Next up for me at #SCCM2022: Thought Leader: Critical Care Nurses and COVID-19 with John Gallagher, DNP, CCNS, CCRN-K.
Nurses faced both stressors & opportunities for unity & leadership. Expanding service delivery in the face of limited understand of #COVID19@SCCM_Nursing 1/
Preparedness, technology, staff wellbeing, education led to innovation. B/C future disasters are inevitable, what did we do well? Where did we lag (PPE)? #SCCM2022
Conventional, Contingency practice are familiar, but we have been in extended Crisis mode 2/
Dr. G talks about Risk = Probability x Severity.
Maybe we should add duration (my own thoughts)
Improving communication with all staff members needed. How to augment with non CC providers?
Sustainability over time - sick staff, burnout, early retirement
Part 3 #Illnessdoesntmeanstillness by @SapnaKmd
🔸we have created a culture of immobility
🔸"prolonged bedrest is anatomically and physiologically unsound" JAMA
Let's talk about Bundled Care of Pediatric Critical Care Patients: Guidelines and Implementation Part 2! We start with Dr. John Berkenbosch talking about choosing the right analgesic/sedation/NMB agent
Underlying disease may cause pain that we cannot well appreciate.
✅Enhancement of sleep should be a goal for its restoration and reduction of delirium.
✅IV opiates strong recommendation to manage moderate to severe pain
❓Need studies comparing opiates #SCCM2022#PedsICU 2/
Non-opioid adjunct
Consider use of non opioids both NSAIDS and APAP
Reduced pain scores, and opiate use #SCCM2022#PedsICU 3/
My friend and former division chief Dr. Jim Besunder talks about evidence based assessment of pain and agitation #SCCM2022#PedsICU#PANDEM 1/
Besunder - while self report is the gold standard, the age, acuity and interventions of the #PedsICU patient make this often not useful. Many other tools aren't validated in the population. 2 that work well are Oucher and Wong Baker #SCCM2022 2/
The guidelines recommend using self report tools when possible, the FLACC or COMFORT-B in non-communicative patients. Avoid use of VS alone to assess pain. #SCCM2022#PedsICU 3/
My next #PedsICU related #SCCM2022 topic is Pediatric TAXI-CAB Guidance. First @nellis discusses aims & general methods to create guidance for plasma & platelet transfusion.
Incredible expert team, but no nurses? Nurses administer🩸products and monitor for adverse events
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