Electronic Interference Can Affect Critical Care Equipment

Mobile phone use has been discouraged in hospitals, as its interference with hospital equipment has caused concerns. A new study published in the Journal of the American Medical Association raises similar questions about autoidentification technologies, such as radiofrequency identification (RFID) devices, and their effect on critical care devices specifically.

Researchers from the Netherlands tested the effect two types of RFIDs had on 41 kinds of medical equipment, including pacemakers, mechanical ventilators, defibrillators, monitors and anesthesia devices. The tests were conducted at varying distances in a one-bed, patient-free intensive care unit room. Of 123 tests for electromagnetic interference between RFIDs and medical devices, 34 instances of interference occurred. In those cases, the midpoint between reader and device was less than a foot. Among the hazardous incidents, a mechanical ventilator switched off, a syringe pump stopped, and an external pacemaker malfunctioned.

“The lack of standardization of RFID in healthcare permits RFID systems originally designed for logistics to enter the medical arena on the basis of requirements such as the range at which medical tagged items or individuals are to be detected. However, the economic benefits of optimal healthcare logistics, including a supply chain of RFID-tagged disposables or pharmaceuticals, could face barriers in the critical care environment. The intensity of electronic life-supporting medical devices in this area requires careful management of the introduction of new wireless communications such as RFID,” the authors write. Read more from USA Today.

Back to top

---

Are Restricted Resident Work Hours Affecting Critical Care?

Limits on the number of hours that medical residents are allowed to work in a day seem to have no negative effects on the outcomes of critically ill patients. Moreover, there has been a decrease in mortality among intensive care unit (ICU) patients in both teaching and non-teaching hospitals during the work-hours reform. When limits restricting the number of weekly working hours, the number of consecutive working hours and the number of working days without a break were implemented, there was concern among clinicians and educators that, despite the projected reduction in fatigue-related medical errors, critically ill patients may suffer from the decrease in continuity of care because of shorter shift times.

"This is the first study to quantifiably determine that there is no net negative outcome in critically ill patients associated with shorter work hours, and in fact, over time, there may even be a benefit to patients," said Meeta Prasad, MD, postgraduate fellow in pulmonary and critical care medicine at the University of Pennsylvania. She recently presented her study during the American Thoracic Society's annual meeting.

The researchers analyzed in-hospital mortality across 40 institutions, including more than 230,000 patients, from July 1, 2001, to June 30, 2005. They compared in-hospital mortality between patients admitted after June 1, 2003, when working hour limits began to be enforced, and those admitted before the change. They found a small but significant decrease in patient mortality after the changes in the work-hours regulations, suggesting that medical training may not require such brutal hours and sleep deprivation and that the means to compensate for fewer work hours from residents has not compromised patient care. Read more from Medpage Today.

Back to top

Earn CME with the Latest Issue of Critical Connections

The June issue of Critical Connections contains the 37th Critical Care Congress Review. With summaries of several sponsored symposia, the Congress Review offers an opportunity for attendees to continue the momentum of learning. Those who could not attend Congress also can get up to speed on the latest critical care issues discussed during these informative industry-sponsored sessions. Earn continuing education credit by reviewing the following presentations:

• Practical Considerations in Sedation Management to Improve Outcomes
• Fighting the Never-Ending Battle Against Antimicrobial Resistance
• Clinical Management Strategies for Patients with Deep Vein Thrombosis and Pulmonary Embolism
• The Impact of Enteral Nutrition on Outcomes in Critical Care

Back to top

---

Improve Patient Outcomes with Real-Time Ultrasound Examinations

Ultrasonography has become an invaluable tool in the management of critically ill and injured patients due to its portability, ease of use and accurate evaluation. Ultrasound is relatively inexpensive and drastically reduces radiation exposure to healthcare professionals and patients because it does not utilize ionizing radiation. For these reasons, demands for ultrasound examinations in the critical care setting have increased, making it imperative for critical care practitioners to become trained in this advanced modality.

