High Accident Rates Stir Controversy over Emergency Medical Flights

Two medical helicopters in Flagstaff, Arizona, recently collided in mid-air, killing six on board, including the patients each was carrying. National Public Radio (NPR) featured this accident as part of a larger report on the controversy surrounding the use medical helicopters. Seventeen people have died in crashes this year involving medical aircraft, putting 2008 on pace to be the deadliest year ever for emergency flights. In Flagstaff, the emergency department usually expects about three medical helicopters per day bringing patients in from outlying rural communities. Over the past two decades, the use of these helicopters has increased; emergency medical flight hours nationwide have doubled. The increase also has led to more accidents. Critics contend there are too many aircraft and too many unnecessary flights. Others argue these flights are necessary as more rural hospitals limit emergency services and cut high-tech treatments. Listen to the full story from NPR.

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Neonates May Need More Pain Control in the ICU

A study published in the Journal of the American Medical Association suggests that neonates in the intensive care unit (ICU) may not receive sufficient interventions to reduce discomfort or pain. In 42,413 painful procedures analyzed by researchers, only 2% of babies received pain medications, and only 18.2% received non-pharmacological pain therapy.

Authors cited several factors for this lack of pain control. One is a concern about side effects from pharmacological interventions; another is unfamiliarity with pain relief management for newborns and a lack of standardized policies in this setting. Pharmaceutical companies also haven't developed analgesic products targeted especially for neonates.

The authors recommended that procedures be done in combination whenever possible and that minor procedures be accompanied by non-pharmacological, pain-reducing methods. Topical anesthetics can be used to reduce pain from needle punctures, though they are not sufficient for heel stick pain. For major procedures, analgesia in combination in non-pharmacological therapy is needed. Read more from HealthDay.

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Cloth Products Commonly Used in the ICU Recalled

As a precautionary measure, Illinois-base Sage Products announced a voluntary recall of a limited supply of 2% chlorhexidine gluconate (CHG) cloth products used to prepare preoperative patients' skin. Testing of the bulk 2% CHG solution by an outside company revealed that the product may be contaminated with Burkholderia cepacia (B. cepacia).

B. cepacia can pose a medical risk for people who have certain health problems, such as weakened immune systems or chronic lung diseases -- particularly cystic fibrosis (CF). B cepacia is known to cause infections in hospitalized patients. The effects of B. cepacia on people vary widely, ranging from no symptoms to serious respiratory infections. The intended application of the 2% CHG cloth product is topical and for the skin only. These products are used commonly in the intensive care unit.

More information, including a list of recalled products, is available from the U.S. Food and Drug Administration or from Sage Products. Clinicians who encounter B. cepacia infections among patients who were exposed to these wipes can contact their state or local health department or the Centers for Disease Control and Prevention at +1 800-893-0485.

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Submit Your Abstract for the 38th Critical Care Congress

Contribute to the advancement of critical care by submitting your original investigative research and case reports for presentation at the Society of Critical Care Medicine's (SCCM) 38th Critical Care Congress, to be held in Nashville, Tennessee, USA. If accepted, your work will be on display from January 31 to February 4, 2009, and will be published in Critical Care Medicine, the #1 critical care subspecialty journal. You also will benefit from:

• Peer evaluation - Select posters will be visited by critical care experts who provide indispensable feedback
• Awards - Multiple awards are offered based on accepted Congress abstracts including scientific awards, educational scholarships and research awards
• Complimentary registration to Congress - All presenting authors with SCCM member status as a non-full physician (fellow, resident, intern, nurse, pharmacist, or respiratory therapist) when the abstract was submitted for consideration are eligible.

Submit your abstract today. Acceptable categories include Administration, Basic Science, Case Reports, Clinical Science, Education and the new Patient and Family category. Learn more about abstract categories and guidelines.

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Register On Site for Board Review Courses

Prepare for your board review with the critical care experts and receive the most comprehensive review and update. The Society of Critical Care Medicine's (SCCM) Adult and Pediatric Multiprofessional Critical Care Review courses are so intense that your entire CME requirement can be fulfilled during this one-week course to be held August 5 to 9, 2008 in Chicago, Illinois, USA.

