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May 7, 2015

Concise Critical Appraisal

Predicting Weaning-Induced Cardiac Dysfunction
The Efficacy of a Two-Tier Rapid Response System

Education

Register Now for ICU Liberation Webcasts
Early Registration Deadline Nearing for Adult Board Review Course
Register for ECMO Management Course
Early-Bird Rates for Ultrasound Courses End Soon
Special Surgery and Anesthesiology Sessions at MCCBRC

SCCM News

Wear Blue Tomorrow to Support Critical Care
Apply for the ICU Design Citation Award
Tragedy in Nepal: Disaster Resources, Ways to Donate
Apply Now for THRIVE Support Group Network Funding
Comments Sought on Use of Blood Glucose Monitoring Systems
Surviving Sepsis Campaign Six-Hour Bundle Revised
Save the Date for SCCM Study Mission to India
Still Time to Apply for SCCM Awards
Register Today: 2015 Critical Care World Congress
Application Deadline Nearing for Grant-Funded ICU Liberation Collaborative
The Efficacy of a Two-Tier Rapid Response System

Rapid response systems (RRSs) have been implemented to facilitate the early recognition and treatment of deteriorating ward patients. Evidence of their effectiveness is conflicting, but recent reviews suggest RRS utilization improves patient safety. Aneman et al recently assessed the clinical attributes and outcomes of patients admitted to the ICU of Liverpool Hospital both before and after implementation of a two-tier RRS. In this system, the clinical team responds to less serious first-tier criteria, and the RRS is activated when the patient meets more serious second-tier criteria.

The authors found that ICU mortality rates were significantly lower after two-tier implementation, as compared to mortality rates under the preexisting one-tier RRS. Although this study’s applicability is limited by its retrospective design, implementing a two-tier system seemingly improves patient outcomes.

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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Predicting Weaning-Induced Cardiac Dysfunction

Weaning-induced cardiac dysfunction is one of the most frequent and treatable causes of weaning failure. Dres et al initiated a study to determine whether the presence of cardiac preload independence before a spontaneous breathing trial (SBT) is associated with weaning failure related to cardiac dysfunction.

They found that detection of cardiac preload independence by passive leg raising (PLR) performed before an SBT reliably predicted the occurrence of weaning-induced cardiac dysfunction. These study results provide compelling support for using PLR as an assessment tool for SBT failure. It is now a matter of waiting for confirmatory studies.

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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Early Registration Deadline Nearing for Adult Board Review Course

The early registration deadline for the Society of Critical Care Medicine’s (SCCM) Adult Multiprofessional Critical Care Board Review Course (MCCBRC) is Wednesday, June 17, 2015. Register online using your customer ID and password, or contact SCCM Customer Service at +1 847 827-6888.

This 4.5-day course provides the most comprehensive review in the diagnosis, monitoring and management of critically ill patients. The course includes interactive board preparation sessions and features practice board questions, answers and rationales. World-class faculty focus on preparing fellows and attendings for their critical care certification and recertification. The course also provides an excellent update for any critical care professional seeking the most current review of the field.

As a registered participant, you will benefit from:

  • Online access to practice questions
  • A comprehensive course syllabus
  • Networking opportunities with colleagues and world-renowned experts
  • Post-course online access to MCCBRC On Demand, which features slides and recorded speaker audio from all sessions of the live course

The 2015 Adult MCCBRC will be held August 11 to 15, 2015, at the Fairmont Chicago, Millennium Park, in Chicago, Illinois, USA. For details, including the agenda, faculty and hotel and travel information, visit SCCM’s website.

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Register Now for ICU Liberation Webcasts

In the month of May, the Society of Critical Care Medicine (SCCM) will feature two webcasts from the ICU Liberation series. Registration is complimentary for all participants.

