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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.


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.


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.


Concise Critical Appraisal: Epinephrine Dosing Intervals on Outcomes From Pediatric In-Hospital Card

The average annual incidence of pediatric in-hospital cardiac arrest (IHCA) has recently been estimated at more than 15,000 cases.1 Survival rates for pediatric patients who have had pulseless cardiac arrest have remained below 50% for the past decade.2,3 The American Heart Association currently recommends epinephrine, the cornerstone medication for cardiac arrest, dosed every 3 to 5 minutes in adult and pediatric cardiac arrest, although there is conflicting evidence about whether this is the best interval.4,5 Epinephrine is believed to acutely increase coronary perfusion pressure by increasing diastolic blood pressure (DBP).


Donor-Funded Training Supports Fundamentals Courses in Rwanda

Learn how Society of Critical Care Medicine (SCCM) members turned a passion for improving care into action by holding donor-funded training in resource-limited areas.


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).


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.


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.


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. 


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.


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.


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.
 


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.


The Future of Sepsis Treatment

Sepsis continues to affect Americans and hospital patients across the United States. The Centers for Disease Control and Prevention (CDC) estimates that approximately 1.7 million adult Americans develop sepsis each year1; this is more than the entire population of Phoenix, the fifth-largest city in the country.2 Approximately 270,000 of these patients die from sepsis.


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.


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.


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).


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.


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.


SARI-PREP Research Collaborative Aims To Revolutionize the Future

Groundbreaking study of hospitalized COVID-19 and influenza patients charts new path in critical care research
 
Severe Acute Respiratory Infection – Preparedness (SARI-PREP) is a groundbreaking new research platform from SCCM’s Discovery, the Critical Care Research Network, that is leading the way in revolutionizing how critical care research is conducted in the United States. It will inform clinical management of patients with severe acute respiratory infection (SARI) and help ensure that health systems are better prepared for future pandemics.