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Category: Quality and Patient Safety

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SCCM Pod-446 Comparison of Bivalirudin Versus Heparin

This webcast will be a comparative analysis of conventional heparin- versus bivalirudin-based systemic anticoagulation in adult and pediatric patients supported on ECMO.

Optimizing Smart Infusion Pumps

This article was first published in the Winter 2022 issue of Critical Connections. Errors associated with administration of IV medications are a primary safety concern for hospitals. Many medication errors can be prevented via safe medication practices, including the use of smart infusion pumps.

SCCM Pod-460 CCE: Multiple PCR for Direct Detection of Bloodstream Infection After Pediatric Cardiac Surgery

Nosocomial infections are a prevalent cause of death and complications in critically ill children. Conventional cultures are able to detect only up to 25% of bacteremias. Several studies have suggested that molecular tests could be a faster and effective tool for detection of bacterial infections. Marilyn N. Bulloch, PharmD, BCPS, FCCM, is joined by Sylvia Belda Hofheinz, MD, to discuss the article, “Multiple Polymerase Chain Reaction for Direct Detection of Bloodstream Infection After Cardiac Surgery in a PICU,” published in the June 2022 issue of Critical Care Explorations (Checa RMC, et al. Crit Care Explor. 2022;4:e0707). Dr. Hofheinz is a physician in the pediatric ICU at University Hospital 12 de Octubre in Madrid, Spain.

SCCM Pod-461 PCCM: A Novel Machine Learning Model to Predict PICU Transfer

Unrecognized clinical deterioration during illness requiring hospitalization is associated with high risk of mortality and long-term morbidity among children. In this podcast hosted by Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, Anoop Mayampurath, PhD, discusses a novel machine learning model that identifies ICU transfers in hospitalized children more accurately than current tools. The discussion centers on the article “Development and External Validation of a Machine Learning Model for Prediction of Potential Transfer to the PICU,” published in the July 2022 issue of Pediatric Critical Care Medicine (Mayampurath A, et al. Pediatr Crit Care Med. 2022 23:514-523). Dr. Mayampurath is an assistant professor of biostatistics and medical informatics at the University of Wisconsin in Madison Wisconsin.

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).

SCCM Pod-415 NIH COVID-19 Treatment Guidelines

The National Institutes of Health has released Coronavirus Disease 2019 (COVID-19) Treatment Guidelines.

Strategies to Approach Drug Shortages of Analgesics and Sedatives During COVID-19

This presentation provides an overview of the types of strategies for approaching the C Element (Choice of Analgesia & Sedation) of the ICU Liberation Bundle in patients with COVID-19. This is SCCM curated COVID-19 microlearning content.

Strategies to Optimize ICU Liberation (A to F) Bundle Performance in Critically Ill Adults With Coronavirus Disease 2019

From Critical Care Explorations. The combination of a novel disease, resource limitations, and risks to medical personnel health have created new barriers to implementing the ABCDEF Bundle, a proven ICU care approach that reduces delirium, shortens mechanical ventilation duration, prevents post-ICU syndrome, and reduces healthcare costs.

Letter to the Editor: Barrier Techniques to Reduce Aerosolization During Cardiopulmonary Resuscitation

From Critical Care Explorations. The authors developed additional modifications to the suggested guidelines to further protect providers from unnecessary aerosolization; it illustrates a sample protocol for provider safety during advanced cardiovascular life support in the coronavirus pandemic.

Letter to the Editor: Barrier Techniques to Reduce Aerosolization During Extubation

From Critical Care Explorations. The authors describe a barrier technique during extubation which contained aerosolized particulates into a non-rebreather mask at time of extubation. The authors believe their protocol allows providers to perform extubations while minimizing exposure to aerosolized particles.

Evaluation of the Risk Prediction Tools for Patients With Coronavirus Disease 2019 in Wuhan, China: A Single-Centered, Retrospective, Observational Study

From Critical Care Medicine. In this study from China, the authors evaluated and compared the efficacy of National Early Warning Score, National Early Warning Score 2, Rapid Emergency Medicine Score, Confusion, Respiratory rate, Blood pressure, Age 65 score, and quick Sepsis-related Organ Failure Assessment on predicting in-hospital death in patients with coronavirus disease 2019.

Relocating IV Pumps for Critically Ill Isolated Coronavirus Disease 2019 Patients From Bedside to Outside the Patient Room

From Critical Care Explorations. The authors discuss advantages and disadvantages of relocating IV pumps for coronavirus disease 2019 patients from bedside to outside the patient room and characterize reproducible details of an external infusion pump model.

Guiding Principles for the Conduct of Observational Critical Care Research for Coronavirus Disease 2019 Pandemics and Beyond: The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study Registry

From Critical Care Medicine. In this article, the authors describe how the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study coronavirus disease 2019 registry sought to develop and implement prespecified best practices combined with grassroots efforts from clinical sites worldwide in order to develop clinically useful knowledge in response to a pandemic.

Letter to the Editor: Tracheostomy for Coronavirus Disease 2019 Patients: Maintaining the Standard of Care

From Critical Care Explorations. In this Letter to the Editor, the authors respond to the new recommendations for delaying tracheostomy for coronavirus disease 2019 patients to day 21 post-intubation to ensure viral clearance.

The POSITIONED Study: Prone Positioning in Nonventilated Coronavirus Disease 2019 Patients - A Retrospective Analysis

From Critical Care Explorations. In this study, the authors investigated explored whether awake self-proning improved outcomes in coronavirus disease 2019-infected patients treated in a rural medical center with limited resources during a significant local coronavirus disease 2019 outbreak.

Evaluation of the Efficacy and Safety of Inhaled Epoprostenol and Inhaled Nitric Oxide for Refractory Hypoxemia in Patients With Coronavirus Disease 2019

From Critical Care Explorations

In this study, the authors evaluated the efficacy and safety of inhaled epoprostenol and inhaled nitric oxide in patients with refractory hypoxemia secondary to coronavirus disease 2019.

Feasibility and Safety of Prone Position Transport for Severe Hypoxemic Respiratory Failure Due to Coronavirus Disease 2019

From Critical Care Explorations

The authors found that critical care transport of severe hypoxemic respiratory failure patients with coronavirus disease 2019 in the prone position is safe when performed by a dedicated team of critical care nurse and paramedics with an established protocol.

Brain Death Evaluation in Children With Suspected or Confirmed Coronavirus Disease 2019

From Pediatric Critical Care Medicine

The authors discuss the challenges of conducting a death by neurologic criteria or brain death evaluation in the coronavirus disease 2019 era and provide guidance to mitigate viral transmission risk and maintain patient safety during testing.

Coronavirus Disease 2019 Immediately Increases Burnout Symptoms in ICU Professionals

Fron Critical Care Medicine. This study shows that overburdening of ICU professionals during an extended period of time leads to symptoms of burnout.