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Category: Quality and Patient Safety

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SCCM Pod-356 Repeated Critical Illness and Unplanned Readmissions to PICUs

Margaret Parker, MD, MCCM, speaks with Jeffrey D. Edwards, MD, MA, MAS, about the article, “Repeated Critical Illness and Unplanned Readmissions Within 1 Year to PICUs,” published in the August 2017 issue of Critical Care Medicine. Dr. Edwards discusses how critical illness impacts children with complex chronic conditions and how these medically complex children impact critical care services. Dr. Edwards is an Assistant Professor in the Division of Pediatric Critical Care in the Department of Pediatrics at Columbia University College of Physician and Surgeons in New York. Crit Care Med. 2017; 45(8):1276-1284. Released: 1/2/18


SCCM Pod-355 The Epidemiology of Hospital Death Following Pediatric Severe Sepsis

Margaret Parker, MD, MCCM, speaks with Scott L. Weiss, MD, MSCE, about the article, “The Epidemiology of Hospital Death Following Pediatric Severe Sepsis: When, Why, and How Children With Sepsis Die,” published in the September 2017 issue of Pediatric Critical Care Medicine. Dr. Weiss discusses research findings regarding when, why, and the mode in which children with sepsis die, and how understanding these factors are important in setting appropriate clinical and research priorities. Dr. Weiss is an Assistant Professor in the Division of Critical Care Medicine in the Department of Anesthesiology and Critical Care at The Children’s Hospital of Philadelphia and the University of Pennsylvania Perelman School of Medicine in Philadelphia, Pennsylvania. Pediatr Crit Care Med. 2017; 18(9):823-830. Released: 12/7/17


SCCM Pod-349 Implementation of an ICU Bundle in the PICU

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. Dr. Simone discusses results from her team's quality improvement project to improve detection, prevention, and management of delirium in the pediatric intensive care unit (PICU). Dr. Simone is Nurse Practitioner Clinical Program Manager for the Women's and Children's Services and a Nurse Practitioner in the Pediatric ICU at the University of Maryland Medical Center in Baltimore, Maryland. She is an Assistant Professor at the University of Maryland School of Nursing in the Pediatric Acute Care Nurse Practitioner program. Access ABCDEF Bundle resources and the Pain, Agitation, and Delirium guidelines at www.iculiberation.org. Pediatr Crit Care Med. 2017; 18(6):531-540. Released: 8/31/17


SCCM Pod-342 Clinician Pro/Con: Paralysis and Proning in ARDS

Margaret Parker, MD, MCCM, speaks with John J. Marini, MD, about the Congress session "Clinician Pro/Con: Paralysis and Proning in ARDS," which was presented at the 45th Critical Care Congress in Orlando, Florida. Dr. Marini served as moderator for this session and is Professor of Medicine at the University of Minnesota and Director of Research at Regions Hospital in Saint Paul, Minnesota. In this interview, Dr. Marini reflects on the use of neuromuscular blockers and prone position in ARDS. 


SCCM Pod-339 Guidelines for Family-Centered Care in the ICU

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.” Dr. Davidson is a member of the American Association of Critical-Care Nurses, National Association of Clinical Nurse Specialists, American Academy of Nursing Ethics Advisory Board, American Nurses Association, and Sigma Theta Tau International. Dr. Curtis is a member of the American Thoracic Society. Access the guidelines and related tools at www.sccm.org/guidelines. Crit Care Med. 2017; 45(1):103-128.


SCCM Pod-336 Surviving Sepsis Campaign Guidelines: 2016 Update

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. Dr. Levy is Professor of Medicine and the Division Chief of Pulmonary and Critical Care Medicine at Brown University School of Medicine in Providence, Rhode Island. He has no relevant disclosures. Download the new Surviving Sepsis Guidelines as well as User Guide and other tools for implementation at www.survivingsepsis.org. Crit Care Med. 2017; 45(3):486-552.


