based on quality improvement initiatives

The second session, Alert Fatigue: Management Approaches and Appropriate Metrics, will take place on Wednesday, April 26, 2017, 1:00 p.m. Central Time. In this session, Sandra L. Kane-Gill, PharmD, MS, FCCM, Associate Professor, Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy, will discuss how clinical decision support systems (CDSSs) are commonly used for preventing medication errors, and how they are gaining interest as electronic syndromic surveillance systems for events such as sepsis and acute kidney injury. While CDSSs improve patient outcomes, the number of alerts increases the risk of alert fatigue. Approaches to managing alert fatigue are needed to ensure effective use of CDSSs.

Learning Objectives

  • Choose evidence-based guidance on tested interventions that reduce alert quantity with the intent of reducing fatigue with clinical decision support systems
  • Apply standardized metrics for alert fatigue

Both 60-minute webcasts will be moderated by Joseph D. Catino, BS, MD. Register online for Alarm Fatigue: Evidence and Management Strategies and Alert Fatigue: Management Approaches and Appropriate Metrics today using your Customer ID and password. If you have any questions, please contact SCCM Customer Service at +1 847 827-6888.

New Edition of SCCM’s Self-Assessment

Assess your knowledge with the new edition of Self-Assessment in Adult Multiprofessional Critical Care.

The eighth edition of Self-Assessment in Adult Multiprofessional Critical Care offers hundreds of multiple-choice study questions designed to help you pass your subspecialty board examination or to refresh and expand your overall knowledge of critical care medicine. Developed by leading experts in critical care, this self-assessment covers the top 20 critical care focus areas. Questions are based on real-world case studies, and an answer key helps you measure your progress. This publication is available in the SCCM Store in print and electronic versions.

Test your knowledge on the go with the interactive edition. This web-based version of the popular print publication consists of a series of test questions pertaining to all areas of critical care knowledge. This online learning experience offers immediate feedback to identify areas of strength and weakness, and provides rationales and references for missed questions.

Buy more, save more! Save up to 30% by purchasing the Self-Assessment Bundle: Adult, which contains both the textbook and its online companion.

For questions, please contact SCCM Customer Service at +1 847 827-6888.

High-Flow Nasal Cannula vs. Noninvasive Ventilation

High-flow conditioned oxygen therapy delivered through nasal cannulae and noninvasive mechanical ventilation (NIV) may reduce the need for reintubation. Therefore, Hernández et al set out to test if high-flow conditioned oxygen therapy is noninferior to NIV for preventing postextubation respiratory failure and reintubation in patients at high risk of reintubation.

They found that among high-risk adults who have undergone extubation, high-flow conditioned oxygen therapy was not inferior to NIV for preventing reintubation and postextubation respiratory failure.

Read the full Concise Critical Appraisal by logging into the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

Congress Session Addresses Antibiotic Stewardship in Sepsis

A session during the 46th Critical Care Congress addressed balancing early antibiotic administration and stewardship in sepsis.

At the start of the session, Mitchell Levy, MD, MCCM, notes the importance of the topic. “Through the Surviving Sepsis Campaign … we’ve produced sepsis performance metrics, which have now been adopted nationally by [the Centers for Medicare & Medicaid Services]. They mandate rapid institution of appropriate antibiotics for all patients suspected of sepsis within the first hour.”

That’s the good news. The bad news, according to Dr. Levy, is that “we live in a time of serious concerns about antibiotics resistance.” He noted many people say “the performance measures may have… unintended deleterious consequences by driving antibiotics into patients that turn out later to not have infections. That’s often been used as the reason to not to adhere to or accept the performance measures.”

The Society of Critical Care Medicine has been collaborating with the Centers for Disease Control and Prevention (CDC) and has been in conversation with the American College of Emergency Physicians (ACEP) and the Infectious Diseases Society of America (IDSA) to address this issue.

“We’ve come to see how to balance this by marrying the rapid institution of appropriate antibiotics with antibiotic stewardship,” Dr. Levy said. Panelists discussed the drive to make early antibiotics effective while minimizing how long patients receive antibiotics.

Panelists took questions from the audience and debated several questions, including whether the goals of integrating antibiotic stewardship with the rapid treatment of severe sepsis and septic shock were mutually exclusive. The group discussed practical and lesser-known benefits of a robust antibiotic stewardship program, and how to balance rapid antibiotic choices while still protecting against antimicrobial resistance.

Panelists included Lauren Epstein, MD, from the CDC, Tiffany Osborn, MD, MPH, FCCM, FACEP, representing the ACEP, and Stephen Weber, MD, representing the IDSA. The session aimed to review coordination and staging of timely antibiotic administration and to recognize the impact that antibiotic resistance has in clinical medicine and sepsis.

