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December 3, 2015

Concise Critical Appraisal

Intravascular Complications of Central Venous Catheterization by Insertion Site

Education

Register for Webcasts on Patient Safety in the ICU
Research Workshop: Fat Emulsions and Protein Delivery to Critically Ill Patient

SCCM News

Congress Early Registration Ends Wednesday, December 16
SCCM Releases Critical Care Ultrasonography Guidelines
Join Us for a Journal Club Twitter Chat
LearnICU.org Resource: Critical Care Protocol Toolkit
New iCritical Care Podcast Discusses PICS and ICU Liberation
Intravascular Complications of Central Venous Catheterization by Insertion Site

Three anatomical sites are commonly used to insert central venous catheters, but insertion at each site has the potential for major complications. In a multicenter trial, Parienti et al randomly assigned nontunneled central venous catheterization in patients in the adult intensive care unit to the subclavian, jugular, or femoral vein (in a 1:1:1 ratio if all three insertion sites were suitable [three-choice scheme] and in a 1:1 ratio if two sites were suitable [two-choice scheme]). The primary outcome measure was a composite of catheter-related bloodstream infection and symptomatic deep-vein thrombosis.

In this trial, subclavian vein catheterization was associated with a lower risk of bloodstream infection and symptomatic thrombosis and a higher risk of pneumothorax than jugular vein or femoral vein catheterization.

Read the full Concise Critical Appraisal by logging in to 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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Register for Webcasts on Patient Safety in the ICU

The Society of Critical Care Medicine’s (SCCM) Project Dispatch is offering a unique webcast series titled “Patient Safety During Bedside Procedures in the ICU.” Register today to take advantage of two upcoming learning opportunities from this series, which is held in collaboration with the Surgery Section Patient Safety Committee. These webcasts were organized and will be moderated by Surgery Section Patient Safety Committee Co-Chair Roy Constantine, PhD, RPA-C, FCCM, Assistant Director of Mid-Level Practitioners at St. Francis Hospital – The Heart Center. Registration is complimentary for both webcasts.

Patient Monitoring and the Use of Checklists During Bedside Procedures in the ICU
1:00 p.m. – 2:00 p.m. Central Time
December 9, 2015
Register online

When it comes to patient safety and successful outcomes, the value of checklists is becoming more apparent in the face of a crisis. During this session, Teodoro Forcht Dagi, MD, DMedSc, MPH, FAANS, FACS, FCCM, FRCSEd, of Harvard Medical School and Queen’s University Belfast, will discuss optimization of patient monitoring and the use of checklists for crisis responses during bedside procedures in the intensive care unit (ICU). The implementation of tools and practice to reinforce this safety culture will also be emphasized.

Learning Objectives

  • Assess preparedness to respond to crises during bedside procedures
  • Implement crisis checklists in the ICU
  • Train and practice emergency response

Electronic Distraction in the ICU: An Impediment to Patient Safety
1:00 p.m. – 2:00 p.m. Central Time
December 16, 2015
Register online

In this session, Peter J. Papadakos, MD, FCCM, FAARC, Director of Critical Care Medicine and Professor of Anesthesiology, Surgery, Neurology and Neurosurgery at the University of Rochester School of Medicine, will focus on limiting noise and distractions in the ICU in order to create a safer environment for the patient and the procedural team. Additional information will be provided on how electronic devices can spread infection and what can be done to avoid it. Preventable medical errors in our ICUs are associated with a culture that focuses on patient safety, and the implementation of tools and practice to reinforce this safety culture will be emphasized in this webcast.

Learning Objectives

  • Assess levels of noise and distraction in the ICU
  • Articulate how the spread of infection via electronic devices occurs

Register online for both webcasts using your Customer ID and password. For more information on both webcasts, please visit the Project Dispatch webpage. If you have any questions regarding either event, please contact SCCM Customer Service at +1 847 827-6888.

Project Dispatch aims to improve the quality, efficacy, accessibility, and cost-effectiveness of healthcare in the United States by developing and distributing resources for critical care clinicians focused on patient-centered research. This project is supported by grant number R18HS21940 from the Agency for Healthcare Research and Quality (AHRQ). The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ.

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Research Workshop: Fat Emulsions and Protein Delivery to Critically Ill Patient

The Society of Critical Care Medicine (SCCM) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) have collaborated to bring you a new educational program, Research Workshop – Fat Emulsions and Protein Delivery to the Critically Ill Patient. This workshop is a precourse to A.S.P.E.N.’s Clinical Nutrition Week and will be held Saturday, January 16, 2016, from 7:30 a.m. to 4:00 p.m. in Austin, Texas, USA.

Morning Session: The Use of New and Traditional IV Fat Emulsions in the Critically Ill Patient Population

The morning session will:

  • Focus on metabolomics/lipidomics as a new biomarker discovery science for personalized medicine in the intensive care unit
  • Explore the impact of omega-3 polyunsaturated fatty acids (PUFAs) on specialized lipid mediators and inflammation
  • Review the published clinical and metabolic data on low-soy-based fat emulsions versus the longstanding soybean-oil-based emulsions
  • Examine the impact of different lipid emulsions on cellular structure and function
  • Examine the data behind existing guidelines for administration of fat emulsions in critical care

Afternoon Session: The Optimal Dose of Protein Provided to Critically Ill Patients: How Do We Know When Enough Is Enough?

