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.

Dr. Shoemaker Remembered during 46th Critical Care Congress

William C. Shoemaker, MD, MCCM, one of the critical care community’s great visionaries and founders, was remembered during the Society of Critical Care Medicine’s 46th Critical Care Congress with a powerful memorial video.

Together with his wife, Norma, the Shoemakers were instrumental in founding the Society of Critical Care Medicine, helping to start the organization from the ground up.

Dr. Shoemaker was a key voice in the effort to have critical care considered a specialized area of medicine, and was a staunch believer that optimal critical care should be delivered by a multidisciplinary team. He served as the third SCCM president, from 1973 to 1974. In addition, one of his most impressive undertakings was serving as the first editor of Critical Care Medicine.

Congress Talk Centers on Science behind Liberating ICU Patients and Families

You are encouraged to check out video of an informative plenary session from the 46th Critical Care Congress entitled ABCDE and F Bundle: The Science Behind Liberating ICU Patients and Families.  It features E. Wesley Ely, MD, MPH, FCCM, describing the Society of Critical Care Medicine’s pain, agitation, and delirium (PAD) guidelines, reviewing the epidemiology and risk factors for critical illness brain injury, and introducing the evidence-based ABCDEF bundle and successful quality improvement methodology. Dr. Ely also discusses optimizing culture change to improve patient outcomes.

The plenary was accompanied by the release of Dr. Ely’s late breaking paper, The ABCDEF Bundle: Science and Philosophy of How ICU Liberation Serves Patients and Families.

In the paper, published in the February 2017 issue of Critical Care Medicine, Dr. Ely notes: “One thing most physicians detest is being told what to do or seeing some ‘recipe’ put forth for their patients’ medical care. We know what we do is a professional calling and an art; we are not merely medical providers or technicians. ICU liberation is not meant as a recipe or a ‘protocol’ to be blindly followed.

Quite the opposite. Some of you may, without reading this synthesis, practice up-to-date and seamless ICU care. If so, then the science and philosophy of ICU liberation are yours, and this article will be of help perhaps as a way of ‘packaging’ what you already do. However, having visited many hundreds of ICUs around the world, I have not seen even one (including those in which I am privileged to serve patients and their families as an attending physician) that I think practices these ICU liberation concepts well enough.”

Dr. Ely also references the connection between ICU treatment and the Society’s THRIVE initiative, noting the importance of continuing to care for patients and families after the ICU.

After watching the plenary session and reading Dr. Ely’s paper, you are further encouraged to check out various ICU Liberation resources, including:

Additional resources related to the family-centered care guidelines include:

Gap Analysis Tool – Identification of Your ICU’s Practice Differences

Family-Centered Care Guidelines – Gap Analysis Tool Instructional Video​

Visit iculiberation.org for additional resources related to the family-centered care guidelines.

After you review the above material, keep the conversation going online using #ICULiberation.

Registration Open for 2017 Study Mission to Cuba

Registration is now open for a unique opportunity to earn continuing education credits during the Society of Critical Care Medicine’s (SCCM) Study Mission to Cuba, scheduled for December 4 to 9, 2017. Limited spots are available.

The Study Mission to Cuba will offer participants the opportunity to meet and engage with fellow Cuban medical professionals while learning about the challenges and advances of medicine in Cuba. Participants will gain firsthand experience and knowledge on the inner workings of healthcare in this country, and attend meetings and meaningful site visits each day. Topics to be covered include:

  • organizational structure and healthcare delivery systems of various critical care units in Cuba
  • quality processes and how change is implemented to improve patient care
  • cultural differences for patients and families faced with end-of-life decisions
  • resource limitations in caring for critically ill patients
  • and more

Continuing medical education credits are available for physicians, pharmacists and nurses.

Following the study mission is an optional Excursion to Matanzas, from December 9 to 12, 2017.

For complete details, please visit the event webpage. The deadline to register for the Study Mission to Cuba is August 1, 2017. If you have any questions, please contact SCCM Customer Service at +1 847 827-6888.

New Fundamental Critical Care Support, Sixth Edition

The Fundamental Critical Care Support (FCCS) course has been updated and enhanced to reflect the latest research and the most effective training approaches in critical care. The sixth edition curriculum emphasizes case-based education, with scenarios that mirror clinical reality.

Start planning your course, and order your sixth edition textbook today! Visit www.sccm.org/FCCS or contact the Fundamentals team at fccs@sccm.org or +1 847 827-6869.

Sixth Edition Highlights:

New Course Textbook

  • The FCCS textbook has updated material in all chapters, following the latest literature and current guidelines including more than 30 new case studies. The textbook is available in print and electronic formats.

Enhanced Skill Stations

  • More relevant: Skill stations have been redesigned to better integrate the core principles taught in the lectures.
  • Customizable: Course directors and instructors can choose relevant content from a variety of integrated scenarios.

Updated Pre- and Posttests

  • Pre- and posttests feature questions emphasizing clinical and practical application.

46th Critical Care Congress On Demand Is Now Available

Now you can experience the stimulating educational content from the Society of Critical Care Medicine’s (SCCM) 46th Critical Care Congress as if you were there.

Congress On Demand provides access to the audio recordings and slides from hundreds of individual presentations drawn from the concurrent, joint and plenary educational sessions, as well as the afternoon symposia, from the 2017 Critical Care Congress. On Demand also includes Star Research Presentations, which highlight the top 64 abstracts submitted, and allows users to view and search all abstracts. Once you have purchased Congress On Demand, you can access the materials by logging in to MySCCM.org.

Congress On Demand is available for purchase in the SCCM store for $295 for SCCM members ($385 for nonmembers).

Additionally, many of the precourses are available for purchase. These include:

Bring the Congress experience to your home or office. If you have any questions, please contact SCCM Customer Service at +1 847 827-6888.

Save the Date for the 2018 Congress!
The 47th Critical Care Congress will be held February 24 to 28, 2018, in San Antonio, Texas, USA. The Society’s Congress is the largest multiprofessional critical care event of the year and features innovative learning experiences that encompass the full range of developments in critical care. Registration opens June 2017.

2017 Edition of Award Winning ICU Designs

The 2017 edition of Award Winning ICU Designs is now available. Functional intensive care unit (ICU) design is crucial to delivering quality critical care. To honor the best examples of such design, an annual awards program is cosponsored by the Society of Critical Care Medicine, the American Association of Critical-Care Nurses, and the American Institute of Architects Academy of Architecture for Health.

This interactive web-based program contains the top projects since 1992, with each project reviewed in short video segments. The companion PDF document contains the features and floor plan of each winning unit. Also included is the Society’s “Guidelines for Intensive Care Unit Design” and a preface from former Co-Chair Dan R. Thompson, MD, MA, FACP, FCCM. This product provides a complete, contemporary resource for creating a facility that fulfills the needs of both ICU patients and caregivers.

To purchase Award Winning ICU Designs, 2017 edition, visit the SCCM Store. Please contact SCCM Customer Service at +1 847 827-6888 with any questions.

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