Listen to the Latest iCritical Care Podcasts

If you haven’t checked out our iCritical Care Podcasts, listen to the latest releases and subscribe! Loyal listeners and newcomers, be sure to rate us on iTunes. Learn more at www.sccm.org/iCriticalCare.

The latest releases feature experts discussing: the interaction of fluids and vasoactive agents during the treatment of sepsis; early mobility implementation strategies in the pediatric intensive care unit (PICU); and implementation of an enteral nutrition algorithm that significantly improved enteral nutrition delivery and decreased reliance on parenteral nutrition in critically ill children.

SCCM Pod-248 Achieving Nutrient Delivery Goals with a Stepwise Enteral Nutrition Algorithm

SCCM Pod-247 Early Mobilization in the PICU

SCCM Pod-246 Interaction Between Fluids and Vasoactive Agents on Mortality in Septic Shock

Project Dispatch Offers Complimentary Educational Material

The Society of Critical Care Medicine’s (SCCM) Project Dispatch initiative aims to put a spotlight on efforts to improve patient- and family-centered care by disseminating the latest research in this exciting field. Complimentary educational material is consequently made available with regularity. Recently released offerings include the following webcasts:

Comprehensive Patient-Centered Care in the Pediatric ICU

Patient-Centered Approach to Community Transition after Catastrophic Injury

The “Tree of Life” Memorial Event: Meaningful for Families

Collaborating with Families to Improve Patient Care and Transitions

Project Dispatch 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.

Advance Registration for Congress Ends Soon

Wednesday, December 10, 2014, is the last day to take advantage of advance registration discounts for the Society of Critical Care Medicine’s (SCCM) 44th Critical Care Congress, to be held in Phoenix, Arizona, USA, January 17 to 21, 2015. Thereafter, registration will be accepted on site only.

Register online using your customer ID and password, or contact SCCM Customer Service at +1 847 827-6888. In addition, discounted hotel rates end December 12; make your hotel reservation online 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 Sunday, January 18, 2015, from 3:45 p.m. to 5:45 p.m. These presentations will highlight the top 64 abstracts submitted.

Poster Discussions and Awards Presentations
Discuss original scientific research findings with abstract authors in the Poster Hall, which will be open Sunday, January 18, through Tuesday, January 20, 2015. Winners of SCCM’s abstract-based awards will be recognized during a ceremony on Tuesday, January 20, 2015, from 1:30 p.m. to 2:00 p.m. in room 222 at the Phoenix Convention Center.

ePosters
In addition to 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 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 breaks on Sunday, January 18, through Tuesday, January 20, 2015.

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

Online Registration Ending Soon for Critical Care Ultrasound – Pediatric

Secure your spot with online registration for the Society of Critical Care Medicine’s (SCCM) popular Critical Care Ultrasound – Pediatric course by Wednesday, December 10, 2014. Critical Care Ultrasound has already sold out, and this course is soon expected to sell out as well.

Learn how to perform and interpret pediatric ultrasound imaging with SCCM’s comprehensive, two-day Critical Care Ultrasound – Pediatric course. Participants benefit from guided, focused skill stations and interactive presentations to reinforce key learning points. Extensive faculty coverage ensures a significant hands-on experience for each participant.

Learning Objectives

  • Demonstrate a foundation of ultrasound knowledge
  • Practice acquisition of high quality images via hands-on exercises
  • Demonstrate image interpretation and utilization of ultrasound as a diagnostic tool

Critical Care Ultrasound – Pediatric will be held January 21 and 22, 2015, at the Sheraton Phoenix Downtown Hotel in Phoenix, Arizona, USA. Register online today to reserve your seat.

Webcast: Comprehensive Patient-Centered Care in the ICU

Patient- and family-centered care considers and anticipates the needs of patients and their families, all of whom are important members of the support and care team. The multidisciplinary team in a mixed medical-surgical adult intensive care unit (ICU) at Memorial Sloan Kettering Cancer Center (MSKCC) in New York received the ICU Design Citation award in 2009 for creation of an ICU that focuses on this approach.

On Thursday, December 11, 2014, at 12:00 p.m. Central Time, the webcast Comprehensive Patient-Centered Care in the ICU will feature the MSKCC team discussing this approach during the latest offering from the Society of Critical Care Medicine’s (SCCM) Project Dispatch series. Neil A. Halpern, MD, FCCM, Chief, Critical Care Medicine Service at MSKCC, will describe how his unit developed a calming, healthy, safe, and healing ICU environment by ensuring shared decision making and frequent communications with patients and families through the ICU stay to end of life. He will discuss innovative programs and technologies linked to direct patient care, such as advanced alarm management systems, early mobility programs for ventilated patients and integrative medicine consultation for bedside massage, music therapy and meditation.

