Do Older Patients Receive Adequate Trauma Care?

Older trauma patients are less likely to be transported to an official trauma center for immediate care than younger patients, according to a study published in the Archives of Surgery. A review of Maryland's statewide emergency medical services (EMS) records suggests that the difference in care first comes into play as patients reach age 50 and worsens again at age 70.

Authors focused on 26,565 level I patients who potentially could have been transported to one of Maryland's officially designated trauma centers. The researchers found that about 18% of trauma patients under the age of 65 were "under-triaged" and not taken to a trauma center. Conversely, almost 50% of patients over the age of 65 were similarly undertreated.

A follow-up survey of 127 EMS workers and 32 medical personnel (including doctors, nurses, and medical students) revealed that the top three reasons for not transporting an older patient to a trauma center were: a lack of sufficient training for handling such patients (more than 25%); not knowing trauma protocols (12%); and potential age bias (just over 13 %).

Read the full story from HealthDay.

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CMS Seeks Public Comment on Telemedicine in Critical Care

The Centers for Medicare and Medicaid Services (CMS) is considering changes to its payment policies under the physician fee schedule. Changes are being proposed to ensure payment systems are up to date and reflect changes in medical practice and the relative value of service. It is important that the healthcare community offer professional input on these proposed changes.

One of the proposed changes pertains to the use of telemedicine within critical care medicine. The University of Pittsburgh Medical Center (UPMC) submitted a request to change critical care services (codes 99291 and 99292) to “Category 1” services. UPMC has found that telecommunications systems and software give critically ill or injured patients (specifically stroke patients) timely access to highly specialized physicians. Physicians are able to give an equally effective examination, spend the same amount of time with the patient, and develop the same course of treatment just as if they were at the bedside. They cited similarities between critical care and approved telehealth services. The primary difference is that critical care is specific to patients with vital organ failure.

CMS contends that the acuity of critical care patients is significantly greater than that of patients receiving services approved for telehealth. Because of this, CMS does not think critical care services are similar to approved telehealth services and that critical care must be evaluated as a “Category 2” service. CMS says it has no evidence to prove that telehealth services can be adequately substituted for face-to-face encounters in critical care situations, and it is not proposing to add critical care services to the list of approved telehealth services.

Public commentwill be accepted on this issue until August 29, 2008.

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Submit or Review Abstracts for the Critical Care Congress

Abstracts for the Society of Critical Care Medicine’s 38th Critical Care Congress must be submitted by Wednesday, September 3, 2008. If accepted, your work will be on display from January 31 through February 4, 2009, and be published in Critical Care Medicine, the #1 critical care subspecialty journal. In addition, you will become eligible for:

• Peer evaluation from world-renown critical care experts
• Multiple awards including scientific awards, educational scholarships and research awards
• Complimentary Congress registration

Act quickly – submit your abstract today. Submission categories include administration, basic science, case reports, clinical science, education, and the new patient and family category. For details about abstract categories and guidelines, click here.

The Congress Program Planning Committee also is seeking abstract reviewers. Abstracts will be reviewed from September 8 to 22, 2008. To be considered, one must have practiced clinically or performed lab/clinical research for at least two years and have been published in at least two publications.

Complete this survey by August 28, 2008, if you are interested in reviewing abstracts. For more information, email congress@sccm.org or call +1 847 827-6869.

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Time is Running Out to Register for SCCM's VTE Conference

Don't miss 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. Register today to guarantee your seat.

The prevention of venous thromboembolism (VTE) is one of the largest patient safety initiatives in the United States. A common and potentially lethal disease in hospitalized and critically ill patients, VTE is attributed to tens of thousands of deaths each year despite therapeutic efforts.

During this conference, experts from multiple specialties will:

• Review the physiology of VTE
• Define an evidence-based approach to prophylaxis
• Examine evolving approaches to therapeutic modalities and complications

For fast and easy registration, register online today using your customer ID. Or, contact SCCM Customer Service at +1 847 827-6888. Click here for additional information or to download the brochure.

Housing for this conference is filling up quickly, so make your hotel reservations at the Seaport Hotel as soon as possible. Reservations made after Tuesday, August 26, 2008, may not receive the discounted rate. Click here for more information.

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

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Prepare Yourself for Lifelong Success: Attend SCCM's 2009 Congress

The Society of Critical Care Medicine (SCCM) is ready to provide you with the most up-to-date, comprehensive critical care training available at its 38th Critical Care Congress. Join your colleagues January 31 through February 4, 2009 in Nashville, Tennessee, USA, for a quality -- yet economical -- educational experience.

The Society’s annual Congress is the largest multiprofessional critical care event of the year, drawing nearly 6,000 nurses, pharmacists, physicians, respiratory therapists, students, veterinarians, and other providers from around the world. The diverse lineup of educational sessions presented at Congress encompasses a variety of topics and tracks that can be tailored to the specific needs of each critical care team member. You won’t want to miss the valuable educational programming at this five-day event, which will include cutting-edge educational sessions, hands-on workshops, compelling plenary sessions, and captivating sponsored symposia.

With fuel and travel costs on the rise, SCCM understands the importance of keeping the 2009 Congress convenient and economical, which is why Nashville serves as the perfect location. The Gaylord Opryland Resort and Convention Center is centrally located and close to everything. It offers luxury accommodations, fine dining and casual restaurants, unique shopping experiences, a resort spa and fitness center, and late-night entertainment all in one venue and is just a short drive from downtown Nashville.

Register for Congress today! For additional information or to download the preliminary program, click here.

Submit to I AM SCCM
Win free tuition to SCCM’s 38th Critical Care Congress by submitting your inspiring patient care story at www.iamsccm.org. All entries must be received by October 1, 2008. Submit your story today!

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Help Choose SCCM's Next International Travel Destination

The August 2008 issue of Critical Connections features the travels of the Society of Critical Care Medicine's (SCCM) delegation members who explored Russia for one week. The group toured hospitals, met with Russian colleagues and experienced the country's culture. The trip allowed medical professionals from various backgrounds to experience first hand the similarities, differences, common struggles and future goals of critical care. This multiprofessional, international group responded to a call for participants open to all Society members. Some were active members, but for many it was their first experience being closely involved with an SCCM activity.

The Society is planning similar trips to various countries and wants member input about the next delegation destination. Read more about the Russian delegation, see photos from the trip and take a survey to help determine the next location!

Read additional articles from the August 2008 issue of Critical Connections focused on therapeutic temperature management.

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Last Chance to Apply for Award Opportunities

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 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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Featured Forum: PICU 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: PICU Protocols

Does anyone have a bronchopulmonary hygiene protocol?

Join this discussion in the Pediatric Critical Care Forum.

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