Access complete lectures plus interviews with our speakers.
Critical Care Nursing: Lecture 10
Does feeding make a difference to critically ill patients….or not? There remains considerable variability in nutrition support practice for the critically ill despite the availability of numerous guidelines to support our practice. The complexity of the metabolic response to critical illness, coupled with patient heterogeneity, means that a one-size-fits-all approach to nutrition support is unlikely to work and that not all patients will benefit equally from nutrition interventions. We also lack clarity on the best way to determine nutritional requirements and there are insufficient data to specify the amount of protein and/or calories that patients should receive. All of these factors contribute to uncertainty regarding the benefits and best practices in relation to nutrition. Nevertheless, we know that if we don’t feed patients they do poorly. We also know that the practices of critical care nurses who manage the delivery of nutrition can have a significant impact on nutrition adequacy both in ICU and during recovery in the ward. Think about what you can do to make a difference to nutrition intake for patients recovering from critical illness.
Critical Care Nursing: Lecture 9
The aim of this lecture is to enhance knowledge on the use of pain assessment tools in the ICU, and on the clinical significance of systematic pain assessment, and to promote understanding of how the neural circuitry of nociception perpetuates increased pain levels in critically ill patients. The majority of critically ill patients experience moderate to severe pain. Pain may also persist after ICU discharge and shift to chronic pain, and is also implicated in the post-intensive care syndrome. Despite guidelines, implementation and use of validated tools to assess pain in routine ICU practice appears to be inconsistent.
Critical Care Nursing: Lecture 8
Do you feel like you have implemented all the evidence, but you're still not getting the expected results? You are not alone. CLABSI's and CAUTI's remain a significant contribution to patient harm and financial losses. The problem may call for a different approach. Quality implementation science tells us that substantial practice and process variation can lead to lower quality and higher cost. It makes sustainability almost impossible. The first step in this journey is a dissection of both physician and nursing practices and processes, then the application of laser target strategies. This session focuses on key practice areas where significant variation has been identified through a national frontline consultation experience. Innovative assessment techniques and evidence-based approaches are outlined to address both insertion and maintenance related central lines and indwelling urinary catheters. The challenge of incorporating new evidence into practice lies in altering routinized behavior and current culture to support new care practices. Leave with a plan for your organizations breakthrough to achieve zero in CLABSI's and CAUTIs.
Critical Care Nursing: Lecture 7
Susan provides a comprehensive review of traumatic brain injury. Injury identification, with associated evidence-based treatment strategies, will provide learners with practical tools to support patient care. The lecture will begin with a review of the mechanism of injury and primary and secondary trauma assessments. Following this, an overview of primary brain injury will occur where associated CT scan imaging will be utilized to enhance participant learning. Pathophysiology of secondary brain injury will be provided followed by strategies to minimize its sequelae. Brain herniation syndromes, intracranial pressure evaluation, and management techniques will be presented along with miscellaneous items such as deep vein thrombosis, feeding, and temperature management strategies to support optimal TBI patient outcomes. Throughout the course, evidenced-based, nursing treatment strategies will be provided to support rapid identification and practical care management that can be applied in global care settings.
Critical Care Nursing: Lecture 6
Approximately 1/3 of survivors of critical illness experience psychological compromise during recovery. Although the pattern of this compromise varies for individual patients, we can monitor and minimise factors in ICU that might make this worse for patients, and also improve our care to reduce problems during recovery. Interventions to be delivered within ICU that might be of benefit include sedation minimisation, sleep improvement, early mobility and psychological support. Interventions to be considered after ICU include information provision and follow-up support.
Episode 10: Kathleen Vollman
A personal interview with Kathleen Vollman, a Critical Care Clinical Nurse Specialist, Educator and Consultant. She has published & lectured nationally and internationally on a variety of topics including critical care, pulmonary medicine, sepsis. From 1989 to 2003 she functioned in the role of Clinical Nurse Specialist for the Medical ICU’s at Henry Ford Hospital in Detroit Michigan. Currently, her company, ADVANCING NURSING LLC, is focused on creating empowered work environments for nurses through the acquisition of greater skills and knowledge. In 2004, Kathleen was inducted into the College of Critical Care Medicine in 2009 she was inducted into the American Academy of Nurses. In 2012, Ms Vollman was appointed to serve as an honorary ambassador to the World Federation of Critical Care Nurses.
