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Ann-Marie Brown PhD-ACPNP 🇺🇸👩🏻‍🦳 Profile picture
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Apr 19 • 4 tweets • 4 min read
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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Semantics of recommendations. #SCCM2022 #PedsICU
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Recommendations
#SCCM2022 #PedsICU
#TAXICAB general good practice statements
#SCCM2022 #PedsICU @PALISInet @BloodNet_PALISI

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More from @brownam130

Ann-Marie Brown PhD-ACPNP 🇺🇸👩🏻‍🦳 Profile picture
Apr 20
Part 3 #Illnessdoesntmeanstillness by @SapnaKmd
🔸we have created a culture of immobility
🔸"prolonged bedrest is anatomically and physiologically unsound" JAMA

#SCCM2022 #PedsICU
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Goal to change culture
🔸initial cost was multiprofessional investment
🔸"PICU Up" became the common name
🔸Followed AHRQ QI model

#SCCM2022 #PedsICU
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Read 12 tweets
Ann-Marie Brown PhD-ACPNP 🇺🇸👩🏻‍🦳 Profile picture
Apr 20
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

#SCCM2022 #PedsICU
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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
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Non-opioid adjunct
Consider use of non opioids both NSAIDS and APAP
Reduced pain scores, and opiate use
#SCCM2022 #PedsICU
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Read 14 tweets
Ann-Marie Brown PhD-ACPNP 🇺🇸👩🏻‍🦳 Profile picture
Apr 20
My friend and former division chief Dr. Jim Besunder talks about evidence based assessment of pain and agitation #SCCM2022 #PedsICU #PANDEM
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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
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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
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Read 5 tweets
Ann-Marie Brown PhD-ACPNP 🇺🇸👩🏻‍🦳 Profile picture
Apr 19
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
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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
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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

#SCCM2022
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Read 6 tweets

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