Last session: Systematic bias in critical care

Dr Chiedozie Udeh: Systemic sources of racial disparities in the ICU

Racism’s history extends to the antebellum, incl Thomas Jefferson. It provided psychological permission for the treatment of slaves.

#SCCM2024
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Udeh: physicians also culpable

Implicit bias: segregation, under funded schools

Black/minorities more likely to live in poor neighborhoods, significantly worse maternal/infant low birth wt & mortality

#SCCM2024
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Part 3 #Illnessdoesntmeanstillness by @SapnaKmd
🔸we have created a culture of immobility
🔸"prolonged bedrest is anatomically and physiologically unsound" JAMA

#SCCM2022 #PedsICU
1/ 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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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
1/ 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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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
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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
1/ Semantics of recommendations. #SCCM2022 #PedsICU
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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
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