Critical Care Nursing: Lecture 5
Outcomes from in-hospital cardiac arrest remain dismal, about 25%. Preventing an arrest is the ultimate goal for hospitalized patients. However, this is not always possible & understanding the components of resuscitation that make a difference should be the focus. This lecture will focus on the top 5 things to focus on in cardiac arrest: high-performance CPR, early & effective defibrillation, feedback to teams & team training and post-arrest temperature control. Incorporating these components will likely increase the patient’s chance of survival.
Critical Care Nursing: Lecture 4
This podcast accompanies the Global Classroom for Critical Care Nurses: fortnightly lectures on core curriculum topics delivered by experts from around the world. Lecture 4 is by David Waters, Associate Professor and Head of Department within the School of Nursing and Midwifery at Birmingham City University, where he leads the Department of Post Qualifying Healthcare Practice. This lecture will explore the critical issues associated with errors occurring within the ICU setting, including the prevalence, nature and contributing factors. In addition, the talk will explore the impact of errors for patients, clinicians and healthcare organisations. The direct consequences for the error maker or 'second victim' will be discussed, with specific focus also on their support needs following an error event.
Critical Care Nursing: Lecture 3
This podcast accompanies the Global Classroom for Critical Care Nurses: fortnightly lectures on core curriculum topics delivered by experts from around the world. Lecture 3 is by Anne Alexandrov, Professor of Nursing and Neurology. This lecture presents evidence-based information about the diagnosis, reperfusion treatment, and prevention of acute ischaemic stroke. The discussion will centre on nursing clinical localization diagnostic skills, the availability and utility of computed tomographic (CT) technology, and nursing’s role in the development of systems of care that support stroke management. Specific topics will include intravenous alteplase and thrombectomy treatments, rapid emergency department management paradigms, the evolution of prehospital treatment on mobile stroke units, and the importance of primary and secondary stroke prevention.
Critical Care Nursing: Lecture 2
This podcast accompanies the Global Classroom for Critical Care Nurses: fortnightly lectures on core curriculum topics delivered by experts from around the world. Lecture 2 is by Stijn Blot, Research Professor at Ghent University, Belgium. Main take-home messages: Administer the first antibiotic dose as soon as possible. In cases requiring a switch in antibiotic therapy, verify whether the reason is de-escalation or inappropriate therapy. Use a controlled infusion, especially for concentration-dependent antibiotics. Respect dosing schedules of time-dependent antibiotics. Start continuous infusion of antibiotics together with the loading dose. Do not interrupt a continuous antibiotic infusion. Consider stability of antibiotic agents in case of continuous infusion. In intermittent antibiotic therapy, deal with dead-space problems.
Critical Care Nursing: Lecture 1
This podcast accompanies the Global Classroom for Critical Care Nurses: fortnightly lectures on core curriculum topics delivered by experts from around the world. Lecture 1 is by Kathleen Vollman, Critical Care Nursing specialist, educator and consultant, USA. Main take-home messages: Incidence of ARDS is higher than we thought Misdiagnosis is more frequent leading to late application of the evidence based supportive care. Frequent assessment of PaO2/FiO2 ratio by nurses can trigger a discussion around earlier diagnosis Keys to therapy to minimize lung injury from the ventilator and biotrauma include; low tidal volume ventilation, PEEP between 10 and 15 cm H2O based on using the FIO2/PEEP table from the ARDS network, prone positioning early in the course if P/F ratios < 150. There is no cure at this time, so the 8 P’s of supportive care can help the patient survive the critical illness and demonstrate improved long-term outcomes. Patient with ARDS are likely to experience the Post Intensive Care Syndrome therefore it is important to educate the patient and family what to expect and while in the ICU focus on consistent delivery of the ABCDEF bundle
Episode 9: Ged Williams
Professor Ged Williams Ged is a Professor of Nursing, currently working as a Nursing and Allied Health Consultant in Abu Dhabi. He was Founding Chair & Past President of the World Federation of Critical Care Nurses and Former Director of the World Federation of Societies of Intensive Care & Critical Care Medicine. He has qualifications in midwifery, critical care nursing, Public Sector Management, Company Directorship, a Masters in Health Administration and a Masters in Law. He has published over 80 peer-reviewed journal articles and book chapters and is regularly involved in strategic nursing and health activities at the state, national and international level.