Road Map for Implementing the New ABCDEF Bundle in Your ICU
Tuesday, May 12, 2015
2:00 p.m. Central Time
Register online today

Mary Ann Barnes-Daly, RN, BSN, CCRN, DC, clinical performance improvement consultant at Sutter Health, and Juliana Barr, MD, FCCM, associate professor of anesthesiology, perioperative and pain medicine at Stanford University and staff anesthesiologist and intensivist at VA Palo Alto Health Care System, will provide a strategy for intensive care unit (ICU) teams striving to implement the new ABCDEF bundle. Faculty will examine the new element of the bundle: family engagement and empowerment. The bundle includes:

A = Assess, Prevent and Manage Pain
B = Both Spontaneous Awakening Trials and Spontaneous Breathing Trials
C = Choice of Sedation
D = Delirium: Assess, Prevent and Manage
E = Early Mobility and Exercise
F = Family Engagement and Empowerment

Learning Objectives

  • Review elements of the new ABCDEF bundle
  • Develop a mental model for successful implementation of bundle elements in an ICU

Successfully Overcoming Assessment and Treatment Challenges for ICU Pain
Thursday, May 28, 2015
1:00 p.m. Central Time
Register online today

Pain management in the ICU may be difficult because of a patient’s severity of injury and unstable health status. During this session, Céline Gélinas, PhD, RN, associate professor of nursing at McGill University, Aaron M. Joffe, DO, associate professor, Department of Anesthesiology & Pain Medicine at Harborview Medical Center, and Kathleen Puntillo, RN, PhD, FAAN, FCCM, professor emerita of nursing, at University of California, San Francisco, will provide an overview of the landscape of pain assessment and management in ICU patients within the context of the ABCDEF bundle and offer suggestions for interventions. The presentation will conclude with a question-and-answer segment.

Learning Objectives

  • Describe the importance of pain assessment and analgesic management within the framework of the ABCDEF bundle
  • Discuss the assessment of pain in non-communicative patients through use of the Critical-Care Pain Observation Tool (CPOT)
  • Evaluate pharmacological options for treating pain in critically ill patients
  • Provide answers to frequently asked questions about pain assessment and management challenges that occur in critical care practice

The ICU Liberation Initiative aims to engage clinicians in improving practice and patient outcomes related to pain, agitation, delirium, and early mobility.

If you have any questions regarding either webcast, please contact SCCM Customer Service at +1 847 827-6888.

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Early-Bird Rates for Ultrasound Courses End Soon

Register by June 17, 2015, to take advantage of discounted early registration rates for the Society of Critical Care Medicine’s (SCCM) Critical Care Ultrasound courses, to be held August 16 to 18, 2015, at the Fairmont Chicago, Millennium Park, in Chicago, Illinois, USA. SCCM now offers four Critical Care Ultrasound courses to help you increase your ultrasound knowledge.

Critical Care Ultrasound and Critical Care Ultrasound – Pediatric are two-day courses that provide the realistic training needed to perform and interpret ultrasound imaging. Participants benefit from guided, focused skill stations featuring live models and interactive presentations to reinforce key learning points. Extensive faculty coverage ensures a significant hands-on experience for each participant.

Expand upon your fundamental echocardiographic skills and knowledge with Advanced Critical Care Ultrasound and Advanced Critical Care Ultrasound – Pediatric on August 18, 2015. These courses focus on the specialty-specific use of echocardiography in the management of the critically ill patient and provide participants with important cardiovascular information for the noninvasive management of the hemodynamically unstable patient.

Space for these courses is limited. Visit the ultrasound courses webpage and register today using your Customer ID and password to guarantee your seat, or contact SCCM Customer Service at +1 847 827-6888. To receive SCCM’s discounted hotel rate, make your reservation by July 13, 2015.

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Register for ECMO Management Course

Attend the Society of Critical Care Medicine’s (SCCM) intense two-day ECMO Management course and explore the basic management principles common to extracorporeal membrane oxygenation (ECMO) programs for both adult and pediatric patients.

Led by expert faculty, this course will provide a comprehensive overview of ECMO programs. Participants will rotate through lectures and simulation scenarios. Each simulation group will have a maximum of 10 participants and two facilitators. Topics include: basic physiology of ECMO, equipment and patient selection, and economic and ethical considerations.

This course will be held August 28 and 29, 2015, at the University of Arizona Center for Simulation and Innovation in Phoenix, Arizona, USA.

Register online today with your customer ID and password. Please contact SCCM Customer Service at +1 847 827-6888 with any questions.

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Wear Blue Tomorrow to Support Critical Care

You are encouraged to wear blue tomorrow in celebration of National Critical Care Awareness and Recognition Month (NCCARM)!

