Healthcare initiative
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11 episodes with Surviving Sepsis Campaign
3 episodes with Surviving Sepsis Campaign
2 episodes with Surviving Sepsis Campaign
2 episodes with Surviving Sepsis Campaign
2 episodes with Surviving Sepsis Campaign
4 episodes with Surviving Sepsis Campaign
3 episodes with Surviving Sepsis Campaign
2 episodes with Surviving Sepsis Campaign
2 episodes with Surviving Sepsis Campaign
Neste episódio, conversamos sobre Sepse e a importância do antibótico. Salientamos pontos importantes, fatores de risco e dicas para escolha da terapia correta, principalmente no contexto de gram negativos MDR. Este é o terceiro episódio da nossa série especial realizada em parceria com a Pfizer, em que trazemos discussões que conectam ciência e prática clínica para enfrentar desafios no combate às infecções.
Dr. Casey Clements spent two hours breaking down the history and influences in sepsis care over the past three decades and going through the best practices in today's emergency medicine. Do you know how Sepsis is defined currently? What is the difference between SEP - 1 and surviving sepsis campaign? What is the role of steroids or vitamin C? Can you resuscitate these patients with albumin? These and so many more questions will be answered in this two part series. So join Venk like vancomycin, and Alex (aka Zosyn) and Casey "not-cidal" Clements in these amazing episodes. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS SOFA Score: Vincent JL, MOreno R, Takala J, et al. The SOFA (Sepsis-related organ failure assessment) score to describe organ dysfunction / failure. On Behalf of the working group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996 Jul;22(7):707-10 Vincent JL, de Mendonca A, Cantraine F, et al. Use of the SOFA score to assess the incidence of organ dysfunction / failure in intensive care units: results of a multicenter, prospective study. Working group on ‘sepsis-related problems' of the European Society of Intensive Care Medicine. Crit Care Med. 1998;26(11):1793-1800 Ferreira FL, Bota DP, Bross A, Merlot C, Vincent JL. Serial evaluation of the SOFA score to predict outcomes in critically ill patients. JAMA. 2001 Oct 10;286(14):1754-8 Cardenas-Turanzas M, Ensor J, Wakefield C, Zhang K, Wallace SK, Price KJ, Nates JL. Cross-validation of a sequential organ failure assessment score-based model to predict mortality in patients with cancer admitted to the intensive care unit. J Crit Care. 2012 Dec;27(6):673-80 qSOFA score Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):762-774 Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a new definition and assessing new clinical criteria for septic shock: For the Third International Consensus Definitions for Sepsis and SEptic Shock (Sepsis-3). JAMA. 2016;315(8):775-787 Freund Y, Lemachatti N, Krastinova E, et al. Prognostic accuracy of Sepsis-3 Criteria for in-hospital mortality among patients with suspected infection presenting to the emergency department. JAMA. 2017;317(3):301-308 Raith EP, Udy AA, Bailey M, et al. Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. JAMA. 2017;317(3):290-300 Comparing Prognostic scores Henning DJ, Puskarich MA, Self WH, Howell MD, Donnino MW, Yealy DM, Jones AE, Shapiro NI. An Emergency Department validation of the SEP-3 Sepsis and Septic Shock definitions and comparison with 1992 consensus definitions. Ann Emerg Med. 2017 Oct;70(4):544-552 IDSA concern Rhee C, Chiotos K, Cosgrove SE, Heil EL, Kadri SS, Kalil AC, Gilbert DN, Masur H, Septimus EJ, Sweeney DA, Strich JR, Winslow DL, Klompas M. Infectious diseases society of america position paper: Recommended revisions to the National Severe Sepsis and Septic Shock early management bundle (SEP-1) Sepsis Quality Measure. Clin Infect Dis. 2021 Feb 16;72(4):541-552 About Barcelona Declaration Slade E, Tamber PS, Vincent JL. The Surviving Sepsis Campaign: raising awareness to reduce mortality. Crit Care. 2003;7:1-2 1- hour surviving sepsis bundle guidance Freund Y, Khoury A, Mockel M, et al. European Society of Emergency Medicine position paper on the 1-hour sepsis bundle of the Surviving Sepsis Campaign: expression of concern. Eur J Emerg Med. 2019 Aug;26(4):232-233 Early Goal Directed Therapy Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. NEJM. 2001 Nov 8;345(19):1368-77 SEP - 1 Quality Measure National Quality Forum Measure submission and evaluation worksheet 5.0 for NQF #0500 Severe Sepsis and Septic Shock: Management Bundle, last updated Date: Oct 05, 2012. Website link Accessed 01-31-2024: https://www.qualityforum.org/Projects/i-m/Infectious_Disease_Endorsement_Maintenance_2012/0500.aspx National Quality Forum: NQF Revises Sepsis Measure. Website link accessed 01-31-2024: https://www.qualityforum.org/NQF_Revises_Sepsis_Measure.aspx Faust JS, Weingart SD. The Past, Present, and Future of the Centers for Medicare and Medicaid Services Quality Measure SEP-1 - the early management bundle for severe sepsis / septic shock. Emerg Med Clin N Am. 2017; 35:219-231 Affordable care act Patient Protection and Affordable Care Act, Public Law 148, U.S. Statutes at Large 124 (2010):119-1024. Website link accessed 01-31-2024: https://www.govinfo.gov/app/details/STATUTE-124/STATUTE-124-Pg119/summary. Fluids for sepsis in concerning populations Pence M, Tran QK, Shesser R, Payette C, Pourmand A. Outcomes of CMS-mandated fluid administration among fluid-overloaded patients with sepsis: A systematic review and meta-analysis. Am J Emerg Med. 2022 May:55:157-166 Zadeh AV, Wong A, Crawford AC, Collado E, Larned JM. Guideline-based and restricted fluid resuscitation strategy in sepsis patients with heart failure: A systematic review and meta-analysis. Am J Emerg Med. 2023 Nov:73:34-39 WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs
The Assessment of Implementation of Methods in Sepsis and Respiratory Failure (AIMS) Study seeks to determine the safest and most effective approach to sepsis intervention using the evidence-based Surviving Sepsis Campaign guidelines. Marylin N. Bulloch, PharmD, BCPS, FCCM, was joined by Mitchell M. Levy, MD, MCCM, at the 2023 Critical Care Congress to discuss the goal of the AIMS Study and the elements of both the Hour-1 and 3-Hour bundles. Dr. Levy is chief of the Division of Critical Care, Pulmonary, and Sleep Medicine and professor of medicine at the Warren Alpert Medical School of Brown University. He is also the medical director of the medical ICU at Rhode Island Hospital in Providence, Rhode Island, USA.
