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Assistant Secretary for Health Admiral Brett P. Giroir, MD, a prominent critical care physician who has a long history of membership and involvement with the Society of Critical Care Medicine (SCCM), has been tapped to lead one of the most important missions in the government's COVID-19 response.
SCCM member Gregory Margolin, DO, FCCP, FCCM, will be volunteering in New York City next week. He has been treating critically ill patients with COVID-19 at his hospital in Scottsdale, Arizona, and will continue his efforts by treating patients at the Javits Center, the convention center in Manhattan repurposed for COVID-19 overflow.
Acute inpatient care - and critical care in particular - has responded to the COVID-19 pandemic in unprecedented ways. Hospital entry screening, reduction or near-elimination of visitation, universal masks, and concerns regarding the supply of beds, medications, personal protective equipment (PPE), ventilators, and ICU team members are chief among the changes. But these are not the only changes that now characterize our daily work and workflow.
With hospitals in hardest-hit areas clamoring for clinicians, supplies, and equipment during the COVID-19 pandemic, SCCM has been working with other nonprofits and corporations to answer the hospitals' call for help. SCCM partnered with Direct Relief to send ICU kits that included more than 86,000 units of essential pharmaceuticals to hospitals in New York and South Dakota.
There is no doubt we are living in a new world. The COVID-19 pandemic is challenging organizations and individuals to react quickly and adapt overnight.
The ICU liberation Bundle (formerly known as the A-F bundle) is more important than ever in the COVID-19 era. While the pandemic has changed much inside intensive care units (ICUs), the commitment to provide multiprofessional, high-quality care is unwavering.
Clinicians responding to the COVID-19 pandemic have experienced shortages of mechanical ventilators, according to a rapid-cycle survey distributed by the Society of Critical Care Medicine (SCCM). Survey respondents reported having to secure additional ventilators from the Strategic National Stockpile or other sources, such as private suppliers. A small percentage even said they declined care because they did not have enough ventilators or placed two patients on one ventilator.
Montefiore Medical Center in the Bronx, New York, USA, quickly converted a children's hospital to an adult COVID-19 hospital. Hear Margaret M. Parker, MD, MCCM, talk with H. Michael Ushay, MD, PhD, FAAP, FCCM, about the process, challenges with staffing and personal protective equipment, and more. Dr. Ushay is professor of pediatrics, interim chief of the division of pediatric critical care medicine, and medical director of the pediatric critical care unit at the Children's Hospital at Montefiore and the Pediatric Hospital for Albert Einstein College of Medicine in the Bronx, New York, USA.
Ludwig Lin, MD, speaks with Charles Hunley, MD, about his talk presented at the 46th Critical Care Congress in Honolulu, Hawaii entitled, “Rapidly Distributing Critical Care Services in Response to a Surge Event with Multiple Casualties.” Dr. Hunley is Medical Critical Care Director at the Orlando Regional Medical Center in Orlando, Florida, and and was one of the chief triage physicians on duty the early morning of the 2016 mass shooting at Pulse nightclub in Orlando. He discusses lessons learned in preparing for a mass casualty event, such as maintaining medical storage supplies, facilitating regular tabletop and coordinated drills, and encouraging collaboration between different disciplines to facilitate coordination and flexibility during a disaster. Dr. Hunley also describes the importance of establishing a command center and systems for rapid triage, communication with family members and press, and support services to address the emotional burden on patients, families, and providers. Dr. Hunley has no relevant disclosures. Released: 8/31/17
Ludwig Lin, MD, speaks with Grete Porteous, MD, about emergency preparedness in healthcare and the role of critical care personnel in catastrophic situations. Dr. Porteous advises on how to prepare institutions for disaster including evaluation of disaster plans, development of standard work processes and cognitive aids, and staff education and training. Dr. Porteous is an anesthesiologist and Associate Program Director of the anesthesiology residency at Virginia Mason Medical Center in Seattle, Washington. She is also an instructor in emergency preparedness at Homeland Security’s Center for Domestic Preparedness in Aniston, Alabama. Dr. Porteous has no relevant disclosures. Released: 8/31/17
Margaret Parker, MD, MCCM, speaks with Chadwick P. Smith, MD, about disaster and mass casualty response strategies in the wake of the Orlando shooting. Dr. Smith is the Program Director for Surgical Critical Care, the Director of the Surgical Intensive Care Unit, and the Vice Chair of the Department of Surgery at Orlando Regional Medical Center in Orlando, Florida.