Learning Objectives

  • Describe the comprehensive program at MSKCC
  • Formulate plans to implement elements of the MSKCC program in the participants’ own organizations
  • Evaluate the impact these types of programs have on patient and family satisfaction

Register online today using your customer ID and password. Complimentary registration is made possible by a grant from the Agency for Healthcare Research and Quality (AHRQ).

This webcast was organized by SCCM’s Project Dispatch. Project Dispatch focuses on the patient and family experience. The initiative highlights a number of patient-centered care approaches to encourage awareness and adoption at the bedside among SCCM’s members. This project is supported by grant number R18HS21940 from AHRQ. The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ.

Diastolic Dysfunction in Children with Fluid Refractory Septic Shock

The presence of cardiac dysfunction in patients with septic shock has been described for decades. However, the true prevalence or ultimate effect of diastolic dysfunction has only been described in septic children in limited fashion. Sankar et al analyzed 56 children (all between three months and 17 years of age) with fluid refractory septic shock, before inotropes or mechanical ventilation were initiated. The primary objectives of this study were to determine the prevalence of diastolic dysfunction in children with fluid refractory septic shock and to determine if there was an association between diastolic dysfunction and mortality.

The authors demonstrated that diastolic dysfunction in children with fluid refractory septic shock is relatively common, similar to some adult findings. Interestingly, children with diastolic dysfunction and those with no cardiac dysfunction had higher mortality rates than those with systolic dysfunction (43%, 37% and 15%, respectively), though these differences were not statistically significant. In the wake of this study, questions still linger about the true prevalence of diastolic dysfunction in children with fluid refractory septic shock. Further studies are needed to confirm these findings.

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.

Discover Clinical Breakthroughs during Congress

Learn about clinical breakthroughs and advances in patient care during the educational symposia at the Society of Critical Care Medicine’s (SCCM) 44th Critical Care Congress. Each stimulating session is presented by leading experts in critical care and offers a thorough analysis of the developments and issues affecting most intensive care unit (ICU) environments. These sessions are complimentary for all Congress registrants, and no additional registration is needed to attend.

Diagnosis and Application of Current and Emerging Therapeutic Interventions for Hyponatremia in the Critical Care Patient
Supported by an educational grant from Otsuka America Pharmaceutical, Inc.

This session will discuss the diagnosis, presentation and impact on patient outcomes of hyponatremia and will review the safety and efficacy of current and emerging therapies for its management. It will also outline individualized treatment approaches for patients with hyponatremia based on their clinical presentation, underlying etiology and severity of symptoms.

Best Practices for the Management of Invasive Fungal Infections in the ICU
Supported by an educational grant from Astellas Scientific and Medical Affairs, Inc.

This session will help participants identify patients at risk for invasive fungal infections. In addition, it will present current and emerging treatment options for the management of these infections and review strategies for the early diagnosis and initiation of appropriate antifungal therapy in patients at risk.

These symposia will be held on Monday, January 19, 2015, at the Phoenix Convention Center. Seating is on a first-come, first-serve basis. A continental breakfast will be available prior to each symposium beginning at 6:00 a.m. The sessions will start promptly at 6:30 a.m.

Register for Congress online today using your customer ID and password. Take advantage of the advance registration rate through December 10, 2014, and save up to $80.

To secure hotel accommodations at the best rates, registrants should reserve their rooms online by Friday, December 12, 2014.

Please contact SCCM Customer Service at +1 847 827-6888 with any questions.

MCCKAP Early Registration Ends Next Week

Early registration ends November 26, 2014, for the Society of Critical Care Medicine’s (SCCM) 2015 Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP). The exam will be administered from February 26 to March 6, 2015.

The MCCKAP online exam assesses critical care fellowship programs nationally.  Held annually, 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

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.

Immediate preliminary scores and analysis are available to the examinee and the program director upon completion of the test. Final results will be available approximately five weeks following the exam.

Register online using your customer ID and password, or contact SCCM Customer Service at +1 847 827-6888. Sign-up by November 26, 2014, to take advantage of discounted registration rates.

Register for Webcast on Comprehensive Patient-Centered Care in the ICU

Registration is now open for the webcast, Comprehensive Patient-Centered Care in the ICU, the latest offering from the Society of Critical Care Medicine’s (SCCM) Project Dispatch series. This session will discuss how patient- and family-centered care considers and anticipates the needs of patients and their families, all of whom are important members of the support and care team. The multidisciplinary team in a mixed medical-surgical adult intensive care unit (ICU) at Memorial Sloan Kettering Cancer Center (MSKCC) in New York received the ICU Design Citation award in 2009 for their creation of an ICU that focuses on this approach.