Die Anzahl effektiver, gezielter Pharmakotherapien im septischen Schock, einem Krankheitsbild mit einer Mortalität über 30%, ist immer noch limitiert. Die aktuellen Leitlinien der Surviving Sepsis Campaign geben eine schwache Empfehlung mit i.v.-Hydrocortison 200mg/d, basierend auf Evidenz von moderater Qualität. Die sogenannte HPA-Achse, also das System zur Regulation der Stresshormone, scheint aber bei differenzierter Betrachtung von größerer Bedeutung für die Immunmodulation in der Sepsis zu sein als bisher angenommen. Über neueste Studien sprechen wir mit Prof. Briegel von der LMU München. Diskutierte Studien zum Nachlesen:Bosch NA, Teja B, Law AC, Pang B, Jafarzadeh SR, Walkey AJ. Comparative Effectiveness of Fludrocortisone and Hydrocortisone vs Hydrocortisone Alone Among Patients With Septic Shock. JAMA Intern Med. 2023;183(5):451-459. doi:10.1001/jamainternmed.2023.0258Annane D, Renault A, Brun-Buisson C, et al. Hydrocortisone plus Fludrocortisone for Adults with Septic Shock. N Engl J Med. 2018;378(9):809-818. doi:10.1056/NEJMoa1705716Venkatesh B, Finfer S, Cohen J, et al. Adjunctive Glucocorticoid Therapy in Patients with Septic Shock (ADRENAL). N Engl J Med. 2018;378(9):797-808. doi:10.1056/NEJMoa1705835Sprung CL, Annane D, Keh D, et al. Hydrocortisone therapy for patients with septic shock (CORTICUS). N Engl J Med. 2008;358(2):111-124. doi:10.1056/NEJMoa071366Briegel J, Möhnle P, Keh D, et al. Corticotropin-stimulated steroid profiles to predict shock development and mortality in sepsis: From the HYPRESS study. Crit Care. 2022;26(1):343. Published 2022 Nov 7. doi:10.1186/s13054-022-04224-5Dequin PF, Meziani F, Quenot JP, et al. Hydrocortisone in Severe Community-Acquired Pneumonia. N Engl J Med. 2023;388(21):1931-1941. doi:10.1056/NEJMoa2215145
Marilyn N. Bulloch, PharmD, BCPS, FCCM, and Daleen Penoyer, PhD, RN, CCRP, FCNS, FAAN, FCCM, discuss how to develop and operationalize performance improvement teams to implement the Surviving Sepsis Campaign's (SSC) Hour-1 Bundle, which was developed in 2021 to minimize time to treatment for patients with sepsis and septic shock. Explore how to overcome barriers teams encounter in implementing the bundle, including inflexibility, lack of awareness about the bundle, competing priorities, and insufficient staffing. This podcast is funded by the Gordon and Betty Moore Foundation through a grant program administered by the Council of Medical Specialty Societies.
Sepsis affects over 30 million people worldwide every year with high morbidity and mortality. Knowledge of the best evidence-based practice for sepsis care is crucial for all healthcare professionals. The Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock were recently updated in 2021 with 93 recommendations for practice in 6 categories. This talk will review the background of the Surviving Sepsis Campaign and their goal in decreasing sepsis mortality. Along with a brief discussion of the recent 2021 guideline methodology, the recommendations most directly relevant to nursing practice will be outlined. Additional resources to sepsis care will also be provided. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Septik şok hepimizin günlük pratikte sık karşılaştığımız durumlardan biridir. Surviving Sepsis Campaign 2021 önerilerine baktığımızda resüsitasyonun ilk 3 saati içinde en az 30 mL/kg intravenöz (IV) kristaloid sıvı verilmesi önerilmiştir (zayıf öneri, düşük kaliteli kanıt). Yine bu kılavuzda resüsitasyonun ilk 24 saatinde kısıtlayıcı veya liberal sıvı stratejilerinin kullanımına ilişkin öneride bulunmak için yeterli kanıt olmadığı bilgisi verilmiştir. Kılavuzda, sepsis veya septik şoklu yetişkinler için IV C vitamini kullanımı uygun değildir olarak vurgulanmıştır (zayıf öneri, düşük kanıt kalitesi). Geçtiğimiz aylarda bu iki öneriyle ilgili iki büyük makale The New England Journal of Medicine'da (NEJM) yayınlandı. Yazımızda bu makalelere yer vereceğim.
In today's episode, we discuss the latest updates on sepsis, courtesy of the recently released International Guidelines for the Management of Sepsis and Septic Shock 2021. This is a long guideline, but we pick out the most relevant pieces to our practise in anaesthesia. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying! Resources for today's episode: Surviving Sepsis Campaign: International Guidelines for the Management of Sepsis and Septic Shock 2021 Surviving Sepsis Campaign home page
Şok, yetersiz hücresel oksijen kullanımı ile sonuçlanan dolaşım yetmezliğinin klinik ifadesidir ve yoğun bakım ünitesindeki hastaların yaklaşık üçte birini etkiler1 Vazodilatör şok, karşılaşılan en yaygın sirkulatuar şok tipidir . En sık nedeni sepsis olmakla birlikte postoperatif vazopleji, anafilaksi ve nörojenik şok diğer nedenleri arasındadır.2 Etyolojiden bağımsız olarak, azalmış sistemik vasküler direnç, arteriyel hipotansiyon ve (vasküler tonusu eski haline getirmek için) vazopressör ihtiyacı ile karakterizedir. Tedavi edilmediği takdirde sistemik perfüzyon basıncı düşer sonuç olarak yetersiz hücresel oksijen sunumu nedenli anaerobik metabolizmada artış, çoklu organ yetmezliği ve ölüme yol açar .3,4 Norepinefrin; vazodilatör-septik şokta on yıldan uzun süredir birinci basamak tedavidir. İkincil ajan seçimi ve zamanlaması hakkında çokça literatür olmasına rağmen kesin bir konsensus sağlanamamıştır.5,6 Sıvıya dirençli vazodilatör şok tedavisine klasik yaklaşım, vazopressörleri belirli bir ortalama arter basıncına (MAP) ulaşmak için titre ederek uygulamaktır. Surviving Sepsis Campaign'da da geçen bu aşamalı yaklaşımda geleneksel olarak tedaviye norepinefrin ile başlanır; ardından istenilen ortalama arter basıncı (MAP) düzeyine ulaşılana kadar, gerekirse toksik seviyelere kadar ilaç dozu yükseltilir. İstenilen MAP düzeyi elde edilemezse katekolamin refrakter durum olduğu düşünülür ve ek vazopressöre geçilir.7 Bu stratejinin, yeterli perfüzyon basınçlarının elde edilmesini geciktirdiğini ve sonuç olarak ilerleyici çoklu organ yetmezliğine bağlı ölüm riskini arttırdığını savunan çalışmalar mevcuttur 5. Dirençli vazodilatör şok, tedavi başarısızlığının son noktasıdır ve klinik olarak, artan dozlarda tek veya çoklu vazopressörlere rağmen sürdürülebilir MAP yetersizliği ile karakterizedir. Patofizyolojide, mikrodolaşımda bozulma, membran hiperpolarizasyonu ve vasküler reaktivite suçlanmaktadır.8 Bu KLASİK yaklaşımın kafamızda bıraktığı önemli sorular şunlardır: 1-Norepinefrin tedavisinin başarısızlığını hangi noktada düşünürsünüz? 2-Ne zaman ikincil bir vazopresör uygularsınız? 3- Hangi ikincil vazopresörü seçersiniz? Normal fizyolojik koşullar altında kan basıncı ve dolaşım; sempatik sinir sistemi, vazopressinerjik sistem ve renin-anjiyotensin sisteminin etkileşimi ile homeostaz içinde korunur. Hemostazı bozan sepsis gibi bir kaynak olduğunda önce mikrovasküler dolaşım bozulmasına rağmen en belirgin klinik bulgu, doğrudan sistemik kan basıncında düşme, yani makrodolaşım disfonksiyonudur. Strese bağlı hiperdinamik durum sıklıkla septik şoka eşlik etse de, sempatik sistemdeki bozulma taşikardi yanıtının ortaya çıkmasını engelleyebilir. Normalde hipotansiyonda arka hipofizden vazopressin salgılanması beklenir, ancak vazodilatör septik hipotansiyonda plazma vazopressin konsantrasyonlarının uygun olmayan şekilde düşük olduğu (3.1 pg/ml) gösterilmiştir .9 Son olarak, şokta renin-anjiyotensin sisteminin aktivasyonuna rağmen, çeşitli anjiyotensin reseptörleri downregüle edilir, bu durum vasküler hiporeaktiviteye katkıda bulunur ve ayrıca endojen katekolamin sekresyonunu bozar. Dolayısıyla vazodilatör-septik şokun patofizyolojisi multihormonal eksiklikler gibi çok faktörlü olmasına rağmen; klasik tedavi yaklaşımı basamak basamak ilerlemeyi önermektedir. ( katekolaminerjik vazopressorlerin tek basına başlanıp dozunun titre edilerek arttırılması ve maximum dozlarda ikinci ajanın eklenmesi gibi) Vazodilatör şokta uygun perfüzyon basıncının sağlanmasındaki gecikme; artmış ölüm oranları ile ilişkilidir10. Çok merkezli yapılan bir kohort çalışmasında 6.514 septik şok hastasının mortalite oranı %53 bulunmuştur. Mortaliteyi etkileyen faktörler incelendiğinde önceden tahmin edilebilen malignensiler, yaş, APACHE 2 skoru gibi nedenlerin yanı sıra ; vazopressör tedavinin başlangıcındaki gecikme süresinin de mortalite artışına anlamlı katkısı gösterilmiştir.5 X.