Dr. Epstein, along with Surviving Sepsis Campaign founder, R. Phillip Dellinger, MD, MCCM, served as guest panelists during the Critical Connections Live broadcast on the New Guidelines for the Management of Sepsis and Septic Shock.

The updated Surviving Sepsis Campaign guidelines (available in both Critical Care Medicine and Intensive Care Medicine) were released during the 46th Critical Care Congress, along with a viewpoint and synopsis published in JAMA. Materials are available at www.survivingsepsis.org.

Affiliated materials released in conjunction with the guidelines include:

Apply for THRIVE Peer Support Collaborative Funding

In support of the THRIVE initiative, the Society of Critical Care Medicine (SCCM) is proud to fund the third round of seed grants to foster an international network of in-person support groups linking survivors of critical illness and their families. These groups will offer survivors mutual support and the opportunity to share solutions to the challenges of recovery after an intensive care unit (ICU) stay.

The goal of these grants is not to fund ICU follow-up clinics but rather to develop peer-support models with strong survivor co-leadership as the foundation for growing an international network.

Applications are due June 1, 2017.

If you have any questions, please contact SCCM staff partner Adair Andrews at aandrews@sccm.org.

2018 Congress Session Builder to Close Tomorrow

For those working on session proposals for the Society of Critical Care Medicine’s 2018 Critical Care Congress, please note that the 2018 Congress Session Builder will close tomorrow.

Access a PDF about the Session Builder, which gives pointers on building a good session. After reviewing the information, go to MySCCM.org, click on the My Involvement tab and select Session Builder. For complete instructions and to review frequently asked questions, visit www.sccm.org/SessionProposals. Click on the tab titled Session Proposals.

Please note: The Congress Program Planning Committee reserves the right to change, alter, merge, and reject sessions, titles, content, moderators, and speakers to meet programming needs. Incomplete submissions will not be reviewed.

In 2018, SCCM will bring the critical care community to San Antonio, Texas, USA. Everything is bigger in Texas and the 47th Critical Care Congress will encourage you to embrace new perspectives and develop innovative ideas that push beyond limitations and challenge the current state of critical care. We invite you to join us February 25 to 28, 2018, for the largest multiprofessional critical care event of the year. Registration opens June 2017.

Help SCCM Expand Fundamentals Training in Africa

Critical care remains in its infancy in many low-income countries in Africa. The care that critically ill patients receive in most parts of the continent is often informal, uncoordinated or even absent in many cases, resulting in a fatality rate that’s unacceptably high. In Africa, the mortality rate for head injuries in Benin is 70% and for eclampsia, a life-threatening complication of pregnancy, it is over 40% in both Senegal and Nigeria. Even more shocking, in 2013, approximately 180,000 women died during pregnancy or childbirth in Sub-Saharan Africa, according to the World Health Organization (WHO).

To help reverse this alarming trend, SCCM, in conjunction with the 2017 All-Africa Anesthesia Congress in Abuja, Nigeria, will be providing fundamentals education through a continent-wide training program. By co-locating our fundamentals course programs at this large gathering of care providers, SCCM will reach participants from 54 different countries from one central location. Healthcare providers will have a unique opportunity to choose from five different fundamentals courses. At this time, the Society anticipates offering training to approximately 200 participants in Fundamental Critical Care Support (FCCS), Pediatric FCCS, Fundamental Disaster Management, FCCS: Obstetrics (pilot version), and FCCS: Tropical Diseases.

If you would like to make a donation to help support the Society’s efforts in Africa, you can go to the SCCM donation page by clicking on the link www.sccm.org/donate and then clicking “Online Donation” and selecting “Resource Limited Areas” from the drop-down menu. This will ensure that your gift is directed toward this important effort. Please read the “Donor Prospectus” to learn more.

Your support is urgently needed to ensure that the proper training and tools are getting to healthcare professionals in Africa.

Registration Open for Webcast Series on Alarm and Alert Fatigue

Registration is now open for the upcoming two-part webcast series on alarm and alert fatigue from the Society of Critical Care Medicine (SCCM). The series is held in collaboration with the Surgery Section Patient Safety Committee. The first session, Alarm Fatigue: Evidence and Management Strategies, will take place on Thursday, March 30, 2017, at 1:00 p.m. Central Time. The second session, Alert Fatigue: Management Approaches and Appropriate Metrics, will take place on Wednesday, April 26, 2017, 1:00 p.m. Central Time.