SCCM Pod-329 A Bedside Model for Mortality Risk in Pediatric Patients with ARDS

Margaret Parker, MD, MCCM, speaks with Aaron C. Spicer, MD, MAS, about the article, “A Simple and Robust Bedside Model for Mortality Risk in Pediatric Patients With Acute Respiratory Distress Syndrome,” published in the October 2016 issue of Pediatric Critical Care Medicine. Dr. Spicer completed a pediatric residency and critical care fellowship and now is a resident in the Department of Anesthesia, Critical Care, and Pain Medicine at the Massachusetts General Hospital in Boston, Massachusetts. In this article, Dr. Spicer and coauthors examine ways to identify patients that are at highest risk of mortality from ARDS. Pediatr Crit Care Med. 2016; 17(10):907-916.


SCCM Pod-326 Surviving Sepsis Campaign: Creating Spread for Quality Improvement

Ludwig Lin, MD, speaks with Jane Taylor, Ed.D, about quality improvement science and her contributions to the Surviving Sepsis Campaign. Dr. Taylor is Improvement Advisor to various institutions including the Institute for Healthcare Improvement and SCCM. 


SCCM Pod-300 Timing of Death in Children Referred for Intensive Care with Severe Sepsis

Margaret Parker, MD, MCCM, speaks with Mirjana Cvetkovic, FRCA, about the article, “Timing of Death in Children Referred for Intensive Care with Severe Sepsis: Implications for Interventional Studies,” published in the June 2015 issue of Pediatric Critical Care Medicine. Dr. Cvetkovic works as a Clinical Fellow at the Children’s Acute Transport Service at Great Ormond Street Hospital in London and a Consultant Intensivist in Anesthesia at Leicester Hospital. In this article, Dr. Cvetkovic and coauthors examine the estimator of pediatric septic deaths and the challenges local hospitals are presented with when treating children with sepsis. UPDATE: Cvetkovic notes that CATS has had extensive outreach education for many years. Reference - http://site.cats.nhs.uk/wp-content/uploads/2013/07/cats_annual_reportvers2.4.pdf


SCCM Pod-296 Guidelines for the Appropriate Use of Bedside General and Cardiac Ultrasonography

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. Dr. Blaivas serves as a Professor of Medicine at the University of South Carolina School of Medicine, and works clinically in the St. Francis Hospital Emergency Department in Columbus, Georgia. In this article, Dr. Blaivas and coauthors seek to establish evidence-based guidelines for the use of bedside ultrasound by intensivists and specialists in the intensive care unit (ICU) and equivalent care sites for diagnostic and therapeutic purposes for organs of the chest, abdomen, pelvis, neck and extremities.


SCCM Pod-290 Morbidity and Survival Probability in Burn Patients in Modern Burn Care

Michael S. Weinstein, MD, FACS, FCCM, speaks with Marc G. Jeschke, MD, PhD, about the article “Morbidity and Survival Probability in Burn Patients in Modern Burn Care*,” published in Critical Care Medicine. Dr. Jeschke works as a Professor in the Department of Surgery, Division of Plastic Surgery, and Department of Immunology at the University of Toronto. He is also the Director of the Ross Tilley Burn Centre at Sunnybrook Health Sciences Centre, Chair in Burn Research, and Senior Scientist at the Sunnybrook Research Institute in Toronto, Ontario, Canada. In this article, Dr. Jeschke and coauthors found that in the modern burn care setting, adults with over 40% total body surface area burned and children with over 60% total body surface area burned are at high risk for morbidity and mortality, even in highly specialized centers.


SCCM Pod-286 Clinical Practice Guideline on Management of the Critically Ill Organ Donor

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. With this article, Dr. Fulda and coauthors aim to provide critical care practitioners with essential information and practical recommendations related to management of the potential organ donor, based on the available literature and expert consensus.


SCCM Pod-248 Achieving Nutrient Delivery Goals with a Stepwise Enteral Nutrition Algorithm

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. Dr. Mehta is an Associate Professor in Anesthesia at Harvard Medical School; Associate Medical Director of Critical Care in the Department of Anesthesiology, Pain, and Perioperative Medicine at Boston Children’s Hospital; and the Director of the Pediatric Critical Care Nutrition Program at Boston Children’s Hospital. In this article, Dr. Mehta and coauthors evaluate the impact of implementing an enteral nutrition algorithm on achieving optimal enteral nutrition delivery in the PICU.