Könnte das eine Sepsis sein? Oft keimt der Verdacht zu spät auf – und so stirbt rein rechnerisch alle sieben Minuten in Deutschland ein Mensch an den Folgen einer Blutvergiftung. Auch außerhalb der Klinik sollte man die Sepsis deshalb immer auf dem Schirm haben: Prof. Dr. Michael Christ hat Empfehlungen für die Sepsis-Früherkennung und die wichtigsten präklinischen Akutmaßnahmen parat.
No segundo episódio da parceria entre o PEBMED e o ILAS (Instituto Latino-Americano de Sepse), o médico intensivista Filipe Amado aborda, junto com a médica Flávia Machado, as principais atualizações da Surviving Sepsis Campaign, publicadas em outubro de 2021. A convidada é uma das autoras das diretrizes. Aperte o play!
2021 Surviving Sepsis Campaign Guideline Updates Special Guests: Carolyn Bell PharmD, BCCCP and Brittany Bissell, PharmD, PhD, BCCCP, FCCM Reference List: https://pharmacytodose.files.wordpress.com/2022/02/2021-sepsis-guideline-updates-references.pdf 05:00 – General thoughts and historical perspective; 12:10 – qSOFA; 14:44 – Author diversity; 19:10 – IV fluids; 27:15 – Vasopressors; 33:12 – Antibiotics (and antifungals); 46:10 – Adjunctive treatments; 57:40 – Hopes for future guidelines; 61:35 – Gender inequity and sexual harassment in pharmacy PharmacyToDose.Com @PharmacyToDose on Twitter PharmacyToDose@Gmail.com
Since the publication of the Surviving Sepsis Campaign guidelines, the focus has been on sepsis management, early identification, and treatment. (Evans L, et al. Crit Care Med. 2021;49:e1063-e1143). As more patients are surviving sepsis, they may be left with short- and long-term problems that need to be addressed. Host Ludwig H. Lin, MD, is joined by Christa A. Schorr, DNP, MSN, RN, FCCM, to discuss the implementation of initiatives for preventing impairments due to sepsis. They will also discuss the challenges faced by survivors of sepsis and the difficulties of matching care to the patient's and family's goals of care.
In this episode of Critical Matters, we will discuss the Surviving Sepsis Campaign Guidelines 2021 update. Our guest is Dr. Laura Evans. Dr. Evans is the medical director for critical care and professor in the division of pulmonary, critical care and sleep medicine at the University of Washington Medical Center. She is the current Surviving Sepsis Campaign guidelines co-chair and the lead author for the 2021 Surviving Sepsis Campaign Guidelines. Additional Resources: Surviving Sepsis Campaign Guidelines 2021: https://journals.lww.com/ccmjournal/Fulltext/2021/11000/Surviving_SepExecutive Summary: Surviving Sepsis Campaign Guidelines 2021: https://journals.lww.com/ccmjournal/Fulltext/2021/11000/Executive_Summary__Surviving_Sepsis_Campaign_.14.aspx Society of Critical Care Medicine Resources for SSC: https://www.sccm.org/SurvivingSepsisCampaign/Home Hanlon's Razor: https://thedecisionlab.com/reference-guide/philosophy/hanlons-razor/ Books Mentioned in this Episode: Good Night Stories for Rebel Girls: 100 Tales of Extraordinary Women by Elena Favilli and Francesca Vallo: https://www.amazon.com/Good-Night-Stories-Rebel-Girls/dp/0997895810/ref=sr_1_1?crid=13KK590LSPF64&keywords=good+night+stories+for+rebel+girls&qid=1638473265&sprefix=good+night+%2Caps%2C182&sr=8-1
The Surviving Sepsis Campaign Guidelines have been updated! It's been over five years since the last update and many new studies have redefined the role of several therapies for sepsis. Redeem your CPE or CME credit here! Claim CPE CreditClaim CME CreditNeed a membership?Join for CPE CreditJoin for CME CreditReferences and resources: Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021, Critical Care Medicine: November 2021 - Volume 49 - Issue 11 - p e1063-e1143 doi: 10.1097/CCM.0000000000005337Continuing Education Information:Learning Objectives: 1. Discuss the role of corticosteroids in septic shock patients requiring vasopressors2. Discuss laboratory and screening tools to aid in treating septic shock patients0.05 CEU | 0.5 HrsACPE UAN: 0107-0000-21-360-H01-PInitial release date: 11/08/21Expiration date: 11/08/22Complete CPE & CME details can be found here: www.ceimpact.com
In this episode, we discuss some of the key recommendations and the rationale behind them from recently published SSCG 2021.
Sepsis is a common, life-threatening disease that requires treatment in the emergency department and inpatient settings. The Surviving Sepsis Campaign (SSC) Guidelines are generally viewed as the gold standard for how to diagnose and manage sepsis. These guidelines were recently updated and contain numerous expected and unexpected recommendations. Join us and panelists Kimberly Won, PharmD, BCCCP and Joshua Garcia, PharmD, BCPS as we discuss some of the pharmacist-relevant updates in the 2021 SSC Guidelines. Guidelines can be found here: https://www.sccm.org/SurvivingSepsisCampaign/Guidelines/Adult-Patients. Interested in joining the Orange County Society of Health-System Pharmacists? Join us at https://ocshp.com/join-us/ ! Interested in appearing on the podcast? Let us know by emailing leadership@ocshp.com.
Mathieu et Ian discutent des nouvelles lignes directrices sur le sepsis 2021 de la Surviving Sepsis Campaign ! Les notes de l'épisodes sont disponibles https://francofoam.com/balado/e72-sepsis-lignes-directrices-2021/ Poursuivez la discussion sur Twitter https://twitter.com/Francofoam1 et Facebook https://fr-fr.facebook.com/francofoam/ Écrivez-nous @ info@francofoam.com
Hoje, no Check-up Semanal, nosso programa de podcast que traz as principais atualizações da última semana, o editor-chefe médico do Portal PEBMED, Ronaldo Gismondi, comenta: os guidelines atualizados da Surviving Sepsis Campaign; recomendações da US Preventive Services Task Force para uso de aspirina para prevenir pré-eclâmpsia; e um estudo que avaliou o melhor momento de iniciar a anticoagulação pós-AVC em paciente com fibirlação atrial.