In this presentation, Neil A. Halpern, MD, FCCM, Chief, Critical Care Medicine Service at MSKCC, will describe how his unit developed a calming, healthy, safe, and healing ICU environment by ensuring shared decision making and frequent communications with patients and families through the ICU stay to end of life. He will discuss innovative programs and technologies linked to direct patient care, such as advanced alarm management systems, early mobility programs for ventilated patients and integrative medicine consultation for bedside massage, music therapy and meditation.

Dr. Halpern will also review the extensive accommodations made for patients and families, as well as how the MSKCC program encompasses patients’ entire ICU experience. Some unique features include video displays to soothe patients, family members and visitors, volunteer greeters in the waiting room to help orient families and visitors to the ICU, food and coffee service, weekly multidisciplinary rounds and end-of-week conferences to discuss the full spectrum of patient and family issues, communication skills training for staff through the Department of Psychiatry and Behavioral Sciences, child visits, and the use of a survey to assess how patients, family members and visitors cope with a difficult situation.

Learning Objectives

  • Describe the comprehensive program at MSKCC
  • Formulate plans to implement elements of the MSKCC program in the participants’ own organizations
  • Evaluate the impact these types of programs have on patient and family satisfaction

This webcast will take place on Thursday, December 11, 2014, at 12:00 p.m. Central Time.

Register online today using your customer ID and password. Complimentary registration is made possible by a grant from the Agency for Healthcare Research and Quality (AHRQ).

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

This webcast was organized by SCCM’s Project Dispatch. Project Dispatch focuses on the patient and family experience. The initiative highlights a number of patient-centered care approaches to encourage awareness and adoption at the bedside among SCCM’s members. This project is supported by grant number R18HS21940 from AHRQ. The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ.

Is the Sun Setting on Goal-Directed Resuscitation for Septic Shock?

Since the landmark 2001 trial by Rivers et al, early goal-directed therapy (EGDT) for septic shock has been endorsed as the standard of care. The multicenter Australasian Resuscitation in Sepsis Evaluation (ARISE) trial was designed to test the hypothesis that EGDT, as compared with usual care, would reduce all-cause mortality at 90 days among patients presenting to the emergency department with early septic shock. The study was a prospective, randomized, parallel-group trial hosted in 51 tertiary care and nontertiary care hospitals in Australia, New Zealand, Finland, Hong Kong, and Ireland.

The authors concluded that EGDT does not offer a survival advantage in patients presenting to the emergency department with early septic shock. This work represents the second published study in a triad of trials. The Protocolised Management in Sepsis (ProMISe) trial has yet to be published; the results of the Protocolized Care for Early Septic Shock (ProCESS) trial were published earlier this year. Strengths of the ARISE trial include an appropriate sample size, the multicenter nature of the study and high compliance with the intervention. However, early resuscitation and antibiotic administration likely are now regarded as “usual care,” and this may have had a significant impact before randomization. A meta-analysis of all three trials is planned when the ProMISe trial is completed. This meta-analysis — which could have greater power than any individual study — may demonstrate benefits of EGDT in certain patient populations.

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.

The Surviving Sepsis Campaign recently released an updated statement regarding hemodynamic and oximetric monitoring. This statement is in response to the ProCESS and ARISE trials. The statement highlights recently released data from the Surviving Sepsis Campaign, which confirms that “adherence to quality improvement measures in severe sepsis and septic shock is associated with mortality decline.”

Critical Care Telemedicine: Evolution and State of the Art

An intensive care unit (ICU) telemedicine program is a practical way to increase access as well as to reduce mortality rates and length of stay, according to a review in the November issue of Critical Care Medicine.

Critical Care Telemedicine: Evolution and State of the Art” summarizes the results of numerous telemedicine studies, reviewing the growth and current penetration of ICU telemedicine programs, their associated outcomes and their impact on medical education. The review also identifies program revenue sources and costs and regulatory aspects.

Proposals for further advancing the field are provided in an editorial by Jeremy Khan, MD, MS.

Developed with input from the Society of Critical Care Medicine’s (SCCM) Tele-ICU Committee, led by Craig M. Lilly, MD, FCCM, the review calls urgently for comparative effectiveness studies. Dr. Lilly has tied telemedicine to current events, noting how such tools have been used to help manage high-risk Ebola patients by limiting room entries, by allowing for consultation without infectious exposure and by facilitating patient communication with family and friends.

