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November 22, 2013

Concise Critical Appraisal

Long-Term Cognitive Impairment After Critical Illness

Education

Early Registration Deadline for MCCKAP is Approaching
Webcast to Discuss Ethics Surrounding Mandatory Vaccinations
Advance Registration for Congress Ends Soon

SCCM News

Pediatric Acute Kidney Injury Survey
There’s Still Time to Join an SSC Local Collaborative
Drug Safety Alert: Acetaminophen
Long-Term Cognitive Impairment After Critical Illness

Long-term cognitive impairment is a significant public health problem. In the October 3 issue of the New England Journal of Medicine, the BRAIN-ICU Investigators, led by Pratik Pandharipande, MD, conducted a multicenter, prospective cohort study to estimate the prevalence of long-term cognitive impairment after critical illness and to test the hypothesis that patients with a longer duration of delirium and a higher sedative and analgesic requirement have more severe cognitive impairment up to 1 year after hospital discharge.

Adults admitted to a medical or surgical ICU with respiratory failure, cardiogenic shock, or septic shock were included. While hospitalized, they were evaluated for delirium and level of consciousness daily with the use of the Confusion Assessment Method for the ICU (CAM-ICU) and the Richmond Agitation-Sedation Scale (RASS). Global cognition and executive functions were assessed three and 12 months after discharge with the use of the Repeatable Battery for the Assessment of Neuropsychological Status and the Trail Making Test, Part B. Multiple linear regression with adjustment for multiple variables was used to examine independent risk factors for global cognition scores and secondary outcomes.

Read more…

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Early Registration Deadline for MCCKAP is Approaching

Register by November 27, 2013, to take advantage of discounted rates for the Society of Critical Care Medicine’s (SCCM) 2014 Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP).

Administered online February 27 to March 7, 2014, the MCCKAP online exam assesses critical care fellowship programs nationally. The MCCKAP exam helps program directors:

  • Prepare fellows for the subspecialty board examinations in critical care
  • Identify specific areas of strength and weakness with lists of references and key terms for missed questions
  • Assess results for each individual fellow and the overall program as well as the institution’s national ranking
  • Review preliminary scores and analysis immediately upon completion of the test

Available in both adult and pediatric formats, the exam is offered exclusively online and consists of 200 multiple-choice questions pertaining to critical care knowledge and patient management. Exam content is developed by critical care professionals experienced in exam preparation and analysis.

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

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Webcast to Discuss Ethics Surrounding Mandatory Vaccinations

In recent years, vaccinations have come under strong social and political fire. One hot topic is the ethical implications of healthcare policies that implement mandatory vaccinations for intensive care unit (ICU) personnel.

In the inaugural webcast of the Society of Critical Care Medicine’s (SCCM) new Controversies in Critical Care series, Kristen Feemster, MD, MPH, MSHP, and Douglas Naylor Jr., MD, FCCM, will debate the evidence and ethical arguments in support of these policies. Their opinions about the potential impact of these policies on the well-being of patients and healthcare personnel will be discussed as well as the potential impact of such policies on the healthcare system and society as a whole.

Learning Objectives

  • Identify those vaccinations that are currently “a mandatory treatment” for healthcare providers working in ICU environments
  • List the current literature and evidence in support of mandatory vaccinations for healthcare providers
  • Detail the federal or local policies that establish the legal framework for instituting this practice
  • Explore the practical and ethical arguments favoring or opposing mandatory vaccinations for ICU personnel
  • Develop a plan of action for vaccination of ICU personnel using an informed opinion on the implications of mandatory vaccinations

The webcast, Ethical Debate about Mandatory Vaccinations in ICU Personnel, will take place on Friday, December 20, 2013, at 3:00 p.m. Central Time (view additional time zones).

Register online today. The registration fee for this 60-minute webcast is $30 for SCCM members and $40 for nonmembers. Participants will receive 1 hour of continuing education credit. Please contact SCCM Customer Service at +1 847 827-6888 to inquire about the $200 group rate for institutions that will host multiple participants.

The Controversies in Critical Care webcast series is a joint project between the SCCM Research Committee and the American College of Critical Care Medicine’s Ethics Committee. The webcast series is intended to provide insight into topics in critical care medicine for which there is no clear consensus or unequivocal evidence for guiding practice decisions.

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Advance Registration for Congress Ends Soon

sq-CongressDecember 4 is the last day to take advantage of advance registration discounts for the Society of Critical Care Medicine’s (SCCM) 43rd Critical Care Congress, to be held in San Francisco, California, USA, January 9 to 13, 2014. Thereafter, registration will be accepted on site only.

Register online using your Customer ID and password, or call SCCM Customer Service at +1 847 827-6888. In addition, discounted hotel rates end December 12, so; make your hotel reservation through the SCCM Housing Bureau today!