The afternoon session will:

  • Review current literature relating to protein/amino acid administration in the critically ill patient and clinical outcomes
  • Discuss key measurement and methodological features of future studies that should be done to inform the optimal protein/amino acid dose provided to critically ill patients

Registration is handled by A.S.P.E.N. and can be completed online or by phone at +1 301 587-6315 (toll-free: +1 800 727-4567). Participants are eligible to receive 6.5 hours of continuing education credit. For more information, including a list of faculty and topics, visit the course webpage.

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Congress Early Registration Ends Wednesday, December 16

Register by Wednesday, December 16, 2015, for the Society of Critical Care Medicine’s (SCCM) 45th Critical Care Congress and save over 15% off the registration fee. Register online using your customer ID and password, or contact SCCM Customer Service at +1 847 827-6888.

Build your critical care knowledge and enhance the care you deliver to patients by attending SCCM’s annual Congress, to be held February 20 to 24, 2016, in Orlando, Florida, USA. Join more than 6,000 members of the critical care community at this five-day event. When the right people come together in one place, ideas become reality.

To secure hotel accommodations at the best rates, reserve your room online by January 15, 2016.

For more information about Congress, or to view the Advance Program, visit www.sccm.org/Congress.

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SCCM Releases Critical Care Ultrasonography Guidelines

The Society of Critical Care Medicine recently released guidelines addressing critical care ultrasonography.

Titled “Guidelines for the Appropriate Use of Bedside General and Cardiac Ultrasonography in the Evaluation of Critically Ill Patients—Part I: General Ultrasonography,” the material was published in the November 2015 issue of Critical Care Medicine.

After reviewing the document, you’re encouraged to listen to an in-depth iCritical Care podcast that discusses the nuances of the guidelines.

SCCM Pod-296 Guidelines for the Appropriate Use of Bedside General and Cardiac Ultrasonography

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Join Us for a Journal Club Twitter Chat

Join us on Tuesday, December 15, 2015, from 2:00 p.m. to 3:00 p.m. Central Time for the Society of Critical Care Medicine (SCCM) Social Media Task Force’s Journal Club Twitter chat.

Azra Bihorac, MD, MS, FCCM, and Chuck Hobson, MD, MHA, will be discussing the Critical Care Medicine article, Critical Care Delivery and ICU Structure: The Elephant in the Room, with moderator and SCCM Social Media Task Force Co-chair Anthony Gerlach, PharmD, BCPS, FCCP, FCCM. Their letter to the editor sought to identify unanswered questions provoked by a paper published by the American College of Critical Care Medicine Task Force on Models of Critical Care. The authors also recommend reading a paper published by Mitchell Fink, MD, MCCM, on the future of critical care and an article by Anthony McLean, MD, that offers examples about critical care medicine organizational structure in New Zealand and Australia.

Join Drs. Bihorac (@azrabihorac), Hobson (@CHobsonMD) and Gerlach (@SICUPharmD) in this highly informative discussion.

The authors will explore the many forces bearing on intensivists, the importance of the organization of critical care in the intensive care unit and how the organization of critical care training can impact these forces. The authors will discuss financial pressures to maximize quality while minimizing complications, hospital readmissions, and lengths of stay. They also will tackle workforce issues, including the limited supply of board-certified providers.

The letter to the editor and related articles are available for free until the conclusion of the Twitter chat:

Come prepared with any relevant questions you may have and make sure to use #SCCMJC in your tweets.

What is a Twitter chat?
A Twitter chat is a live event on Twitter, moderated and focused around a general topic. To filter all the chatter on Twitter into a single conversation, a hashtag is used. A set time is also established.

How do you participate?
To participate, all you need to do is tweet during the designated time using the conversation hashtag. It’s easiest to follow and participate at www.twubs.com/SCCMJC.

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LearnICU.org Resource: Critical Care Protocol Toolkit

You are encouraged to check out a very useful LearnICU.org resource titled the Critical Care Protocol Toolkit.

Developed by the Society of Critical Care Medicine’s (SCCM) Clinical Pharmacy and Pharmacology Section Education Committee, this resource is meant to assist members of the critical care team with identifying clinical problems and developing, implementing and sustaining success in the provision of critical care services through the use of protocols, which can be defined as “a standard set(s) of tasks that define precisely how classes of patients should be managed or treated.”

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New iCritical Care Podcast Discusses PICS and ICU Liberation

You are encouraged to listen to an in-depth iCritical Care podcast featuring former Society of Critical Care Medicine (SCCM) President Maurene A. Harvey, MPH, RN, MCCM, in which she raises awareness about post-intensive care syndrome (PICS) and related research and management strategies. Such strategies include ICU Liberation ABCDEF Bundle implementation.

SCCM Pod-303 Post-Intensive Care Syndrome: Truth About Consequences, Right Care Right Now … and Later

The podcast provides a nice preview of Ms. Harvey’s upcoming plenary session at SCCM’s 45th Critical Care Congress.

On a related note, you are encouraged to check out educational content centered on ABCDEF Bundle implementation strategies that are available in PDF format on the ICU Liberation website.

Implementing the A Component of the ABCDEF Bundle
Implementing the B Component of the ABCDEF Bundle
Implementing the C Component of the ABCDEF Bundle
Implementing the D Component of the ABCDEF Bundle
Implementing the E Component of the ABCDEF Bundle
Implementing the F Component of the ABCDEF Bundle

The ICU Liberation Initiative aims to engage clinicians in improving practice and patient outcomes related to pain, agitation, delirium, and early mobility, along with educating and empowering patients and families.

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