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THE UNIT: The Official Newsletter of the ACEP Critical Care Section - Fall 2015

Volume 16, Issue 4

ACEP15 Edition: Have we gone too far with restrictive blood transfusion practices?


Restrictive Blood Transfusions: Have We Gone Too Far?

RedBloodCellsAnemia is a common comorbid condition in the critically ill patient. A 2012 study found that 28% of intensive care patients met criteria for anemia (<12 g/dL) on admission, with a mean admission hemoglobin of 9.4 g/dL.(1) Anemia is itself a predictor of increased morbidity and mortality in ICU patients.(2,3) However, the transfusion of packed red blood cells, the most common treatment for anemia, is itself associated with harms including transfusion reactions, transfusion related acute lung injury (TRALI), transfusion associated cardiac overload (TACO) and transfusion related immunomodulation (TRIM).(4) Thus the physician resuscitating a critically ill patient must balance the benefits of oxygen delivery capacity in the anemic patient with the harms of the transfusion itself.

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Brigham and Women’s Hospital Emergency Medicine Critical Care Fellowship

BWHSpecialty certification pathway: Internal Medicine

Length of fellowship: 2 years

Number of fellows: 1 per year (will likely expand in the future)

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Critical Care Track Courses – ACEP 15 in Boston

Check the onsite program for course location and changes.

Beyond the BP: Hemodynamics that Matter in the ED!
Haney Mallemat, MD
Wednesday, 10/28/2015 / 8:00 AM - 8:25 AM

Cruising the Literature: Top Articles in Critical Care
Michael E. Winters, MD, FACEP
Thursday, 10/29/2015 / 8:00 AM - 8:50 AM

Cutting-Edge Resuscitation Beyond the Ivory Tower
Michael E. Winters, MD, FACEP
Wednesday, 10/28/2015 / 3:30 PM - 4:20 PM

From Ordinary to Extraordinary: Critical Care Medicine in the ED
David Pearson, MD, FACEP
Thursday, 10/29/2015 / 9:00 AM - 9:50 AM

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Notes from the Chair

EvieMarcoliniI hope you will all be able to join us for a very exciting section meeting at Scientific Assembly in Boston this year, as our lineup will not disappoint you.

In this election year, I pass the chair baton to Ayan Sen, who I know will take us great places in the next couple of years. In addition to hearing from our liaisons and constituents, we will announce the results of the election for the next chair-elect, secretary/newsletter editor and website editor. The deadline for nominations was September 7. Section leadership is a great opportunity, and I am grateful to have had such a great team to work with.

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Board Certification Dates

For candidates seeking an upcoming board exam, click 'Read More' for the application deadlines.

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Life after Fellowship, Part III: Career Satisfaction

RaghuSeethala2015The most recent Medscape Physician Lifestyle Report demonstrated that the top two burnout specialties were emergency medicine (EM) and critical care medicine (CCM).1 As a newly minted EM-CCM physician you are probably thinking ... uh oh this does not bode well. Never fear in this final installment of the life after fellowship series we will give you some tips on how to survive your first year out of fellowship and ensure job satisfaction and career longevity.

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Meet the Section Staff Liaison

Margaret Montgomery 2015It was a late afternoon in the middle of July. I had just wrapped up rounds in the ICU, and was wondering how I could sneak out without somebody else demanding intubation or a bed for continuous EEG monitoring. I quietly tiptoed past the admission desk and up to the research building, closed the door in an abandoned back office and kicked my feet up with a pad of paper and pen. You see, Margaret Montgomery had agreed to be interviewed for her fans in the Critical Care Section, and it was my job to bring together the picture of our much beloved staff liaison. Margaret is sharp as a tack and doesn’t miss a trick. She has a very academic demeanor and a serious dedication to her work. But alas, I have been around long enough to know that there must be a mischievous side to our guide and mentor. Nobody lasts as long as she has in the organization without a sense of humor and some secrets to tell! It was my job to ferret those out and report back to the membership. My “girl noir” techniques must be honed and skillful, because, as I mentioned – Margaret doesn’t miss a trick…

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Program for the Section Meeting

The CCM Section meeting is scheduled for Tuesday, October 27th from 1 to 5 pm.

The meeting will include:

  • Business meeting with updates from Section Leaders, EMRA CCM Division Chair, ABEM, ACCM-EM Section in addition to election results
  • Panel Discussion with internationally known speakers: Sepsis- Getting Back to the Emergency Department
  • Brief Talks: EM/CCM Topics

A social hour hosted by Teleflex will immediately follow the meeting. Please join this networking event and thank our sponsor for their continuing support.

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The Unit is produced by the ACEP Critical Care Medicine Section

Newsletter Editor: Nick Mohr, MD, FACEP
Associate Editor: Joseph Tonna, MD
Associate Editor: Raghu Seethala, MD
Assistant Editor: Michael Haarstad, MD

If you are interested in contributing to The Unit, please contact Nick Mohr via email.

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