This five-day event will offer opportunities to make valuable connections and draw diverse perspectives from all members of the multiprofessional critical care team. Learn about the latest developments in critical care by attending the always-popular abstract presentations and Poster Hall events offered at Congress:

Oral Presentations
Oral presentations will be scheduled, unopposed, on Friday, January 10, 2014, from 3:45 p.m. to 5:45 p.m. These presentations will highlight the top 62 abstracts submitted.

Poster Discussions and Awards Presentations
Interact and discuss original scientific research findings with abstract authors in the Poster Hall, which will be open Friday, January 10, through Sunday, January 12, 2014. Winners of SCCM’s abstract-based awards will be recognized during a ceremony on Sunday, January 12, 2014, from 1:30 p.m. to 2:00 p.m. in Room 270 at Moscone Center South.

ePosters
In addition to visiting the standard Poster Hall, attendees will have the opportunity to view all posters in an electronic format via computers, screens and other mobile views. These posters will be searchable and will may include enhanced information to provide the most recent critical care research available.

Professor Walk Rounds
Select poster presentations will be assigned by category to noted faculty and experts who will facilitate the exchange of ideas and commentary between younger scientists and established clinicians. Presentations will be scheduled during the lunch break each day, Friday, January 10, through Sunday, January 12, 2014.

For more information on Congress, visit www.sccm.org/Congress or view the advance program.

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Pediatric Acute Kidney Injury Survey

You are invited to participate in a national survey of clinical practice patterns and awareness of the incidence and outcomes in pediatric acute kidney injury (AKI). The study, being conducted by Amanda Hassinger, MD, at the Women and Children’s Hospital of Buffalo, New York, USA, seeks to elucidate the divide between AKI research and bedside practice.

The survey consists of 25 questions about acute kidney injury and should take no longer than 15 minutes to complete. Participation is voluntary, and you are free to withdraw from this study at any time.

The study has been approved by the Children and Youth Institutional Review Board of the State University of New York at Buffalo. Participation is not associated with any risk as the survey collects no identifying information on the respondent, and all responses will be recorded anonymously. While you will not experience any direct benefits from participation, your input could inform future research and practice guidelines for the detection and management of pediatric acute kidney injury.

If you have any questions regarding the survey or this research project in general, please contact Dr. Hassinger at ahassinger@upa.chob.edu. For questions concerning your rights as a research participant, please contact the Children and Youth Institutional Review Board of the State University of New York at Buffalo (+1 716 878-7141).

By completing and submitting this survey, you are indicating your consent to participate in the study.

Your participation is greatly appreciated. Please click on the link below and complete the survey no later than January 1, 2014.

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There’s Still Time to Join an SSC Local Collaborative

SSC LogoThe Surviving Sepsis Campaign (SSC) is launching a quality improvement initiative to increase early recognition and treatment of sepsis in patients on hospital medical, surgical and telemetry units. It is seeking hospitals to participate in collaboratives in San Francisco, Chicago and the East Coast (meeting in Providence, RI). Be part of the SSC collaboratives. The application deadline has been extended, and applications are now due by November 30, 2013.

The aim of this new initiative is to study, test and disseminate tools related to the early identification and treatment of sepsis on hospital floors. Participating hospitals will select one unit to enroll in this pilot project. During the course of the collaborative, hospitals that experience significant improvements may choose to implement changes in other units outside the collaborative. At the end of the collaborative, a consensus statement will be produced along with change/tool packages free to hospitals interested in improving their own care.

The SSC Collaborative initiative is made possible through a generous grant from the Gordon and Betty Moore Foundation to continue the work of the SSC in the United States. There is no fee to join the collaborative. The Foundation’s support covers the costs of the faculty, collaborative project management, database support and benchmarking, virtual meeting support, and other related expenses.

The SSC Data Collection Tool is now available. Hospitals worldwide are encouraged to download this tool to improve the care of sepsis patients. Collecting data helps improve outcomes and inform benchmarking data. Hospitals seeking to download the Data Collection Tool should seek the help of their Information Technology Department.

The SSC has recently released new resources, including:

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Drug Safety Alert: Acetaminophen

In August, the U.S. Food and Drug Administration (FDA) notified healthcare professionals and patients that acetaminophen has been associated with a risk of rare but serious skin reactions. Acetaminophen is commonly used to treat pain and reduce fever; it is included in many prescription and over-the-counter (OTC) products. These reactions, known as Stevens-Johnson syndrome, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis, can be fatal and can occur with first-time use or at any time it is taken. This new information resulted from a review of the FDA Adverse Event Reporting System database and the medical literature to evaluate cases of serious skin reactions associated with acetaminophen. It is difficult to determine how frequently these reactions occur, due to the widespread use of the drug, differences in usage among individuals (e.g., occasional vs. long-term use), and the length of time that the drug has been on the market; however, it is likely that these events occur rarely.

Access the complete MedWatch Safety Alert, including a link to the Consumer Update and Drug Safety Communication.

PDR Drug Alerts provides immediate, electronic delivery of safety information from the U.S. Food and Drug Administration. Society of Critical Care Medicine members can sign up to receive complimentary alerts as well as updates reflecting labeling changes.

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