Bir çoğumuzun Sepsis Kılavuzu diye kısaltacağı "Surviving sepsis campaign: international guidelines for management of sepsis and septic shock" kılavuzunun 2021 güncellemesi BUGÜN yayınlandı.1 Önümüzdeki günlerde önceki versiyonları ile kıyaslayarak tartışacağımız bu kılavuzun öneriler bölümlerini hemen Türkçeye kazandırmak istedik. Aşağıda başlıklar halinde önerileri bulabilirsiniz. Çeviri sırasında İngilizce "Recommend" kelimesini "öneri", "suggest" kelimesini ise "uygun" gibi çevirerek farklarını belirgin hale getirmeye çalıştık. Öneri maddelerinin hemen altındaki kanıt düzeylerine bakılarak, önerinin güç düzeyini değerlendirebilirsiniz. Sepsis ve Septik Şoklu Hastalar için Tarama 1- Hastaneler ve sağlık sistemleri için, akut hastalar, yüksek riskli hastalar için sepsis taraması ve tedavi için standart uygulama prosedürleri dahil olmak üzere, sepsis için bir performans iyileştirme programı kullanılmasını öneririz.Tarama için güçlü öneri, orta kalitede kanıtStandart operasyon prosedürleri için güçlü öneri, çok düşük kalitede kanıt 2- Sepsis veya septik şok için tek bir tarama aracı olarak SIRS, NEWS veya MEWS'ye kıyasla qSOFA'nın kullanılmamasını öneririz.Güçlü öneri, orta kalitede kanıt 3- Sepsis olduğundan şüphelenilen yetişkinler için kan laktat ölçümü yapılması uygundur.Zayıf öneri, düşük kaliteli kanıt İlk Resüsitasyon 4- Sepsis ve septik şok tıbbi acil durumlardır ve tedavi ve resüsitasyonun hemen başlamasını öneririz.En İyi Uygulama Bildirimi 5- Sepsis kaynaklı hipoperfüzyon veya septik şoklu hastalar için resüsitasyonun ilk 3 saati içinde en az 30 mL/kg intravenöz (IV) kristaloid sıvı verilmesi uygundur.Zayıf öneri, düşük kaliteli kanıt 6- Sepsis veya septik şoku olan yetişkinlerde; sıvı resüsitasyonuna rehberlik etmek için, fizik muayene veya tek başına statik parametreler yerine dinamik ölçümlerin kullanılması uygundur.Zayıf öneri, çok düşük kalitede kanıtYorumDinamik parametreler, atım hacmi (SV), atım hacmi varyasyonu (SVV), nabız basıncı varyasyonu (PPV) veya varsa ekokardiyografi kullanılarak pasif bacak kaldırmaya veya sıvı bolusuna yanıtı içerir. 7- Sepsis veya septik şoku olan yetişkinler için, laktat düzeyi artmış hastalarda serum laktatını azaltacak şekilde resüsitasyonun yönlendirilmesini, serum laktatının kullanılmamasına göre uygundur.Zayıf öneri, düşük kaliteli kanıtYorumAkut resüsitasyon sırasında, serum laktat düzeyi klinik durum ve laktat yüksekliğinin diğer nedenleri göz önünde bulundurularak yorumlanmalıdır. 8- Septik şoklu yetişkinler için, diğer perfüzyon önlemlerine ek olarak resüsitasyona rehberlik etmesi için kapiller dolum süresinin kullanılması uygundur.Zayıf öneri, düşük kaliteli kanıt Ortalama Arteriyel Basınç (MAP) 9- Vazopresör ihtiyacı olan septik şoklu yetişkinler için, daha yüksek ortalama arter basıncı (MAP) hedeflerine kıyasla 65 mm Hg'lik bir başlangıç hedef MAP'ı öneriyoruz.Güçlü öneri, orta kalitede kanıt Yoğun Bakıma Yatış 10- Yoğun bakım ünitesine yatış yapılması gereken sepsis veya septik şoklu yetişkinler için, hastaların 6 saat içinde yoğun bakım ünitesine yatışı uygundur.Zayıf öneri, düşük kaliteli kanıt ENFEKSİYON Enfeksiyon Tanısı 11- Sepsis veya septik şok şüphesi olan ancak enfeksiyonu teyit edilmemiş yetişkinler için, sürekli olarak yeniden değerlendirmeyi ve alternatif tanıları araştırmayı ve alternatif bir hastalık nedeni gösterildiğinde veya bu yönde kuvvetli şüphe ortaya çıktığında ampirik antimikrobiyallerin kesilmesini öneriyoruz.En İyi Uygulama bildirimi Antibiyotik Zamanlaması 12- Olası septik şoku olan veya sepsis olasılığı yüksek olan yetişkinler için, antimikrobiyallerin hemen, ideal olarak tespitten sonraki 1 saat içinde verilmesini öneririz.Güçlü öneri, düşük kanıt kalitesi (Septik şok)Güçlü öneri, çok düşük kanıt kalitesi (şokun eşlik etmediği sepsis) 13- Şokun eşlik etmediği olası sepsisi olan yetişkinler için, akut hastalığın muhtemel bulaşıcı olan ve olmayan nedenlerine karşı hızlı bi...