Also, remember to share your photos on Twitter using #NCCARM, or post them to the Society’s Facebook page. We’d especially love to see any photos of you and your ICU team reuniting with former patients and their families! You can also send your pictures to criticalconnections@sccm.org.

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Special Surgery and Anesthesiology Sessions at MCCBRC

The Society of Critical Care Medicine’s (SCCM) Adult Multiprofessional Critical Care Board Review Course (MCCBRC) is the preferred resource for critical care professionals seeking a comprehensive review of content focused on the diagnosis, monitoring and management of critically ill patients.

New in 2015, special afternoon concurrent sessions have been specifically designed to review surgery and anesthesiology. Topics include: transplant, gastrointestinal and cardiovascular surgery, and pre-, intra- and postoperative anesthesia.

The 2015 Adult MCCBRC will be held August 11 to 15, 2015, at the Fairmont Chicago, Millennium Park, in Chicago, Illinois, USA. Register online using your customer ID and password, or contact SCCM Customer Service at +1 847 827-6888.

To view the complete line of board prep and review products, visit www.sccm.org/adultboardreview.

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Apply for the ICU Design Citation Award

Applications for the 2015 ICU Design Citation award are now being accepted. Co-sponsored by the Society of Critical Care Medicine (SCCM), the American Association of Critical-Care Nurses (AACN) and the American Institute of Architects Academy of Architecture for Health, this award honors a critical care unit already in operation that combines functional design with the humanitarian delivery of critical care.

Entries are reviewed in a blinded fashion and evaluated on the following criteria:

  • Demonstrates commitment to creating a healing environment and promoting safety and security
  • Demonstrates commitment to efficiency
  • Demonstrates attention to an innovative, unique aesthetic and creative design features

The award is given to the unit that best resolves both functional and humanitarian issues in a unique and complementary manner. The patient bedside area, overall unit design, integration of technology, staff/support areas, and family/waiting areas also are assessed.

The winning unit receives two plaques and one complimentary registration to the annual meetings of SCCM and AACN. Honorable mentions will also be awarded with a plaque. Citation recipients will be notified in November 2015.

Visit www.sccm.org/ICUDesignCitation for requirements and to begin the application process. The deadline to apply is August 15, 2015.

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Tragedy in Nepal: Disaster Resources, Ways to Donate

On behalf of its membership, the Society of Critical Care Medicine (SCCM) has reached out to those affected by the devastating earthquake and avalanche in Nepal, offering our deepest condolences and assistance in response efforts.

The Society maintains a website with various emergency response resources at www.sccm.org/disaster. There is also a thread on the SCCM Disaster eCommunity site specific to the situation in Nepal. This is a great forum for sharing pertinent resources and information.

At this time, there is no call for critical care volunteers, but the Society will continue to communicate with those in the affected region and do everything possible to assist in the effort. To learn more about critical care development in Nepal and ways to donate to relief efforts, please visit www.nccdfnepal.org. To the many SCCM members who have already contacted our headquarters offering to go to Nepal, thank you. And to those that have chosen to assist through other means, your efforts are very much appreciated and admired by your colleagues worldwide.

You are encouraged to listen to the recent iCritical Care podcast centering on post-disaster efforts in Nepal. Donation opportunities are also discussed.

SCCM Pod-272 Tragedy in Nepal: Post-Disaster Efforts, Ways to Help

In this podcast, Margaret Parker, MD, MCCM, speaks with Laura Hawryluck, MD, FRCPC, about Nepal’s critical care infrastructure and how it has been affected by the earthquake. They also discuss the post-disaster efforts and ways the critical care community can help. As noted in the podcast, those interested in contributing to the Nepal Critical Care Development Foundation can find more information at http://www.indiegogo.com/projects/nepal-icu-care-box. The Society has contributed to the relief efforts in this manner and encourages its members to do likewise as they are inclined and able. For additional information, contact Dr. Hawryluck at laura.hawryluck@gmail.com. Dr. Hawryluck works as a critical care physician at the University Health Network in Toronto, Ontario, Canada.

Pediatric Universal Life-Saving Effort, a nonprofit organization, is also raising funds for the Nepal relief efforts. Society members are encouraged to donate.

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