SCCM Pod-246 Interaction Between Fluids and Vasoactive Agents on Mortality in Septic Shock

Todd Fraser, MD, speaks with Allan Garland, MD, about the article, “Interaction Between Fluids and Vasoactive Agents on Mortality in Septic Shock: A Multicenter, Observational Study,” published in Critical Care Medicine. Dr. Garland is the co-head of the Section of Critical Care Medicine at the University of Manitoba in Winnipeg, Canada. In this article, Dr. Garland and coauthors examine best practices in administering fluids and vasoactive agents, both common treatments of septic shock, and how these treatments interact.


SCCM Pod-228 CCM: Screening Criteria for Palliative Care

Michael Weinstein, MD, FACS, FCCP, speaks with Judith Nelson, MD, JD, lead author on an article published in the October Critical Care Medicine, “Choosing and Using Screening Criteria for Palliative Care Consultation in the Intensive Care Unit: A Report From The IPAL-ICU (Improving Palliative Care in the ICU) Advisory Board.” The authors found that use of specific criteria to prompt proactive referral for palliative care consultation seems to help reduce utilization of ICU resources without changing mortality, while increasing involvement of palliative care specialists for critically ill patients and families in need. Dr. Nelson is professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine and the Hertzberg Palliative Care Institute at Mount Sinai School of Medicine in New York, New York. She is also the director of the IPAL-ICU (Improving Palliative Care in the ICU) Project.


SCCM Pod-227 Highlights from the Surviving Sepsis Campaign Guidelines

Jeffrey Guy, MD, MSc, MMHC, speaks with R. Phillip Dellinger, MD, MCCM, co-chair of the updated Surviving Sepsis Campaign Guidelines. In a must-listen interview for those implementing the Surviving Sepsis Campaign guidelines, Dr. Dellinger discusses guideline highlights as well as significant changes from the previous guideline and bundles. Dr. Dellinger is Chair and Chief, Department of Medicine, Cooper University Hospital, Camden, New Jersey. More information about the Surviving Sepsis Campaign is available at www.survivingsepsis.org.


SCCM Pod-220 CCM: Dysglycemia and In-Hospital Mortality in the ICU

Jeffrey Guy, MD, MSc, MMHC, speaks with Omar Badawi, PharmD, MPH, to discuss his article published in the December Critical Care Medicine, “Association Between ICU-Acquired Dysglycemia and In-Hospital Mortality.” Study results suggest severe ICU-acquired hyperglycemia, hypoglycemia and variability are associated with a higher risk of mortality. Badawi works for Phillips Healthcare in Baltimore, Maryland, USA.


SCCM Pod-219 PCCM: Readmissions to the Pediatric ICU

Margaret Parker, MD, FCCM, speaks with MD, MPH, Angela S. Czaja, MD, MSc, lead author on an article published in the July Pediatric Critical Care Medicine titled, “Unscheduled Readmissions to the Pediatric Intensive Care Unit: Epidemiology, Risk Factors and Variation Among Centers.” Dr. Czaja’s study found that the rate of unscheduled PICU readmissions was low but associated with worse outcomes. Additionally, patient and admission/discharge characteristics associated with increased risk of readmissions could be used to target high-risk populations or modifiable factors to improve outcome. Czaja is an Assistant Professor of Pediatrics at Children’s Hospital Colorado, in Aurora, Colorado, USA.


SCCM Pod-218 PCCM: Severity of Illness Assessment in Children

Margaret Parker, MD, FCCM, speaks with Murray M. Pollack, MD, lead author on the article “The Ideal Time Interval for Critical Care Severity-of-Illness Assessment,” which was published in the June 2013 Pediatric Critical Care Medicine. Dr. Pollack is Chief Medical Officer at Phoenix Children’s Hospital in Phoenix, Arizona, USA.


SCCM Pod-214 CCM: Benchmarking Severe Sepsis

Michael Weinstein, MD, FACS, FCCP, speaks with David F. Gaieski, MD, lead author on an article published in the May Critical Care Medicine titled, “Benchmarking the Incidence and Mortality of Severe Sepsis in the United States.” The study found that there is substantial variability in incidence and mortality of severe sepsis depending on the method of database abstraction used (Angus, Martin, Dombrovskiy, Wang). Dr. Gaieski is an assistant professor in the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania, USA.