Episode 8: TBS19 Day Three
The Big Sick Conference is gathering of top Critical Care Experts from around the world. It takes place over three days in Zermatt, Switzerland. This episode aims to capture some of the learning from the conference. Eoghan gathers summaries from some of the speakers as well as some take-home points from the attendees. Speakers included in this talk include: Sundeep Dhillon Hermann Brugger Matthieu Komorowski
Episode 7: TBS19 Day Two
The Big Sick Conference is gathering of top Critical Care Experts from around the world. It takes place over three days in Zermatt, Switzerland. This episode aims to capture some of the learning from the conference. Eoghan gathers summaries from some of the speakers as well as some take-home points from the attendees. Speakers included in this talk include: Zach Shinar Jostein Brede Niklas Nielsen Geir Strandenes Philip C. Spinella Patrick Thomson
Episode 6: TBS19 Day one
The Big Sick Conference is gathering of top Critical Care Experts from around the world. It takes place over three days in Zermatt, Switzerland. This episode aims to capture some of the learning from the conference. Eoghan gathers summaries from some of the speakers as well as some take-home points from the attendees. Speakers included in this talk include: Søren Steemann Rudolph Anna Milton Caroline Leech Tim Harris Sophie Hamada
Episode 5: Sepsis Updates
The international Sepsis Symposium was a gathering of leading world-experts in sepsis delivering their latest evidence-based recommendations in sepsis management. This episode features 5 talk summaries from our expert panel as well as one complete talk from the symposium. Summaries: Anthony Gordon: the best use of vasopressors and inotropes in sepsis Kathy Rowan: sepsis outcomes and why the vary nationally and internationally Mervyn Singer: novel therapies currently being researched Ron Daniels: Politics and Medicine to better outcomes Derrick Crook: the rise of E.Coli and Pneumonia Talk: Jecko Thachil: Consultant Haematologist, Manchester Royal Infirmary and Chair of the DIC committee, ISTH. an incredible talk on 'Coagulopathy in Sepsis'
Episode 4: Max Valois & Jean-Francois Lanctot
A personal interview with two ED/ICU docs from Montreal, Canada and the brains' behind the EGLS course Max Valois and Jean-François Lanctôt are colleagues in the ED at Charles-LeMoyne Hospital and in the ICU at Verdun Hospital in Montréal, Québec, Canada. Max is Adjunct Professor at McGill University and Université de Montréal, and Associate Professor at Université de Sherbrooke. Jean-François is Adjunct Professor at McGill University, and Professor of Clinical Teaching at Université de Sherbrooke. They are founders and co-directors of the Echo-Guided Life Support course which teaches the use of ultrasound to quickly diagnose and manage the hypotensive patient. They talk life, loves and challenges.
Episode 3: Arun Sayal & Matt DiStefano
Arun Sayal is an Emergency Medicine Doctor at North York General Hospital in Toronto and the founder of The Casted Course - a renowned emergency orthopaedic course for doctors and nurses. Eoghan finds out about Arun and in particular why he has such an incredibly positive outlook on life, with some great tips and advice for us all. (Everyone should spend time with him!!) Matt Di Stefano is an Emergency Physician, ski coach, drag racer, and accomplished orthopaedic surgeon from Toronto who delivers a lot of the teaching on the Casted Course. Eoghan and Matt discuss various topics including why Matt ought to be a politician!!
Episode 2: Rich Levitan
A personal conversation with Rich Levitan. Rich is an Adjunct Professor of Emergency Medicine at Dartmouth School of Medicine (New Hampshire) and visiting Professor at University of Maryland School of Medicine (Baltimore, Maryland). Professor Levitan is director of the New York City Airway Course, the Yellowstone Airway Course and the worlds largest cadaver airway course, in Baltimore (monthly for 16 years). He has given more than 350 invited international lectures on airway management and authored 42 publications and 3 textbooks on airway management. He is the inventor of the AirwayCam, which captured real-time, advanced airway skills for the first time. These resources have been used in 4000 hospitals in 26 different countries. Rich discusses his early years in medicine and how he got into airway training and research. Eoghan gets to know a little bit more about Rich by discussing his likes, dislikes, passions, annoyances and his hopes for the future.
Episode 1: Peter Brindley
A personal conversation with Peter G. Brindley MD, FRCPC, FRCP (Edin) FRCP (Lond). Peter is a full-time Critical Care Physician at the University of Alberta Hospital, Canada and professor of Critical Care Medicine, Anaesthesiology, and Medical Ethics. He has 100 peer-reviewed manuscripts, 30 book chapters, over 70 lesser manuscripts and one textbook focusing on resuscitation; crisis management; human factors; and improving teamwork & communication. He was a founding member of the Canadian Resuscitation Institute; former Medical-Lead for Simulation, and prior Education Lead for Surgery, Anaesthesia and Critical Care at the UofA. He is on the Board for the Canadian Critical Care Society, and the organizing committee for five major conferences. He has delivered over 400 invited presentations in ten countries, and over 50 plenaries. He welcomes disagreements because he doesn’t want to be wrong a moment longer than necessary.