Margaret Parker, MD, MCCM, speaks with Laura Hawryluck, MD, FRCPC, about Nepal’s critical care infrastructure and how it has been affected by the April 2015 earthquake. In this interview, they discuss the post-disaster efforts in Nepal and ways the critical care community can help. Those interested in contributing to Nepal Critical Care Development Foundation can find more information at www.indiegogo.com/projects/nepal-icu-care-box. Dr. Hawryluck works as a Critical Care Physician at the University Health Network in Toronto, Canada.
Michael Weinstein, MD, FACS, FCCP, speaks with Warren C. Dorlac, MD, FACS, about his Critical Care Congress lecture titled “Joint Theater Trauma System: Impact of Standardizing Practice During Wartime.” Dr. Dorlac is an associate professor of surgery at the University of Cincinnati, Ohio, USA. Additionally, he is a Colonel in the U.S. Air Force and Director, of C-STARS (Cincinnati Center for Sustainment of Trauma and Readiness Skills). C-STARS is a joint program between University of Cincinnati Medical Center and the Air Force offering training for military medical personnel in the areas of trauma and critical care. Dr. Dorlac discusses how trauma care is delivered on the battlefield during wartime as well as the lessons learned from this war and the importance of having a standardized system in place.
Randy S. Wax, MD, and Marie Baldisseri, MD, FCCM, discuss disaster management and their relief efforts after the 2010 Haiti earthquake. Randy S. Wax, MD, is the medical director of critical care and resuscitation at Lakeridge Health Corporation in Oshawa, Ontario, Canada. He is an assistant professor in the department of medicine at the University of Toronto. He is the former chair of the H1N1 Task Force for the Society. Marie Baldisseri, MD, FCCM, is an associate professor of critical care medicine at the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania. Both guests have been leaders within SCCM's Fundamental Critical Care Support and Fundamental Disaster Management programs.
Judith Jacobi, PharmD, BCPS, FCCM, discusses drug shortages in the intensive care unit and how such shortages affect critical care patients and those requiring anesthesia. She discusses reasons for various drug shortages, the Society of Critical Care Medicine’s recent participation in an information summit on the matter, and the U.S. Food and Drug Administration’s limited ability to help resolve the situation. In a robust and insightful conversation, Jacobi addresses the potential unintended consequences of shortages and the future of drug availability. Jacobi is a clinical pharmacy specialist at Methodist Hospital/Clarian Health in Indianapolis, Indiana. She is also the immediate past president of the Society of Critical Care Medicine.
Barbara McLean, ACNP, CCNS-NP, a nurse from Piedmont Healthcare in Atlanta, Georgia, discusses her recent volunteer efforts in Haiti following the January 12, 2010, earthquake that devastated the area. McLean discusses general disaster management strategies as well as patient populations and care challenges specific to the event.
Robert Truog, MD, discusses his article in the April 2006 issue of Critical Care Medicine, "Rationing in the Intensive Care Unit." Dr. Truog is professor of medical ethics and anesthesia, pediatrics at Harvard Medical School, Children's Hospital Boston. The article focuses on how ICU caregivers distribute resources in the ICU.
Because all of us are learning as we go and hungry for insights from other healthcare professionals and facilities that have been treating patients who are critically ill with COVID-19, SCCM has created the report Configuring ICUs in the COVID-19 Era.
SCCM Member and disaster management expert Marie R. Baldisseri, MD, MPH, FCCM, is helping Italy remotely with their COVID-19 response plans. Dr. Baldisseri shares her knowledge about the situation in Italy and talks about what drives her to respond in times of crisis.
With the rise in cases among children across the country, more healthcare professionals who typically work with adult patients are being tasked with treating pediatric patients. SCCM’s latest blog post summarizes two webcasts SCCM hosted to help smooth this transition.