Critical Connections Blog

Remembering a Founder: Ake Grenvik, MD, PhD, MCCM
Ake Grenvik, MD, PhD, MCCM, a founding member of the Society of Critical Care Medicine (SCCM) and one of the earliest pioneers of critical care, died on September 5, 2021. He was 92.
Posted: 9/9/2021 | 13 comments |

ICU Liberation: How Pharmacists Can Champion Change and Improve Outcomes
Joanna L. Stollings, PharmD, FCCP, FCCM, and Devin N. Holden, PharmD, BCPS, BCCCP, summarize how pharmacists can play an important role in the development and implementation of each element of the ICU Liberation Bundle (A-F).
Posted: 9/9/2021 | 0 comments | ICU Liberation, ICU Liberation Bundle (A-F)

Concise Critical Appraisal: Awake Prone Positioning For COVID-19 Acute Hypoxemic Respiratory Failure
This Concise Critical Appraisal explores an article in The Lancet Respiratory Medicine that evaluated the efficacy of awake prone positioning to prevent intubation or death in patients with severe COVID-19. This meta-trial used a new study design that allowed for the combination of six simultaneous national randomized, controlled, open-label trials.
Posted: 9/9/2021 | 0 comments | Concise Critical Appraisal, Coronavirus, COVID-19, Proning, respiratory

Prepare for a Surge of Pediatric Patients With COVID-19
With children going back to school, continued outbreaks of respiratory syncytial virus (RSV), and the upcoming flu season, it is important to prepare for potential surges of pediatric patients with COVID-19.
Posted: 8/26/2021 | 0 comments | Coronavirus, COVID-19, pediatrics

An Update on SCCM Relief Efforts in Haiti
SCCM President Greg S. Martin, MD, MSc, FCCM, provides an update on the SCCM relief efforts in Haiti.
Posted: 8/20/2021 | 1 comments | Disaster Response, Message from the President, Natural Disaster

Updated Guidelines on Management of Clostridioides difficile Infection in Adults
Clostrididioides difficile infection (CDI) occurs in about 4% of ICU patients, causing fulminant colitis and death in nearly 60% of symptomatic critically ill patients, so it is imperative for ICU professionals to stay abreast of the evidence-based advancements of CDI management. In June 2021, the Infectious Diseases Society of America and Society for Healthcare Epidemiology of America updated their recommendations on the management of CDI in adults. This Concise Critical Appraisal offers a review of the updated guidelines.
Posted: 8/12/2021 | 2 comments | Concise Critical Appraisal, Guidelines, infection

Concise Critical Appraisal: Improving Training for Invasive Bedside Procedures
Invasive bedside procedures (IBPs) require a high degree of familiarity and skillful expertise. Yet effective and thorough bedside training can be haphazard or unattainable. Chest published a systematic review and meta-analysis that highlights gaps in research on IBP training in critical care. The study included four focus groups of pulmonary and critical care medicine faculty and fellows from four U.S. medical centers. The focus groups identified traits, behaviors, and context as common themes of effective teachers. This Concise Critical Appraisal takes a deep dive into the study and the takeaways for experts and novices seeking to improve procedural knowledge and increase patient safety.
Posted: 7/7/2021 | 0 comments | Concise Critical Appraisal, Procedures

Ethical Considerations for a COVID-19 Vaccine Mandate

Mandate to vaccinate or nudge if there is no budge? COVID-19 vaccines remain a key weapon in the fight against the deadliest modern-day pandemic the world has seen. In this article, we summarize key facts and ethical considerations for healthcare organizations when considering a COVID-19 vaccine mandate for U.S. healthcare workers (HCW).

Posted: 6/17/2021 | 0 comments | Coronavirus, COVID-19, Ethics, Vaccines

Concise Critical Appraisal: Cardiac Ultrasound in Pediatric Septic Shock Assessment
How can clinical information gleaned from focused cardiac ultrasound (FCU) be used to augment clinical assessments in children with suspected septic shock? This month’s Concise Critical Appraisal analyzes a study published in Pediatric Critical Care Medicine that sought to show how often a clinician’s hemodynamic characterization of a child with septic shock was altered by FCU and to further validate an expert-developed algorithm for these assessments.
Posted: 6/10/2021 | 0 comments | Concise Critical Appraisal, pediatrics, Septic Shock, Ultrasound

An SCCM Member Responds to a Call for Volunteers
Before the COVID-19 pandemic, Tina R. Shah, MD, MPH, focused her work on two questions: How can technology help improve the United States health system and, more specifically, how can it be used to improve patient and practitioner well-being?
Posted: 6/4/2021 | 0 comments | COVID-19, COVID-19 Calls for Volunteers, COVID-19 Member Stories