Merhabalar. Sepsis bakımında yıllardır Surviving Sepsis Campaign önerileriyle gidiyoruz. Surviving Sepsis Campaign kılavuzları daha çok hastanın kritik bakım ünitesindeki bakımına odaklı, sepsis hastaları için kapsamlı kritik bakım önerileri sunuyor. Ancak acil servislerdeki durum, başvuran hastaların henüz ayırıcı tanısının yapılmamış olması. American College of Emergency Physicians (ACEP) Derneği tarafından hazırlanan ve diğer dernekler tarafından da desteklenen bu konsensus temelli çalışma grubu raporunda1 sepsisin erkenden tanınmasına ve hastane dışı şartlarda ve acil servis şartlarında yapılabileceklere odaklanılmış. İyi okumalar. Sepsisin ve Septik Şokun Hasta Bakımının İlk Dakikalarında Belirlenmesi Sepsis Tanıma Prensipleri Öncelikle, sepsisi kabaca “Yeni veya kötüleşen organ disfonksiyonu ve enfeksiyona karşı düzensiz konak yanıtı” olarak tanımlayabiliriz. Tek bir veri veya bulgu ile tanımlanamaz.Septik şok ise, sepsis hastalarında dolaşım bozukluğu varlığı. Tek başına hipotansiyondan, resüsistasyona rağmen vazopressör desteği gerektiren hipotansiyon ve laktat yüksekliğine kadar değişen bir hastalık spektrumuna sahip.Sepsis sebebiyle kardiyovasküler fonksiyonu bozulmuş hastaların, septik şokun daha ciddi bulguları olan diğer hastalarda olduğu gibi, erkenden tespit edilip bu hastalara hızlıca tedavi verilmesi gerekir.Herhangi bir kılavuz veya bakım algoritması veya paket, sepsis tespitinin zor olabileceği gerçeğini göz önünde bulundurmalı.Sepsisin klinik bulguları diğer hastalıkların bulguları ile örtüşebilir ve sıklıkla tespit edilmesi uzun süre ve çaba gerektirir.Örneğin, immunkompromize hastada, yaşlılarda veya kompensatuvar yanıtın iyi olduğu çok erken evre hastalarda sepsisi tanımak zor olabilir. Bu nedenle kılavuzlar, hastalığın olası nedenlerinden biri olarak kabul edilmek yerine, sepsis tanısı konulduğunda en iyi şekilde uygulanabilir.Hastalarda sepsisin ayırıcı tanısı genellikle geniştir ve sepsisin diğer hastalıklardan ayrılıp doğru olarak tanı alması için ileri testler, tekrarlanan testler ve gözlem gerekebilir. Hastalarda sepsisin ayırıcı tanısı genellikle geniştir ve sepsisin diğer hastalıklardan ayrılıp doğru olarak tanı alması için ileri testler, tekrarlanan testler ve gözlem gerekebilir. Sepsis ve septik şokun ayırıcı tanısında organ yetmezliklerinin diğer sebepleri de göz önünde bulundurulmalı. Diğer sebeplerin yönetimi daha farklı olacaktır ve muhtemelen bu hastalara sepsis bakımından fayda görmeyecektir. Ör. pulmoner emboli, kardiyojenik şok, ilaç doz aşımı. Erken Tarama ve Sepsis Hastalarının Tespiti Standardize edilmiş erken sepsis tarama araçları sepsis tanıma ve bakımını iyileştirebiliyor. Ancak günümüzde acil serviste veya hastane dışında bunu sağlayabilecek etkinliği kanıtlanmış bir araç veya strateji yok. Acil Serviste ve Hastane Dışı Ortamda Başlangıç Bakımı Adımları Erken Sepsis Yönetimi Prensipleri Öykü ve fizik muayene, enfeksiyon ve organ yetmezliğinin saptanmasına yardımcı olabileceği belirtilmiş.Sepsis tanındığında, enfeksiyonu tedavi etmek ve hipotansiyon ve hipoperfüzyonu geri döndürmek veya önlemek için hızlı davranmak önemli. Yine de hasta bakımı için zaman eşiklerinin, sepsisin diğer kliniklerden ayırt edildiği zamanı baz alması önerilmiş. Enfeksiyon, organ yetmezliği ve hipotansiyon/hipoperfüzyon kanıtlarının belirlenmesi ileriye dönük takip ile mümkün olabilir. Bu şu demek, sepsis bakım süreleri hedefinin hastanın kaydının açılması ile başlatılması uygun olmayabilir. Sepsis ayırıcı tanı değerlendirmesi henüz sürmekteyken, hasta bakımı için uygulanabilir erken eylem önerileri aşağıdaki tabloda (Tablo 1) verilmiştir. Tablo 1. Hastane dışı ortamlarda ve acil serviste sepsis şüphesi olan hastaların başlangıç yönetiminde temel ilkeler. KonuHastane dışıAcil servisEnfeksiyon kaynağının değerlendirilmesiHastanın ne zaman hastalandığına ve semptomların zaman seyrine dair öyküOdaklanmış fizik muayene.
Sepsis and septic shock are leading causes of death worldwide as identified by the Surviving Sepsis Campaign which initiated the implementation of the surviving sepsis campaign bundles in an effort to reduce morbidity and mortality. Intensivist Peter Velloza joins us to talk about sepsis in general and within the ICU.
Septic shock is a medical emergency that is caused by a systemic infection in the body. This infection leads to a response by the immune system of releasing cytokines which leads to a cytokine storm. Subsequently, this action causes an increase in capillary permeability which makes blood vessels leak or shift fluid from the intravascular space. This causes lower systemic vascular resistance and hypotension. It is important to recognize the symptoms of septic shock and act as fast as possible to prevent the death of the patient. The Society of Critical Care Medicine created the Surviving Sepsis Campaign which has resources on sepsis and septic shock. One of these resources is the 1--Hr bundle which indicates the following: Measure the lactate levels of patients going through septic shock, obtain blood cultures BEFORE administering IV antibiotics, administer broad-spectrum IV antibiotics, initiate rapid IVF resuscitation by administering 30 mL/kg crystalloid for hypotension or lactate ≥ 4 mmol/L, start vasopressors if hypotension persists during or after fluid resuscitation and maintain a MAP >65 ( Levophed is 1st line of choice). You can learn about septic shock, sepsis, and the 1-hr bundle on the Society of Critical Care Medicine website at https://www.sccm.org/SurvivingSepsisCampaign/Home --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/itsjdramos/support
In this programme, recent improvements in the understanding and treatment of sepsis will be presented, including how SARS-COV2 induces sepsis. A review of past therapies and the recent introduction of newer treatments for sepsis will be discussed. Updates from the Surviving Sepsis Campaign will be presented, as will recent studies that address the management of sepsis. Controversies in the treatment and identification of sepsis will be reviewed, as well as case studies using novel treatments in the care of the patient with sepsis. The emphasis on early identification and how to implement protocols in hospitals, from the ED and floor to the ICU will be highlighted. The program emphasises innovative learning strategies in an attempt to help the learner retain more information as well as make the program a more enjoyable event.
Pediatric intensivist Smitha Mathew, PICU fellow Katie Verdone and emergency physician Dan McCollum join Zac Hodges on this episode to discuss pediatric sepsis. How do you effectively screen for sepsis and systematically evaluate septic children? What are the initial steps to treat children diagnosed with sepsis and septic shock? What do we we need to know from the Surviving Sepsis Campaign 2019 Pediatric Guidelines? All this and more on this episode from the Department of Pediatrics at Augusta University https://www.augusta.edu/mcg/pediatrics/residency/podcast.php Special thanks to Dr. Mary Lynn Sheram and Dr. Eric Ring for providing peer review for this episode. References: See the SCCM 2019 sepsis guidelines for more information: https://journals.lww.com/pccmjournal/Fulltext/2020/02000/Surviving_Sepsis_Campaign_International_Guidelines.20.aspx SCCM simplified sepsis algorithm https://www.sccm.org/getattachment/SurvivingSepsisCampaign/Guidelines/Pediatric-Patients/Initial-Resuscitation-Algorithm-for-Children.pdf?lang=en-US
Joe Alcock talks about the Surviving Sepsis Campaign's recent recommendation to use acetaminophen in patients with COVID-19. Can we bring concept from evolutionary medicine to help us decide what to do in the pandemic? Spoiler alert: yes
Explore the Surviving Sepsis Campaign Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)
Explore the Surviving Sepsis Campaign Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)
In this episode, we discuss more ARDS, filters and some thoughts in regards to COVID-19. The Society of Critical Care Medicine recently released guidelines that were developed in conjunction with the Surviving Sepsis Campaign. We go through the guidelines step by step and discuss the rationale behind the recommendations.https://www.sccm.org/getattachment/Disaster/SSC-COVID19-Critical-Care-Guidelines.pdf?lang=en-UShttps://www.sccm.org/getattachment/Disaster/SCCM-COVID-19-Infographics1.pdf?lang=en-UShttps://www.sccm.org/getattachment/Disaster/SCCM-COVID-19-Infographics2.pdf?lang=en-UShttps://emcrit.org/ibcc/covid19/https://heavyliesthehelmet.com/2018/03/17/017/
Margaret M. Parker, MD, MCCM, and Scott L. Weiss, MD, FCCM, discuss the release of: Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children
Margaret M. Parker, MD, MCCM, and Scott L. Weiss, MD, FCCM, discuss the release of: Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children
Presentation from November 21 Florida Journal Club With Diane Sanders-Cepeda, DO, CMD Post-acute and Long-term Care Settings as First Responders for the Surviving Sepsis Campaign, Robin L.P. Jump MD, PhD, Susan M. Levy MD, CMD, Wayne S. Saltsman MD, PhD, CMD Can Sepsis Be Detected in the Nursing Home Prior to the Need for Hospital Transfer?, Philip D. Sloane MD, MPH, Kimberly Ward BA, David J. Weber MD, MPH, Christine E. Kistler MD, MASc, Benjamin Brown BS, Katherine Davis BS, Sheryl Zimmerman PhD Early Identification and Management of Sepsis in Nursing Facilities: Challenges and Opportunities, Bernardo J. Reyes MD, Joseph Chang MD, Lena Vaynberg MD, Sanya Diaz NP, Joseph G. Ouslander MD
Margaret M. Parker, MD, MCCM, and Mitchell M. Levy, MD, MCCM discuss the Hour-1 Bundle, the controversies of the Surviving Sepsis Campaign, and the future of sepsis.
