Critical Connections Blog

Concise Critical Appraisal: Dexamethasone Use in the Treatment of COVID-19
This Concise Critical Appraisal offers a look into the results of the RECOVERY trial published in the New England Journal of Medicine, which demonstrated that dexamethasone improved mortality in hospitalized patients with COVID-19.
Posted: 9/9/2020 | 0 comments | Concise Critical Appraisal, Coronavirus, COVID-19, Dexamethasone

SCCM Experts Weigh in on Latest COVID-19 Treatment Strategies
This article distills some of the challenges and lessons learned in key areas of COVID-19 management: convalescent plasma therapy and strategies for diabetes/hyperglycemia and myocarditis.
Posted: 9/4/2020 | 0 comments | Coronavirus, COVID-19, Treatments

Clinicians Report Ventilator Shortages
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.
 
Posted: 8/28/2020 | 1 comments |

Concise Critical Appraisal: Early Use of Tranexamic Acid in the Treatment of Gastrointestinal Bleeds
This Concise Critical Appraisal offers a deep dive into the HALT-IT trial, which investigated whether early use of tranexamic acid to treat acute severe gastrointestinal bleeds would reduce overall mortality while limiting the burden of thromboembolic events.
Posted: 8/12/2020 | 1 comments | Concise Critical Appraisal, Nutrition

PPE Strategies for the COVID-19 Era
The supply of personal protective equipment (PPE) has been uncertain since the start of the COVID-19 pandemic. Months into this healthcare crisis, supply chains are unpredictable as reports of shortages continue. Follow these key strategies for managing PPE.
Posted: 7/30/2020 | 0 comments | Coronavirus, COVID-19, Disaster, Disaster Response, Emergency Response, Pandemic

How to Maintain Wellness in the COVID-19 Era
Intensive care unit (ICU) clinicians tend to pride themselves on their ability to care for others, even if it is at the expense of taking care of themselves. Some think of this mantra of "others before me" as a badge of honor, according to James C. Jackson, PhD, PsyD, research professor and assistant director of the ICU Recovery Center at Vanderbilt University Medical Center. Dr. Jackson has a strong message to these clinicians: Now is not the time to dismiss your own needs.
Posted: 7/23/2020 | 0 comments | Coronavirus, COVID-19, Pandemic, Stress, Wellness

Concise Critical Appraisal: PERSEVERE Biomarkers in Predicting AKI in Pediatric Septic Shock
Can the biomarkers identified in the Pediatric Sepsis Biomarker Risk Model (PERSEVERE II) be used to predict acute kidney injury and renal recovery in pediatric septic shock? This Concise Critical Appraisal explores a study in which Stanski et al (Am J Respir Crit Care Med. 2020;201:848-855) sought to answer this question.
Posted: 7/14/2020 | 0 comments | Concise Critical Appraisal, renal, sepsis, Septic Shock

Configuring the ICU in the COVID-19 Era: Real-World Experience
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.
Posted: 7/6/2020 | 0 comments | Coronavirus, COVID-19, Disaster Response, Emergency Response, Pandemic

Countering COVID-19 Delirium with the ICU Liberation Bundle
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.
Posted: 6/17/2020 | 0 comments | Coronavirus, COVID-19, Disaster Response, Emergency Response, ICU Liberation, Pandemic

Concise Critical Appraisal: Early Self-Proning in Awake, Nonintubated Patients in the ED
This Concise Critical Appraisal explores an article by Caputo et al published in Academic Emergency Medicine describing the use of early self-proning in awake, nonintubated patients in the emergency department (ED) during the COVID-19 pandemic.
Posted: 6/10/2020 | 2 comments |

Message From the SCCM President
Currently, we face extraordinary challenges on a global scale, with multiple crises erupting one after another. Each of them compels us to thoughtfully reexamine the professional and deeply personal aspects of how we work and live within our communities.
Posted: 6/9/2020 | 0 comments |

SCCM's Decision on In-Person Meetings
SCCM is adjusting the format of its meetings and conferences to reflect these new realities. After careful consideration and feedback from many members, SCCM has come to the difficult decision to reposition its upcoming in-person meetings and educational programs.
Posted: 6/1/2020 | 0 comments |

SCCM and Its Members Rise to the COVID-19 Challenge
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.
Posted: 5/27/2020 | 0 comments | Coronavirus, COVID-19

What Critical Care Clinicians Need to Know Today About MIS-C
Clinicians are sharing early findings about an emerging critical illness predominantly affecting school-aged children and young adults. The Centers for Disease Control and Prevention (CDC) has defined criteria, calling it Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19.
Posted: 5/22/2020 | 0 comments | Coronavirus, COVID-19, Emergency Response, MIS-C, Multisytem Inflammatory Syndrome in Children, Pandemic

Sharing Data is the Key to Unlocking Remdesivir Challenges
Critical care teams should consider using remdesivir to treat patients with severe acute SARS-CoV-2 infection, but supply of the drug is limited and best practices for maximizing its effectiveness are not completely understood.
Posted: 5/15/2020 | 0 comments | Coronavirus, COVID-19, Emergency Response

Concise Critical Appraisal: Planning and Provision of ECMO for Severe ARDS From COVID-19
This Concise Critical Appraisal explores a Lancet Respiratory Medicine article by Ramanathan et al, which outlines how to plan for extracorporeal membrane oxygenation (ECMO) for patients with severe acute respiratory distress syndrome (ARDS) related to COVID-19. ECMO is a complex therapy usually restricted to specialized centers. World Health Organization guidelines suggest that carefully selected patients with ARDS may benefit. The authors explore how good planning can help during outbreaks of emerging infectious diseases.
Posted: 5/13/2020 | 0 comments | Appraisal, Coronavirus, COVID-19, ECMO, Emergency Response, Pandemic

Clinicians Report High Stress in COVID-19 Response
Critical care clinicians are feeling increased personal stress about COVID-19 and are especially worried about infecting loved ones, while also expressing continued concern about personal protective equipment (PPE) and staffing shortages, according to a rapid-cycle survey from SCCM.
Posted: 5/5/2020 | 0 comments | Coronavirus, COVID-19, Emergency Response, Pandemic

SCCM President-Elect to Fast-Track COVID-19 Testing
SCCM's president-elect Greg S. Martin, MD, MSc, FCCM, is among the experts tapped to lead a national effort to super-charge the innovation, development, and commercialization of a COVID-19 testing by fall 2020.
Posted: 5/1/2020 | 0 comments | Emergency Response

SCCM Deploys Supplies and Volunteers to Support ICUs in Need
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.
Posted: 4/24/2020 | 0 comments | Coronavirus, COVID-19, Emergency Response, Pandemic

Concise Critical Appraisal: Use of Early Versus Late Enteral Nutrition in Critically Ill Children
What is the benefit of early versus late nutrition in critically ill children? In this Concise Critical Appraisal, Daniel E. Sloniewsky, MD, FCCM, offers a deep dive on this Pediatric Critical Care Medicine article by Srinivasan et al, which sought to answer this question using data from the Heart and Lung Failure-Pediatric Insulin Titration (HALF-PINT) study.
Posted: 4/22/2020 | 0 comments | Concise Critical Appraisal, Nutrition