Enhance your board review by participating in the pre-course, American Board of Internal Medicine (ABIM) Critical Care Self-Evaluation Process (SEP) Module Review, to be held on August 3 and 4. This two-day program simplifies the maintenance of certification process by helping critical care practitioners complete 80 of the required 100 points of self-evaluation.

Registration will be available on site at The Fairmont Chicago. Society staff will be available to assist you with pre-course registration starting Sunday, August 3, from 6:45 a.m. to 5:30 p.m., at the SCCM registration desk, located in the International Ballroom foyer. To sign up for a review course, visit the SCCM staff starting Monday, August 4, from 4:00 p.m. to 7:00 p.m., at the SCCM registration desk, located in the Imperial Ballroom foyer.

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

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Provide Your Patients with the Maximum Benefits of Nutrition Therapy

Studies have shown that provision of adequate nutritional support in critically ill patients reduces complication rates and improves outcomes. However, many controversies exist about the appropriate assessment of nutritional status and the choice of substrate, timing and route as well as of the amount of nutritional support in this population.

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.

This comprehensive program features two complimentary special events:

Breakfast with the Experts
Discuss your questions and topics of interest with conference faculty in an informal setting.

Sponsored Symposium Luncheon
Learn about the current guidelines and formulas for administering enteral nutrition as well as the controversies surrounding the contribution of nutritional support to patient outcomes.

Registration will be available on site at The Fairmont Chicago. Society staff will be available to assist you with registration starting Sunday, August 3, from 6:45 a.m. to 5:30 p.m., at the SCCM registration desk, located in the International Ballroom foyer. For more information and to download the course brochure, click here.

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Gain Strategies for the Diagnosis, Prevention and Treatment of VTE

Venous thromboembolism (VTE) occurs frequently in critical care patients and causes significant rates of mortality and long-term disability. It is difficult for practitioners to determine the incidence of this disease: clinical signs and symptoms are nonspecific, and screening tests are not always sensitive enough to detect VTE in asymptomatic patients. At the same time, methods to prevent and diagnose VTE are highly controversial and physicians’ practices vary widely. Consensus on both VTE risk and the various prophylaxes is lacking.

During the Society of Critical Care Medicine’s latest event in the Clinical Focus series, Venous Thromboembolism in the Critically Ill and Injured, to be held September 4 and 5, 2008, in Boston, Massachusetts, USA, expert faculty will discuss risk stratification as well as explore controversies and complications associated with various recommended therapies. Other topics to be covered include:

• Epidemiology and prevention of VTE
• Regulatory requirements and guidelines
• Evidence-based approach to prophylaxis

Help prevent mortality and morbidity associated with VTE. Register online using your customer ID, or contact SCCM Customer Service at +1 847 827-6888. Click here for additional information or to download the brochure.

Additional Resources
The Society has several resources on the topic of deep vein thrombosis (DVT) available at LearnICU.org.

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Deadline for ICU Design Citation is Approaching

Applications for the ICU Design Citation are due August 15, 2008. This award, sponsored by the Society of Critical Care Medicine (SCCM), the American Association of Critical-Care Nurses and the American Institute of Architects, recognizes a critical care unit that combines functional design with the humanitarian delivery of critical care. For more information contact cprendergast@sccm.org.

Apply for additional SCCM awards by September 1, 2008:

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.

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Critical Care Medicine: Editor's Picks:

Log into MySCCM.org to access Critical Care Medicine online. Check out these choice features from journal editor, Joseph Parrillo, MD, FCCM.

July Critical Care Medicine Features:

• Risk factors for albicans and non-albicans candidemia in the intensive care unit.  Abstract
• Multicenter, randomized, placebo-controlled study of the nitric oxide scavenger pyridoxalated hemoglobin polyoxyethylene in distributive shock.  Abstract
• Aerosolized antibiotics and ventilator-associated tracheobronchitis in the intensive care unit. Abstract
• Lipopolysaccharide binding protein in a surgical intensive care unit: A marker of sepsis? Abstract

Join SCCM today to receive full access to Critical Care Medicine.

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