SCCM resources related to telemedicine are available in the Administration Knowledge Line of LearnICU.org. In past issues, Critical Connections has featured two articles on the topic: “Should Critical Care Training Programs Start Offering Formal Training in Tele-ICU?” and “All Eyes on the ICU – Telemedicine.”

Elections: SCCM Council and ACCM Board of Regents

Society of Critical Care Medicine (SCCM) members will have the opportunity to cast their votes for SCCM Council and American College of Critical Care Medicine (ACCM) Board of Regents as elections are open November 6 through December 4. There is also a proposed amendment to the SCCM bylaws as the Neuroscience and Emergency Medicine Sections have requested designated seats on SCCM Council. Notices with voting instructions will be sent via email as well as through the U.S. Postal Service. Candidates and open seats are as follows:

SCCM Council

President Elect
Todd Dorman, MD, FCCM

Treasurer
Jerry Zimmerman, MD, FCCM

Anesthesia Designated Seat
Daniel R. Brown, MD, PhD, FCCM
Andrew J. Patterson, MD, PhD, FCCM

Collective Designated Seat
Heatherlee Bailey, MD, FCCM
Cherylee W. J. Chang, MD, FCCM

Pediatric Designated Seat
Vinay Nadkarni, MD, MS, FCCM
Ken Tegtmeyer, MD, FCCM

Surgery Designated Seat
Lewis J. Kaplan, MD, FCCM
H. Mathilda Horst, MD, MCCM

At Large Seat (2 seats)
Lauren Sorce, RN, PhD(c), CPNP-AC/PC, FCCM
Antoinette (Toni) Spevetz, MD, FCCM
Sandralee Blosser, RN, MD, FCCM
Mohan Mysore, MD, FCCM

 

ACCM Board of Regents

Secretary General
Bruce Greenwald, MD, FCCM
Abstain

Regent (3 years; choose 1)
Edward Conway Jr., MD, FCCM
Elizabeth Farrington, PharmD, BCPS, FCCM
Abstain

Regent (2 years; choose 1)
Aryeh Shander, MD, FCCP, FCCM
Julie Mayglothling, MD, FCCM

Congress Early Registration Ends Next Week

The Society of Critical Care Medicine (SCCM) is hosting its 44th Critical Care Congress January 17 to 21, 2015, in Phoenix, Arizona, USA.  Register early for this exciting event and take advantage of lower registration fees. Early registration, which lasts until Wednesday, November 12, 2014, can save participants over 15% on Congress registration. Register online using your customer ID and password, or contact SCCM Customer Service at +1 847 827-6888.

To secure hotel accommodations at the best rates, registrants should reserve their rooms online by Friday, December 12, 2014.

The 2015 Congress will provide unique opportunities to network with leadership in critical care and experience enlightened and innovative learning experiences that highlight the most up-to-date, evidence-based developments in critical care medicine.

SCCM Continues to Provide a Variety of Ebola-Related Resources

During the recent annual meeting of the American College of Chest Physicians, late-breaking sessions were held in collaboration with the Society of Critical Care Medicine (SCCM) and featured personal protective equipment (PPE) demonstrations. Content was drawn from SCCM’s Fundamental Disaster Management program. This joint effort was intended to better prepare health professionals who may soon manage the treatment of patients exposed to the Ebola virus.

SCCM continues to actively monitor the Ebola outbreak and will continue to provide pertinent information to the critical care community. A variety of resources are available at www.sccm.org/disaster, including new Ebola guidelines for emergency departments, which were recently published by the U.S. Centers for Disease Control and Prevention. The guidelines establish consistency for emergency care workers and reflect lessons learned thus far in the fight against Ebola.

SCCM also recently released an iCritical Care podcast in which Margaret Parker, MD, MCCM, speaks with SCCM President-Elect Craig M. Coopersmith, MD, FCCM, and Jay Varkey, MD, about the Ebola epidemic and how clinicians should be preparing for emerging infections. Dr. Varkey was on a team of clinicians at Emory University Hospital who successfully treated an American missionary and doctor infected with the Ebola virus.

SCCM Pod-242 Preparing for Emerging Infections

Finally, SCCM also recently made available the following Ebola protocols from Baylor Scott & White Health:

Ebola Mandatory Protocol – Screening PPE

Ebola Mandatory Protocol – Observer Role

Ebola Mandatory Protocol – Treatment PPE for Healthcare Worker and Coach

To share valuable Ebola-related resources akin to those enumerated above, visit the Society’s Disaster eCommunity. This forum is an excellent venue offering insight and any recent developments.

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