At the Society of Critical Care Medicine’s innovative new course, Fundamentals of Critical Care Ultrasound, to be held August 3 and 4, 2008, in Chicago, Illinois, USA, you will learn how to recognize imaging characteristics of common critical care cases and how to guide treatment based on your findings. Topics to be covered include:

• Ultrasound artifacts and pitfalls
• Advantages and disadvantages of transthoracic and transesophageal echocardiography
• Echocardiographic evaluation of shock and assessment of volume status

This course is almost sold out – register today to guarantee your spot. Pre-registration will  be accepted only until Thursday, July 10. For fast and easy registration, click here and log in using your customer ID to register online. Or, contact SCCM Customer Service at +1 847 827-6888. Click here for more information or to download the brochure.

Back to top

---

Decrease Morbidity and Mortality Rates Using Nutrition Therapy

Malnutrition, associated with increased morbidity and mortality, is prevalent in critically ill patients. Nutrition support is an important adjunctive therapy with primary goals to prevent malnutrition. However, many clinical considerations in the intensive care unit have limited evidence regarding the therapy's safety or effectiveness for patient care. Therefore, development and use of evidence-based practice guidelines that reflect current nutrition therapy recommendations are valuable tools for practitioners.

Gain effective strategies and investigate current controversies associated with the application of nutrition therapy at the Society of Critical Care Medicine's new conference, Nutrition Therapy in the ICU – Saving Lives Safely, to be held August 3 and 4, 2008, in Chicago, Illinois, USA. Topics to be covered include:

• Current nutrient controversies
• Benefits and limitations of nutrition delivery routes
• Safety provisions of nutrition therapy
• And more!

This comprehensive program features two complimentary special events:

Breakfast with the Experts

Meet with the conference faculty in an informal setting. Bring your questions and topics of interest, and get ready to digest a buffet of invaluable information.

Sponsored Symposium Luncheon

Don’t miss this highly anticipated educational session! Expert faculty will examine current guidelines and formulas for administering enteral nutrition and explore the controversies surrounding the contribution of nutritional support to patient outcomes.

Register online using your customer ID, or contact Customer Service at +1 847 827-6888. For more information and to download the course brochure, click here.

Back to top

---

Advance Registration Ends Soon for SCCM's Board Review Courses

Register today to guarantee your spot at the Society of Critical Care Medicine’s (SCCM) board review courses, to be held August 5 to 9, 2008, in Chicago, Illinois, USA. Pre-registration will be accepted only until Thursday, July 10.

Whether you need help preparing for your boards and recertification or to fulfill CME requirements, SCCM's Critical Care Academy will provide you with comprehensive, high-quality programming. You will benefit from:

• Small group problem-based discussions
• Accurate assessments of your knowledge base
• Effective study materials
• The most extensive coverage on core concepts in cardiology, endocrinology, gastrointestinal disorders, infectious diseases, monitoring, neurology, nutrition, respiratory care, sepsis, and more!

To join hundreds of your colleagues who have already registered, act now. To register, click here and select the course for which you would like to register. Download the course brochures here.

Earn 80 of the required 100 points toward maintenance of certification
Attend the ABIM Critical Care Self-Evaluation Process (SEP) Module Review August 3 and 4, 2008. During this two-day course, you will review and complete three critical care modules: Annual Update 2007, Internal Medicine and Pulmonary Disease. In addition, you will receive guidance on how to fulfill the Performance Improvement requirement. For more information or to register, click here.

If you are unable to attend the review courses, you can still prepare with the critical care experts by using SCCM's line of board review publications and CD-ROMs.

Back to top

---

Get Your Dose of Inspiration at the 38th Critical Care Congress

Stay abreast of new developments, obtain needed tools to help advance your knowledge, and further your practice of critical care during the Society of Critical Care Medicine’s (SCCM) 38th Critical Care Congress, to be held in Nashville, Tennessee, USA, January 31 to February 4, 2009.

The five eventful days of SCCM’s Congress offer numerous cutting-edge sessions, hands-on workshops, compelling plenary sessions, and informative symposia. Enrich your experience by taking part in pre-Congress educational sessions and postgraduate review courses, to be held Friday, January 30 and/or Saturday, January 31, 2009. These sessions provide a cost-effective, convenient way to enhance your knowledge base.