Margaret M. Parker, MD, MCCM, and Mitchell M. Levy, MD, MCCM discuss the Hour-1 Bundle, the controversies of the Surviving Sepsis Campaign, and the future of sepsis.
In this episode of Critical Matters, we discuss the Hour-1 Bundle for sepsis. The Surviving Sepsis Campaign has been working on improving outcomes for patients with sepsis for well over a decade. Today we are fortunate to have one of its leaders as a guest to discuss the 2018 update: The Hour-1 Bundle. Our guest is Mitchell Levy, MD, MCCM. Dr. Levy is Professor of Medicine and Division Chief, Pulmonary and Critical Care Medicine at the Alpert Medical School of Brown University in Providence, Rhode Island. Additional Resources: The Surviving Sepsis Campaign website. A wealth of resources for clinicians interested in improving outcomes for patients with sepsis and septic shock. http://www.survivingsepsis.org/Pages/default.aspx The Surviving Sepsis Campaign Bundle: 2018 Update (The Hour-1-Bundle) http://www.survivingsepsis.org/SiteCollectionDocuments/Surviving-Sepsis-Campaign-Hour-1-Bundle-2018.pdf Books Mentioned in This Episode: Shambhala: The Sacred Path of the Warrior: https://www.amazon.com/Shambhala-Sacred-Warrior-Chogyam-Trungpa/dp/1611802326/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1528317558&sr=8-1
Earlier this year, we were asked to present at a local critical care conference. Due to the recent release of the 1-hour bundle, this was a timely discussion regarding pre-hospital sepsis. We touched on various definitions, diagnostics, treatments, and the ongoing controversy surrounding the Surviving Sepsis Campaign. Since we try to record most of our talks, we decided to share this particular presentation with you on the podcast. We hope you enjoy this format for a change of pace. ------------------------------------------------ Follow our Twitter @heavyhelmet Follow our Facebook @heavyliesthehelmet Follow our Instagram @heavyliesthehelmet Subscribe to our YouTube @heavyliesthehelmet Visit our website at heavyliesthehelmet.com Contact us at heavyliesthehelmet@gmail.com Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services. ------------------------------------------------ Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com Creative Commons Attribution 3.0 Unported License https://creativecommons.org/licenses/by/3.0/deed.en_US
SURVIVING SEPSIS CAMPAIGN – The International Guidelines for Management of Sepsis and Septic Shock as of 2016 are as follows: Administer broad-spectrum intravenous antimicrobials for all likely pathogens within 1 hour after sepsis recognition. Obtain anatomic control as rapidly as practical. Assess patients daily for deescalation of antimicrobials; narrow therapy based on cultures and/or clinical improvement. For patients with sepsis-induced hypoperfusion, provide 30 mL/kg of intravenous crystalloid within 3 hours with additional fluid based on frequent reassessment, preferentially using dynamic variables to assess fluid responsiveness. For patients with septic shock requiring vasopressors, target a mean arterial pressure (MAP) of 65 mm Hg. Use norepinephrine as a first-choice vasopressor. Target a tidal volume of 6 mL/kg of predicted body weight and a plateau pressure of ≤30 cm H2O. Hospitals and health systems should implement programs to improve sepsis care that include sepsis screening.
This episode is all about sepsis! We discuss various identification and risk stratification scores, as well as the work up and management of the patient with sepsis. As always, we have an associated infographic as well as relevant resources at www.theinternatwork.com.This episode was written by Dr. Laiya Carayannopoulos (Internal Medicine Resident) and reviewed by Dr. Alison Fox-Robichaud (Intensivist, President of Canadian Sepsis Foundation), Dr. Waleed Alhazzani (Intensivist and Gastroenterologist, Methodology Chair of Surviving Sepsis Campaign), and Dr. Rebecca Kruisselbrink (Internist and Intensivist).
Paul E. Marik, MD, FCCP, and Mitchell M. Levy, MD, FCCP, join CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, to debate whether the Surviving Sepsis Campaign guidelines should be retired.
This is Hallie Prescott's presentation from the opening plenary session at the Intensive Care Society State of the Art Meeting 2018 Dr. Hallie Prescott is an Assistant Professor in Pulmonary & Critical Care Medicine at the University of Michigan and staff physician at the Ann Arbor Veterans Affairs Hospital. She leads grants on post sepsis morbidity and hospital performance measurement from the US National Institutes of Health and the US Department of Veteran’s Affairs. She is an expert in long-term outcomes and recovery after sepsis, with a focus on preventable hospital readmissions. She is co-chair of the Surviving Sepsis Campaign guidelines, inaugural Lowry-Fink fellow of the International Sepsis Forum (2017-2019), a former ANZICS Intensive Care Global Rising Star fellow (2015), and winner of the Early Career Achievement award from the American Thoracic Society’s Critical Care Assembly (2018).
When chatting with Sam it reminded me how much I missed the ER. She gave us a wonderful perspective on how it is to work in the ER and what traits would make an ideal ER RN. We discussed the various routes to become a nurse and she shared her personal pros and cons with us about nursing in the emergency setting. Thank you Sam! Registered Nurses* Registered nurses (RNs) provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their family members. 2017 Median Pay: $70,000 per year ($33/hour) Educational Degree: Initially Associate's Degree or Bachelor's Degree Number of US jobs in 2016: 2,955,200 10 Year Job Outlook: 15% growth, much faster then avg. *Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Registered Nurses, on the Internet at https://www.bls.gov/ooh/healthcare/registered-nurses.htm (visited November 16, 2018). Terms Covered in Episode American Nurses Association UC College of Nursing CNA (Certified Nursing Assistant) - Takes care of patients under the supervision of Licensed Practicing Nurses and Registered Nurses in a facility. Microbiology - The study of microorganisms, encompasses numerous sub-disciplines including virology, parasitology, mycology and bacteriology. Satellite clinic - A facility owned by a hospital, but operated at a distant site. Urgent care - Walk-in clinics focused on the delivery of acute care in a dedicated medical facility outside of a traditional emergency room. Urgent care centers treat injuries and illnesses that are not serious enough to require an emergency department visit. Pediatrics Medicine - A branch of medicine that involves the medical care of infants, children, and adolescents. BSN - Bachelor of Science in Nursing, more schooling then Associate's. Usually four to five years. ASN/ADN - Associate’s Degree in Nursing. Usually around two years. NP (Nurse Practitioner) - A nurse practitioner is trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose illness and disease, prescribe medication and formulate treatment plans. They may work in a solo practice independently or they may work within part of a hospital system. They graduate from a Master's or Doctorate level medical program. Med/Surg/Floor Nursing - Refers to what you would think of "general hospital patients." Those with pneumonia, new cardiac issues, skin infections, etc that do not require focal subspecialty involvement (cardiac, neuro, ortho, etc) or critical care support. Drug Reps - Pharmaceutical Representatives are professionals that work for the companies that manufacture, market, and sell medications that work with clinics, hospitals, and other health care facilities to educate about new products and continue to support current products. PureWick External Female Catheter
Professor Andrew Rhodes (London) discusses the latest iteration of the Surviving Sepsis Campaign at the Critical Care Reviews Meeting 2018, at Titanic, Belfast.
