Critical Connections Blog

Innovating Consistency in Care Through the STOP-VIRUS ICU Learning Collaborative
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.
Posted: 10/21/2021 | 1 comments | Coronavirus, COVID-19, STOP VIRUS

Critical Care and Pulmonary Societies Encourage Flu Shots Amid COVID-19 Spread
The members of the Critical Care Societies Collaborative, which are the American Association of Critical-Care Nurses (AACN), American College of Chest Physicians (CHEST), American Thoracic Society (ATS), and Society of Critical Care Medicine (SCCM), strongly urge people to get vaccinated against the COVID-19 virus and to receive their influenza (flu) immunizations for the upcoming flu season.
 
Posted: 10/19/2021 | 0 comments |

Concise Critical Appraisal: Epinephrine Dosing Intervals on Outcomes From Pediatric In-Hospital Cardiac Arrest
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).
Posted: 10/14/2021 | 0 comments | Cardiovascular, Concise Critical Appraisal, pediatrics

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.
Posted: 10/8/2021 | 1 comments | COVID-19, Discovery Research Network

Surviving Sepsis Campaign Releases 2021 Adult Sepsis Guidelines
Updated global adult sepsis guidelines, released by the Surviving Sepsis Campaign (SSC), place an increased emphasis on improving the care of sepsis patients after they are discharged from the intensive care unit (ICU) and represent greater geographic and gender diversity than previous versions. The updated guidelines are especially important today, as many who are seriously ill with COVID-19 are particularly vulnerable to sepsis.
 
Posted: 10/4/2021 | 0 comments |

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