In the first session, Maria M. Cvach, DNP, RN, FAAN, Director of Policy Management and Integration at The Johns Hopkins Health System, and Bradford D. Winters, MD, PhD, FCCM, Associate Professor, Anesthesiology and Critical Care Medicine and Surgery at The Johns Hopkins Hospital, will discuss how alarm fatigue has become a health technology hazard and will offer strategies for management. Missed alarms have resulted in patient injury and death; this hazard has been listed on the Emergency Care Research Institute’s Top 10 Health Technology Hazards list since its inception in 2007. The Joint Commission instituted a National Patient Safety Goal on Alarm Management in 2014 with a requirement that hospitals fully implement it by January 2016.

During the second session, Sandra L. Kane-Gill, PharmD, MS, FCCM, Associate Professor, Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy, will discuss how clinical decision support systems (CDSSs) are commonly used for preventing medication errors, and how they are gaining interest as electronic syndromic surveillance systems for events such as sepsis and acute kidney injury. While CDSSs improve patient outcomes, the number of alerts increases the risk of alert fatigue. Approaches to managing alert fatigue are needed to ensure effective use of CDSSs.

Learning Objectives

Session 1

  • Discuss clinical alarm hazards and The Joint Commission’s National Patient Safety Goal on Alarm Management
  • Rate available evidence regarding alarm fatigue literature
  • Identify gaps in knowledge and research needs
  • Discuss alarm management strategies based on quality improvement initiatives

Session 2

  • Choose evidence-based guidance on tested interventions that reduce alert quantity with the intent of reducing fatigue with clinical decision support systems
  • Apply standardized metrics for alert fatigue

These 60-minute webcasts will be moderated by Joseph D. Catino, BS, MD. Registration is complimentary for all participants. Register online for Alarm Fatigue: Evidence and Management Strategies and Alert Fatigue: Management Approaches and Appropriate Metrics today using your Customer ID and password. If you have any questions, please contact SCCM Customer Service at +1 847 827-6888.

2017 Editions of Current Concepts Available: Adult & Pediatric

Each year, the Society of Critical Care Medicine’s (SCCM) popular precourses, Current Concepts in Adult Critical Care and Current Concepts in Pediatric Critical Care, deliver the latest clinical information relevant to patients in the intensive care unit. These courses are available On Demand and the companion textbooks are available in print and as eBooks.

Save over 10% by purchasing the Adult or Pediatric bundle, which include the 2017 book and unlimited access to the On Demand course.

A sample of topics featured at the 2017 Current Concepts in Adult Critical Care course include:

  • Management of Neuro-ICU Emergencies
  • Patient Safety and the Electronic Medical Record
  • Ethical Controversies in Critical Care
  • Fluid Management in Septic Shock

A sample of topics featured at the 2017 Current Concepts in Pediatric Critical Care course include:

  • Innovations in the Diagnosis and Management of Sepsis
  • Advances in Congenital Heart Surgery
  • Contemporary Issues in Renal Replacement Therapies
  • Update on Pediatric Damage Control Resuscitation

All of the Current Concepts resources are available for purchase. Visit www.sccm.org/AdultCC or www.sccm.org/PediatricCC. If you have any questions, please contact SCCM Customer Service at +1 847 827-6888.

Registration Open for 2017 Critical Care Review Course: Adult

Registration is now open for the Society of Critical Care Medicine’s (SCCM) Multiprofessional Critical Care Review Course (MCCRC): Adult.

The 2017 MCCRC: Adult will be held July 25-29, 2017, at the Loews Chicago O’Hare Hotel in Rosemont, Illinois, USA. Rosemont offers the convenience and amenities of downtown Chicago but at a lower price, and it’s just minutes from O’Hare International Airport.

Register online using your Customer ID and password, or contact SCCM Customer Service at +1 847 827-6888.

Led by co-chairs Pamela A. Lipsett, MC, MHPE, MCCM, and Stephen M. Pastores, MD, FCCM, this course will provide the most comprehensive review and update of the diagnosis, monitoring and management of critically ill patients.

Course highlights include:

  • Modular course content, allowing for single or multiday registration to meet comprehensive or specific learning needs
  • Interactive sessions that utilize audience response technology and practice questions, answers and rationales
  • Cutting-edge topics such as extracorporeal membrane oxygenation, choice of vasopressor in shock states, renal replacement therapy techniques, environmental injuries, emerging infections, and delirium.

Efficacy of Combined Intravenous Thrombolysis and Thrombectomy

Mechanical thrombectomy (MT) improves clinical outcomes in patients with acute ischemic stroke (AIS) caused by a large vessel occlusion. However, it is not known whether intravenous thrombolysis (IVT) is of added benefit in patients undergoing MT. Coutinho et al set out to address this unknown.

The results indicate that treatment of patients experiencing AIS due to a large vessel occlusion with IVT before MT does not appear to provide a clinical benefit over MT alone.

Read the full Concise Critical Appraisal by logging into the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

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