Sepsis guidelines are constantly changing. Refer to your national guidelines or institutional protocol for most up to date treatment information. Introduction Sepsis is bad and needs to be treated aggressively Confusion around multiple conflicting guidelines and requirements Surviving Sepsis Campaign recommendations CMS requirements Sepsis-3 SOFA/SIRS/qSOFA Institutional protocols Sepsis-3 Proposed Recommendations Screen for sepsis by applying […]
This Month in AJN – February 2018 monthly highlightsFebruary 2018Editor-in-Chief Shawn Kennedy and Clinical Editor Betsy Todd present the highlights of the February issue of AJN. The authors of our first CE, “Original Research: Physical Activity Among Chinese American Immigrants with Prediabetes or Type 2 Diabetes,” describe a mixed-methods study that analyzed this population's levels of exercise intensity and examined the types of activity performed, as well as the barriers to such activity. Our second CE, “Managing Sepsis and Septic Shock: Current Guidelines and Definitions,” discusses recent updates to the Surviving Sepsis Campaign's sepsis treatment guidelines, changes in the sepsis bundle interventions, and the new definitions and predictive tools introduced in the Third International Consensus Definitions for Sepsis and Septic Shock. Our next article, “Moving Closer to the 2020 BSN-Prepared Workforce Goal,” report findings from the four-year Academic Progression in Nursing initiative to identify and develop the most promising strategies for creating a more highly educated nursing workforce. “Cultivating Quality: A Multidisciplinary QI Initiative to Improve OR–ICU Handovers” examines the impact of a standardized handover process on ensuring safe patient transfer between the OR and the ICU. In addition, there's News, Reflections, Drug Watch, Art of Nursing, and more.
AJN editor-in-chief Shawn Kennedy speaks with author Mary Beth Flynn Makic about her article, which discusses recent updates to the Surviving Sepsis Campaign’s sepsis treatment guidelines, changes in the sepsis bundle interventions, and the new definitions and predictive tools introduced in the Third International Consensus Definitions for Sepsis and Septic Shock.
This Month in AJN – February 2018 monthly highlightsFebruary 2018Editor-in-Chief Shawn Kennedy and Clinical Editor Betsy Todd present the highlights of the February issue of AJN. The authors of our first CE, “Original Research: Physical Activity Among Chinese American Immigrants with Prediabetes or Type 2 Diabetes,” describe a mixed-methods study that analyzed this population’s levels of exercise intensity and examined the types of activity performed, as well as the barriers to such activity. Our second CE, “Managing Sepsis and Septic Shock: Current Guidelines and Definitions,” discusses recent updates to the Surviving Sepsis Campaign’s sepsis treatment guidelines, changes in the sepsis bundle interventions, and the new definitions and predictive tools introduced in the Third International Consensus Definitions for Sepsis and Septic Shock. Our next article, “Moving Closer to the 2020 BSN-Prepared Workforce Goal,” report findings from the four-year Academic Progression in Nursing initiative to identify and develop the most promising strategies for creating a more highly educated nursing workforce. “Cultivating Quality: A Multidisciplinary QI Initiative to Improve OR–ICU Handovers” examines the impact of a standardized handover process on ensuring safe patient transfer between the OR and the ICU. In addition, there’s News, Reflections, Drug Watch, Art of Nursing, and more.
Editor-in-Chief Shawn Kennedy and Clinical Editor Betsy Todd present the highlights of the October issue of AJN. Our first CE, “Original Research: Exploring How Nursing Schools Handle Student Errors and Near Misses,” investigates nursing school policies and practices for reporting and tracking student errors and near misses. Our second CE, “Assessing Patients During Septic Shock Resuscitation,” discusses how to integrate capillary refill time and skin mottling score into the perfusion reassessment after initial fluid resuscitation—as recommended by revisions to the Surviving Sepsis Campaign six-hour bundle. Our next article, “Sexually Speaking: Obesity and Sexual Dysfunction: Making the Connection,” reviews the evidence on obesity and sexual functioning, plus nursing considerations for addressing weight-loss strategies with patients. The author of “Question of Practice: Workarounds Are Routinely Used by Nurses—But Are They Ethical?” discusses how nurses can be creative problem solvers without resorting to workarounds that may be ethical in intent yet potentially harmful in their consequences. In addition, there's News, Reflections, Drug Watch, Art of Nursing, and more.
Editor-in-Chief Shawn Kennedy and Clinical Editor Betsy Todd present the highlights of the October issue of AJN. Our first CE, “Original Research: Exploring How Nursing Schools Handle Student Errors and Near Misses,” investigates nursing school policies and practices for reporting and tracking student errors and near misses. Our second CE, “Assessing Patients During Septic Shock Resuscitation,” discusses how to integrate capillary refill time and skin mottling score into the perfusion reassessment after initial fluid resuscitation—as recommended by revisions to the Surviving Sepsis Campaign six-hour bundle. Our next article, “Sexually Speaking: Obesity and Sexual Dysfunction: Making the Connection,” reviews the evidence on obesity and sexual functioning, plus nursing considerations for addressing weight-loss strategies with patients. The author of “Question of Practice: Workarounds Are Routinely Used by Nurses—But Are They Ethical?” discusses how nurses can be creative problem solvers without resorting to workarounds that may be ethical in intent yet potentially harmful in their consequences. In addition, there’s News, Reflections, Drug Watch, Art of Nursing, and more.
AJN editor-in-chief Shawn Kennedy speaks with author Elizabeth Bridges about her article, which discusses how to integrate capillary refill time and skin mottling score into the perfusion reassessment after initial fluid resuscitation—as recommended by revisions to the Surviving Sepsis Campaign six-hour bundle.
