Douglas White (UPMC): ICU triaging both on saving most lives and those with longest life expectancy, even based on SOFA scores invariably will bias against patients of color, or lower SES #CCC50#PedsICU
White: 4 strategies for ICU triage that promote equity
White: Arizona as an example, some hospitals were overburdened, others had empty beds. Arizona surgeline addressed this to coordinate and facilitate transfer 5000 patient transfer so they didn't need to triage. #CCC50#PedsICU
White: exclude criteria that would disadvantage already-disadvantaged groups (like long term life expectancy) #CCC50#PedsICU
White: Apply correction factor to reduce impact of inequities #CCC50#PedsICU
White: there are calculators for area deprivation as this one for Pittsburgh #CCC50#PedsICU
White: Give heightened priority to frontline essential workers (not just healthcare workers, all those we need to work) owe them some consideration for putting themselves at risk. #CCC50#PedsICU
White: how do we put this all together? similar to scoring systems for organ allocation #CCC50#PedsICU
Sevransky: rationale for Vitamin C in sepsis and shock #CCC50#PedsICU
Sevransky: CITRIS-ALI #CCC50#PedsICU 167 patients with Sepsis AND ARDS for < 24 hours.
Sevransky: it did raise Vitamin C levels but didn't modify SOFA or other scores. But interventional group had a lower mortality (not a primary outcome measure of the study though, one of 46 secondary measures) #CCC50#PedsICU Billiard analogy of calling your shot -
The legend Ann Thompson, MD, MHCPM, MCCM talking about her career in #PedsICU, including offering herself up as chief at Pittsburgh 6 months out of fellowship. #CCC50#PedsICU (her caveat was that the division was 2 people with one fellow, 7 nurses, 10 PICU beds)
Dr. Laura Evans, FCCM asking Dr. Thompson about that transition from fellowship to leadership, the growth of the program. Dr. Thompson relying back on her guidance from Drs Raphaelly and Downes at CHOP who mentored her. "Holding on by your fingertips" at times. #CCC50#PedsICU
Dr. Thompson points out that having a strong team helped them persevere. (A team of course that she built over the years). #CCC50#PedsICU