Concise Critical Appraisal: Development of the CCEeXAM
Bedside echocardiography has become increasingly widespread among physicians caring for critically ill patients. The Examination of Special Competence in Critical Care Echocardiography (CCEeXAM) was administered for the first time in 2019 to 524 physicians from multiple specialties. The examination was designed for physicians to demonstrate an objective competence and obtain certification in advanced critical care echocardiography (CCE).
Posted: 5/13/2021 | 0 comments | Concise Critical Appraisal, Echocardiography

Johnson & Johnson’s Janssen COVID-19 Vaccine: What Clinicians Need to Know
In the past few weeks more than 7 million doses of Johnson & Johnson’s Janssen COVID-19 vaccine have been administered to people in the United States. In clinical trials of approximately 40,000 people, the J&J vaccine given as a single shot was 66% effective at preventing the illness due to the SARS-CoV-2 virus known as COVID-19. Because the J&J vaccine is a single shot, it has been preferred in some circumstances.
Posted: 4/16/2021 | 0 comments | Coronavirus, COVID-19, Vaccines

Concise Critical Appraisal: Surviving Sepsis Campaign COVID-19 Guidelines Update
The updated Surviving Sepsis Campaign (SSC) COVID-19 guidelines are now available, reflecting the learnings from the latest major studies. This month’s Concise Critical Appraisal dives into the update to outline the changes and new recommendations made by the international panel and discusses limitations of the available data.
Posted: 4/7/2021 | 0 comments | Concise Critical Appraisal, COVID-19, Surviving Sepsis Campaign

ICU Liberation: The Role of Rehabilitation Professionals
The ICU Liberation Bundle (A-F) can help rehabilitation practitioners and respiratory care practitioners (RCPs) assess the broad, long-term goals of patients while zooming in on the immediate steps needed to achieve short-term goals. Physical therapists (PTs), occupational therapists (OTs), speech language pathologists (SLPs), and RCPs all have a role in using the ICU Liberation Bundle when caring for patients in the intensive care unit (ICU).
Posted: 4/6/2021 | 0 comments | Early Mobility

Concise Critical Appraisal: Asynchronous and Distance Learning in the Age of COVID-19 and Beyond
The medical community has faced many challenges as a result of the COVID-19 pandemic, including ensuring continued medical education in the face of social distancing guidelines and the increased workloads of faculty and trainees. This Concise Critical Appraisal explores an article published in ATS Scholar that sought to outline distance learning options and develop a practical framework for transitioning content to a virtual platform.
Posted: 3/10/2021 | 0 comments | Concise Critical Appraisal, Professional Development

Achieving Buy-In for the ICU Liberation Campaign
As a bedside nurse in the intensive care unit (ICU), I did not have much understanding of the financial impact my care was having on the patients and my hospital. I have since graduated with a master’s degree in nursing as a clinical nurse specialist and achieved a doctorate of nursing practice. Since moving into an operations role nearly three years ago, I have seen the financial impacts of care to which I had been oblivious for the first part of my career. I ask myself: How do I advocate for the best patient care while balancing costs to ensure a financially healthy organization?

The answer: The ICU Liberation campaign.
 
Posted: 3/8/2021 | 0 comments | ICU Liberation

Discovery VIRUS Registry Outcomes and STOP-VIRUS ICU Learning Collaborative
The first outcomes of VIRUS were recently published in Critical Care Medicine. More than 20 manuscripts are being prepared for publication during the next several months. Additionally, sites have been invited to submit ancillary study ideas drawing on registry data. Of the 150 proposed, more than 60 have been approved.
 
Join the registry today and contribute to this important data collection.
Posted: 2/19/2021 | 0 comments | Coronavirus, COVID-19, Discovery Research Network, Statistics

Tocilizumab May Reduce Mortality in Certain COVID-19 Patients
Two recent trials suggest that immune-damping drugs such as tocilizumab may reduce mortality in patients with severe COVID-19.
Posted: 2/19/2021 | 0 comments | Coronavirus, COVID-19, Pharmacology, Therapies

Concise Critical Appraisal: Early Hemostatic Management of Disseminated Intravascular Coagulopathy
This Concise Critical Appraisal delves into a study published in Pediatric Critical Care Medicine that sought to determine whether early hemostatic intervention can prevent the development of DIC and improve outcomes.
Posted: 2/17/2021 | 0 comments | Concise Critical Appraisal, Hematology, pediatrics, Sepsis

Addressing Implicit Bias in the Critical Care Workforce
Implicit bias is an unconscious negative view of a group of people that can compromise relationships and, in the case of the medical community, stand in the way of good healthcare. Learn how to approach and mitigate implicit bias. 
Posted: 2/14/2021 | 1 comments | Congress, Diversity, Implicit Bias