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This Concise Critical Appraisal delves into the impact of blood culture positivity on community-acquired sepsis and evaluates the epidemiology, resistance profiles, and clinical outcomes of culture-positive and culture-negative sepsis. In a recent study, 14% of patients with community-acquired sepsis had positive blood cultures, in-hospital mortality was lower in patients with culture-positive sepsis, and 55% involved gram-negative bacilli.
The Assessment of Implementation of Methods in Sepsis and Respiratory Failure (AIMS) Study seeks to determine the safest and most effective approach to sepsis intervention using the evidence-based Surviving Sepsis Campaign guidelines. Marilyn N. Bulloch, PharmD, BCPS, FCCM, was joined by Mitchell M. Levy, MD, MCCM, at the 2023 Critical Care Congress to discuss the goal of the AIMS Study and the elements of both the Hour-1 and 3-Hour bundles.
Sepsis is the leading cause of hospitalization and hospital deaths in the United States. SCCM has received a grant from the Council of Medical Specialty Societies to improve diagnostic excellence. SCCM’s Diagnostic Excellence Program focuses on providing education and technology for accurate and rapid-cycle sepsis diagnosis via webcasts, podcasts, and toolkits.
Nanchal R, et al. Crit Care Med. 2023;51657-676.
How can nurses champion change and improve outcomes by implementing the ICU Liberation Bundle (A-F)? Laura S. Maples, MSN, RN, CCRN-K, summarizes how nurses become early adopters of the bundle, focusing on advocacy for their patients’ best outcomes, and advocating for multiprofessional collaboration to successfully implement the elements of the bundle.
The new Agency for Healthcare Research and Quality (AHRQ) Toolkit for Preventing CLABSI and CAUTI in ICUs offers customizable tools and training resources to help your facility prevent dangerous infections. Its unique design gives users resources to assess current clinical and safety practices, implement a reduction plan, and overcome common cultural and technical challenges in reduction efforts.
Robert D. Truog, MD, MA, discusses new guidelines published in the March 2008 issue of Critical Care Medicine, "Recommendations for End-of-Life Care in the ICU."
Margaret Parker, MD, FCCM, associated podcast editor, speaks with Patrick M. Kochanek, MD, MCCM, about the revised guidelines for acute medical management of severe traumatic brain injury in infants, children, and adolescents, published as a supplement to the January 2012 Pediatric Critical Care Medicine.
Former SCCM president Mitchell M. Levy, MD, FCCM, discusses communications bundles with podcast editor Jeffrey Guy, MD, MSc, MMHC. Levy was a presenter for the April 26th webcast titled “Integrating the Communication Bundles into your ICU,” which outlined strategies to reduce patient and family anxiety and to create a positive environment for the critically ill patient.
Jeffrey Guy, MD, MSc, MMHC, speaks with Judith Jacobi, PharmD, FCCM, lead author on the new glycemic control guidelines from the Society of Critical Care Medicine's American College of Critical Care Medicine titled, “Guidelines for the Use of an Insulin Infusion for the Management of Hyperglycemia in Critically Ill Patients,” published in the December Critical Care Medicine.
Jeffrey Guy, MD, MSc, MMHC, speaks with Christa A. Schorr, RN, MSN, FCCM, about implementing the Surviving Sepsis Campaign (SSC) guidelines.
Jeffrey Guy, MD, MSc, MMHC, speaks with R. Phillip Dellinger, MD, MCCM, co-chair of the updated Surviving Sepsis Campaign Guidelines.
Margaret Parker, MD, MCCM, speaks with Nilesh M. Mehta, MD, about the article, “A Stepwise Enteral Nutrition Algorithm for Critically Ill Children Helps Achieve Nutrient Delivery Goals,” published in Pediatric Critical Care Medicine.
Michael Weinstein, MD, FACS, FCCP, speaks with E. Wesley Ely, MD, FCCM, at the 44th Critical Care Congress in Phoenix, Arizona. Dr. Ely discusses the "Evolution of the ABCDEF Bundle" and the Society’s ICU Liberation initiative, which aims to help practitioners become more familiar with the Pain, Agitation and Delirium guidelines and assessment tools.
Michael S. Weinstein, MD, FACS, FCCM, speaks with Gerard J. Fulda, MD, about the guideline, “Management of the Potential Organ Donor in the ICU: Society of Critical Care Medicine/American College of Chest Physicians/Association of Organ Procurement Organizations Consensus Statement,” published in Critical Care Medicine.
Ludwig Lin, MD, speaks with Michael Blaivas, MD, FACEP, FAIUM, about the article, “Guidelines for the appropriate use of bedside general and cardiac ultrasonography by the intensivist in the evaluation of critically ill patients—Part I: general ultrasonography,” published in Critical Care Medicine.
Todd Fraser, MD, speaks with Joseph L. Nates, MD, MBA, FCCM, about the article, “Intensive Care Unit Admission, Discharge, and Triage Guidelines: A Framework to Enhance Clinical Operations, Development of Institutional Policies, and Further Research,” published in Critical Care Medicine.
Ludwig Lin, MD, speaks with Mitchell M. Levy, MD, MCCM, about the release of the “Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016,” presented at the 46th Critical Care Congress in Honolulu, Hawaii.
Ranjit Deshpande, MD, speaks with Guideline co-chairs Judy E. Davidson, DNP, RN, FAAN, FCCM, and J. Randall Curtis MD, MPH, about the newly released “Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU.”