WIHI - A Podcast from the Institute for Healthcare Improvement
Date: January 24, 2013 Featuring: John D’Angelo, MD, FACEP, Chairman, Department of Emergency Medicine, Glen Cove Hospital, North Shore-Long Island Jewish Health System Martin E. Doerfler, MD, Vice President, Evidence Based Clinical Practice, North Shore-Long Island Jewish Health System Darlene Parmentier, RN, MSN, MBA, Assistant Director of Critial Care and Telemetry, Glen Cove Hospital, North Shore-Long Island Jewish Health System Andrea Kabcenell, RN, MPH, Vice President, Institute for Healthcare Improvement Diane Jacobsen, MPH, CPHQ, Director, Institute for Healthcare Improvement Developing an infection can be complicated enough, but when the body's immune system reacts by going into overdrive in the form of sepsis, every second counts. The diagnosis needs to be swift and, if sepsis is confirmed, interventions in the form of fluids and antibiotics must be administered immediately. Because the global death rate from sepsis remains painfully high — tens of millions each year — stepped-up efforts to reduce mortality have been underway on a global scale for at least the past decade. And there is progress to report on multiple continents where many health care organizations have been working hard on sepsis, often as part of international initiatives such as the Surviving Sepsis Campaign and in concert with professional societies such as the Society of Critical Care Medicine.In the US, where 25 percent of the 750,000 people who develop sepsis each year die, North Shore–Long Island Jewish (NSLIJ) Health System has reduced its sepsis mortality rate significantly. North Shore–LIJ is now in the midst of a strategic partnership with IHI to maintain and further these gains, and key learning has begun to emerge. WIHI host Madge Kaplan explores this progress on reducing deaths from sepsis with three clinical leads from North Shore–LIJ and two improvement leaders from IHI. Early detection and intervention are key, but in order to execute best practices reliably, changing the culture and engaging the leadership of the organization have proven essential. At North Shore–LIJ, focusing on the emergency department has also been foundational to testing best practices and spreading them to the rest of the hospital system.Don't miss this very important discussion about a critical problem that everyone in acute care needs to be aware of and working on. Patients and families are getting engaged too.
David Farcy, MD FAAEM FCCM, Chairman of the Department of Emergency Medicine at Mount Sinai Medical Center - Miami Beach and President-Elect of AAEM, speaks with Tiffany Osborn, MD MPH FACEP, Professor of Emergency Medicine and Acute and Critical Care Surgery at Barnes-Jewish Hospital. Drs. Farcy and Osborn discuss the recent update of the Surviving Sepsis Campaign and its application in patient treatment. Discussion points include: upcoming changes, lactate clearance, and Vitamin C. Intro music by NICOCO, "Quiberon," from the album "Nicoco," powered by JAMENDO.
David Farcy, MD FAAEM FCCM, Chairman of the Department of Emergency Medicine at Mount Sinai Medical Center - Miami Beach and President-Elect of AAEM, speaks with Tiffany Osborn, MD MPH FACEP, Professor of Emergency Medicine and Acute and Critical Care Surgery at Barnes-Jewish Hospital. Drs. Farcy and Osborn discuss the recent update of the Surviving Sepsis Campaign and its application in patient treatment. Discussion points include: upcoming changes, lactate clearance, and Vitamin C. Intro music by NICOCO, "Quiberon," from the album "Nicoco," powered by JAMENDO.
New 2016 recommendations from the Surviving Sepsis Campaign and what do they mean for the Emergency Department? Featuring Dr. Laura Evans and Dr. Tiffany Osborn. (Podcast Host: Dr. Jason Woods) https://www.acep.org/Content.aspx?id=105270
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.
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.
SSC 2016 Guidelines
Ludwig Lin, MD, speaks with Jane Taylor, Ed.D, about quality improvement science and her contributions to the Surviving Sepsis Campaign.
Ludwig Lin, MD, speaks with Jane Taylor, Ed.D, about quality improvement science and her contributions to the Surviving Sepsis Campaign.
The management of the septic patient in ICU is a recurrent topic for debate amongst intensivists. The decision of if and/or when to give blood transfusions is one of the key sources of contention. Dr Anders Perner is one of the most qualified people to weigh in on this debate. In this talk from SMACC Chicago, he delivers his stance on when to pull the transfusion trigger.Dr Anders Perner is an Intensive Care Specialist at Rigshospitalet and a professor in intensive care at Copenhagen University. He is the chairman of the Scandinavian Critical Care Trials Group and the strategic research program “New resuscitation strategies in patients with severe sepsis’. The contents of this talk are based on the findings of the TRISS trial - Transfusion Requirements in Septic Shock. This trial, Lower versus Higher Hemoglobin Threshold for Transfusion in Septic Shock was published in the NEJM in October 2014. The aim was to evaluate the recommendations from the Surviving Sepsis Campaign regarding transfusion in septic shock. The recommendation is that after the first 6 hours, transfusion threshold should be a Hb
Anthony Delaney, on of the key Investigators in the ARISE trial discusses the recent results from the ProCESS trial and what this means for sepsis management at the right now. The Surviving Sepsis Campaign statement is here and paper Anthony mentions describing the differences between the three sepsis trials is here.
Jeffrey Guy, MD, MSc, MMHC, speaks with R. Phillip Dellinger, MD, MCCM, co-chair of the updated Surviving Sepsis Campaign Guidelines.
David Farcy, MD FAAEM FCCM, Chairman of Emergency Medicine at Mount Sinai Medical in Miami Beach, Florida, speaks with Tiffany Osborn, MD MPH FACEP, Associate Professor of Emergency Medicine and Acute and Critical Care Surgery at Barnes-Jewish Hospital. Drs. Farcy and Osborn discuss the recent update of the Surviving Sepsis Campaign and its application in patient treatment. Discussion points include: lactate clearance, vasopressors, blood transfusions, and steroids. Intro music by NICOCO, "Quiberon," from the album "Nicoco," powered by JAMENDO.
Jeffrey Guy, MD, MSc, MMHC, speaks with Christa A. Schorr, RN, MSN, FCCM, who is with us today to discuss implementing the Surviving Sepsis Campaign (SSC) guidelines.
Jeffrey Guy, MD, MSc, MMHC, speaks with Christa A. Schorr, RN, MSN, FCCM, who is with us today to discuss implementing the Surviving Sepsis Campaign (SSC) guidelines.
2012 Surviving Sepsis Campaign Guidelines from my Practical Evidence Podcast
SSC Guidelines 2012
For our Christmas special we're delighted to be joined by numbers guru and journal editor John Carlisle. John helps us look at the latest from the Surviving Sepsis Campaign, interpret the recent guidance from NICE regarding depth of anaesthesia monitoring and teaches us all how to make the perfect pancake. We've also got discoveries, rants and a festive themed Biology or Bunkum.
Mitchell Levy discusses an article about the Surviving Sepsis Campaign.
Guest: Mitchell Levy, MD Host: Shira Johnson, MD What is the impact of re-education on outcomes in sepsis in an ICU? Host, Dr. Shira Johnson is joined by Dr. Mitchell Levy, professor of medicine at Brown Medical School and Medical Director of the Medical Intensive Care Unit at Rhode Island Hospital, who discusses the "Surviving Sepsis Campaign." Re-education of physicians and nurses in this global study had a remarkable impact on reducing mortality and morbidity. Dr. Levy explains why outcomes were so dramatically affected.
We continue our discussion of the Surviving Sepsis Campaign (SSC). This includes fluids types, steroids, rhAPC (Xigris), and blood sugar control.
The Surviving Sepsis Campaign (SSC) is concensus document that attempts to provide the best evidence to assist in the care of the septic patient. All providers who provide care to the septic patient should be aware of the contents of the SSC.
Michael Gropper, MD, PhD, is director of critical care medicine for the University of California San Francisco Medical Center and professor of medicine and anesthesiology at the medical school. He is one of the many healthcare professionals who have found success in implementing the Surviving Sepsis Campaign guidelines and discusses the strategies for implementation as well as the challenges his institution faced.
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