In addition to providing the same level of thought-provoking sessions you have come to expect at SCCM’s annual Congress, this year will showcase SCCM members and their dedication to improving patient-centered care through the culminated efforts of the I AM SCCM campaign. Submit your inspiring patient care story at www.iamsccm.org. You could win FREE tuition to the 38th Critical Care Congress and have your story published in the December 2008 issue of Critical Connections.

Register online for Congress using your customer ID, or contact  Customer Service at +1 847 827-6888.

Back to top

Nursing Research Grant Helps Junior Investigator Break New Ground

Last year’s Norma J. Shoemaker Grant for Critical Care Nursing Research is being used to break new ground in delirium management. Sheila Alexander, BSN, PhD, RN, from the University of Pittsburgh in Pennsylvania, will use the grant to research biomarkers that may be able to predict delirium onset or duration in the intensive care unit (ICU).

The idea for her project stemmed from a January 2007 Critical Care Medicine study that examined the potential association between presence of the apolipoprotein E (APOE) 4 allele, a gene with known influence on neurologic recovery and disease, and delirium in ICU patients. Alexander’s research is exploring that relationship more deeply.

Alexander’s study involves extracting DNA blood samples from qualifying subjects, who are screened by nursing staff. The serum is extracted from each sample for apoE protein and cytokine quantification and delirium is assessed daily by the clinical nurse. Chi-square analysis and repeat measures analysis of variance are used to explore associations between APOE 4 allele presence and the development and duration of delirium.

Alexander, a junior investigator, credited the Society of Critical Care Medicine for providing resources that can stimulate and launch new ideas. “Grants like this one are extremely helpful, especially for projects related to genomics, which are really expensive,” she said. “It’s hard to find monies to do things without already having results, and this grant gives you an opportunity to launch an idea. I think this will be instrumental in helping me establish myself in this area of research.”

Alexander and her research team hope this investigation will lead to the identification of a genetic biomarker for individuals at risk for delirium, which could help focus nursing care on individuals at risk and improve outcomes.

Apply for the Norma J. Shoemaker Grant for Critical Care Nursing Research today and be the next to launch a successful research career. Applications are due September 15, 2008.

Back to top

---

Apply for SCCM's Awards

Do you know a Society of Critical Care Medicine (SCCM) member whose dedication and commitment to multiprofessional critical care deserves to be recognized? Are you seen as an example of teaching excellence at your institution? Has your intensive care unit (ICU) recently been redesigned or adopted a new family-centered policy? If so, now is the time to apply for or nominate colleagues for one of SCCM’s many awards.

Apply by August 15, 2008!
ICU Design Citation Award – Intensive care units designed with attention to functional and humanitarian issues may be eligible for this award.

Apply by September 1, 2008!
Dr. Joseph and Rae Brown Award

Dr. Joseph and Rae Brown Award – Nominate an SCCM member who has significantly advanced multiprofessional quality care at the regional or local level.

Grenvik Family Award for Ethics – Recognize an SCCM member who has made significant contributions toward addressing ethical problems in critical care.

Norma J. Shoemaker Award for Critical Care Nursing Excellence –Recognize an SCCM nurse member who demonstrates excellence in clinical practice, education and/or administration in the field of critical care.

Family-Centered Care Award – Nominate an ICU team that has made an extra effort to improve the care of patients and their families. This award recognizes efforts to move family-centered care forward and to raise standards.

Back to top  

Featured Forum: ETT Cuff Check Protocols

Your colleagues are posing questions and engaging in informative conversations in the Critical Care Forum. All SCCM members and customers have access to the Critical Care Forum through MySCCM.org.

Featured Forum: ETT Cuff Check Protocols

Where can I find information/articles on the cuff checking protocol for intubated patients? There is a lot of debate in the ICU I work in as to whether or not the cuff should be deflated or just have the pressure checked.

Join this discussion in the Protocols Forum.

Back to top