Ludwig Lin, MD, speaks with Brenda Pun, DNP, RN, ACNP, about the ICU Liberation ABCDEF Bundle Improvement Collaborative.
Margaret Parker, MD, MCCM, speaks with Shari Simone, DNP, about the article, “Implementation of an ICU Bundle: An Interprofessional Quality Improvement Project to Enhance Delirium Management and Monitor Delirium Prevalence in a Single PICU,” published in the June 2017 issue of Pediatric Critical Care Medicine.
Margaret Parker, MD, MCCM, speaks with Dana E. Niles, MS, about the article “Characterization of Pediatric In-Hospital Cardiopulmonary Resuscitation Quality Metrics Across an International Resuscitation Collaborative,” published in the May 2018 issue of Pediatric Critical Care Medicine.
Kyle B. Enfield, MD, speaks with John W. Devlin, PharmD, FCCM, about the article "Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU" (Devlin JW, et al. Crit Care Med. 2018;46:e825-e873).
Margaret M. Parker, MD, MCCM, and Lorry R. Frankel, MD, FCCM, discuss the updated pediatric critical care admission, discharge, and triage criteria and levels of care guidance published in the September issue of Pediatric Critical Care Medicine (Frankel L, et al. Pediatr Crit Care Med. 2019;20:847-887).
Margaret M. Parker, MD, MCCM, and Mitchell M. Levy, MD, MCCM discuss the Hour-1 Bundle, the controversies of the Surviving Sepsis Campaign, and the future of sepsis.
Margaret M. Parker, MD, MCCM, and Scott L. Weiss, MD, FCCM, discuss the release of "Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children," published in the February 2020 issue of Pediatric Critical Care Medicine (Weiss S, et al. Pediatr Crit Care Med. 2020;21(2);e52-e106).
Explore the Surviving Sepsis Campaign's guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19) (Alhazzani W, et al. Crit Care Med. 2020;46:854-887) with host Kyle B. Enfield, MD, and authors Mitchell M. Levy, MD, MCCM, and Waleed Alhazzani, MD, MSc, FRCPC.
Sudden cardiac arrest remains a leading cause of premature death worldwide and survival with favorable neurologic function is less than 10%. Review a practical, attainable roadmap for enhancing the likelihood of neurologically intact survival in this podcast.
The PANDEM guidelines evaluate current practices and provide recommendations for management of pain, agitation, iatrogenic withdrawal, neuromuscular blockade, delirium, ICU environment, and early mobility in critically ill infants and children. Host Margaret M. Parker, MD, MCCM, is joined by Heidi A. B. Smith, MD, MSCI, FAAP, to discuss the guidelines.
This article describes the new Leapfrog quality metrics and their methodology, focusing on postoperative sepsis identification and the potential impact of dashboard performance tracking moving forward. Critical care professionals routinely encounter patients with sepsis and play an integral role in the formulation and implementation of management plans for postoperative sepsis, making them key participants in this effort.
Emphasize importance of continual assessment, nonpharmacologic interventions, and family involvement. The PANDEM guidelines for children and infants were published in the February 2022 issue of Pediatric Critical Care Medicine.
In the preliminary analysis of the VIRUS COVID-19 Registry of Discovery, the Critical Care Research Network, investigators discovered significant variations in mortality that were not readily explained by patient comorbidities, demographics, or severity of illness. It became evident that much of the disparity in outcomes was tied to variations in processes of care from one intensive care unit (ICU) to another. This realization inspired the creation of the STOP-VIRUS Learning Collaborative, which seeks to help participants rapidly evaluate and effectively implement best practice recommendations from the ever-evolving body of knowledge related to the care of critically ill patients with COVID-19.
From Critical Care Explorations. In this Narrative Review, the authors conclude that clinicians should be prepared for the early identification of patients with suspicious symptoms and prompt treatment should be initiated to avoid catastrophic deterioration. They note that major societal guidelines provide useful recommendations for the diagnosis and management of patients with vaccine-induced immune thrombotic thrombocytopenia.
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).
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.
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.
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).
Explore the Surviving Sepsis Campaign’s Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) (Alhazzani W, et al. Crit Care Med. 2020 Mar 27; Epub ahead of print) with host Kyle B. Enfield, MD, and authors Mitchell M. Levy, MD, MCCM, and Waleed Alhazzani, MD, MSc, FRCPC.
The ICU Liberation Labs during the 49th Critical Care Congress featured information about the ICU Liberation Initiative – which aims to liberate patients from the harmful effects of pain, agitation/sedation, delirium, immobility, and sleep disruption that are common after ICU stays – and offered insights on the bundle’s implementation from ICU Liberation Collaborative members.
The Society of Critical Care Medicine (SCCM) is committed to reducing mortality and morbidity from sepsis and septic shock worldwide. The Surviving Sepsis Campaign (SSC) released its first evidence-based guidelines for the pediatric patient population. “Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children” was published in the February 2020 issue of Pediatric Critical Care Medicine (Weiss S, et al. Pediatr Crit Care Med. 2020;21(2);e52-e106).
The Joint Commission (TJC) is proposing the addition of new and revised requirements for hospital, critical access hospital, ambulatory care, home care, behavioral healthcare, and nursing care center accreditation programs.
An interview with an ICU Liberation Collaborative Leader and Participant.