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THE UNIT: The Official Newsletter of the ACEP Critical Care Section - Spring 2016

Social Media in Critical Care and an Interview with Kyle Gunnerson


Interview with Dr. Kyle Gunnerson

GunnersonCurrently, emergency medicine residents have three options for critical care fellowships, leading to board certification, via internal medicine, surgery, or anesthesia. These options and pathways would not be available, were it not for the work of the leaders in emergency medicine – critical care (EM-CC), such as Dr. Kyle Gunnerson.

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Tips and Tricks: Pulse Pressure Variation

Tips1One of the most important concepts in resuscitation is volume responsiveness, or the ability of the cardiac output to increase in response to a fluid challenge. As compared to prior static measures of venous filling, such as central venous pressure (CVP) or pulmonary artery occlusion pressure (PAOP or wedge pressure), clinicians are increasingly turning to dynamic means of assessing patients’ volume responsiveness.1,2 One such measure is the pulse pressure variation (PPV).1,2

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AyanSenThe flu season may be just about getting over. The calls for possible VV-ECMO for severe ARDS keep coming. Hospitals have been running over capacity. Beds have been short and triage has been challenging as we deal with increased patient census. Burnout is, but, obvious, when you have to deal with increased surge capacity while maintaining patient safety and providing good outcomes for a protracted period of time. Variation in the quality of critical care among hospitals has prompted calls for regionalization of care for critically ill patients similar to trauma centers/ stroke centers etc. What are the best models for regionalization? Where does telemedicine fit into it all? Especially, when it comes to providing extracorporeal support, despite some existing guidelines and prognostication scores, we know that triage and transfer decisions may be challenging. And then, there are individual provider and specialty-related biases to decision-making.

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Make A Difference: Write That Council Resolution!

Many College members introduce new ideas and current issues to ACEP through Council resolutions. This may sound daunting to our newer members, but the good news is that only takes two ACEP members to submit a resolution for Council consideration. In just a few months the ACEP Council will meet and consider numerous resolutions.

ACEP’s Council, the major governing body for the College, considers resolutions annually in conjunction with Scientific Assembly. During this annual meeting, the Council considers many resolutions, ranging from College regulations to major policy initiatives thus directing fund allocation. This year there are 394 councillors representing chapters, sections, AACEM, CORD, EMRA, and SAEM.

The Council meeting is your opportunity to make an impact and influence the agenda for the coming years. If you have a hot topic that you believe the College should address, now is the time to start writing that resolution.

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The Role of Social Media (SoMe) in Emergency Medicine/Critical Care Medicine (EM/CCM)

Group Interview with Cliff Reid, BM, FACEM, Lillian Emlet, MD, FACEP, and John C. Greenwood, MD

Moderator: Joseph E. Tonna, MD
(liberally edited for content and clarity)

Joe: So what format in social media is the best for dissemination of ideas? We have Twitter, Blogs and Podcasts and there are a lot of different formats and they all seem to have various niche uses…What is the most durable and predominant format going forward in SoMe for EM/CCM? Also, what about the decline of Twitter?

Cliff: I think it is impossible to predict, just as the situation we’re in now wasn’t predicted by anyone, we probably can’t predict the directions that the different forms of social media are going to go in. I can’t see Twitter dying. Certainly not in my Twitter peer group in the way that we use it for education. Blogs, Twitter and Podcasts each fulfill a different role and each are convenient in different environments.

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SCCM Update

The EM section enjoyed a successful 2016 Congress in Orlando, Florida on multiple different fronts. We sponsored the first annual “Year in Review: Emergency Medicine” congress session with speakers Scott Weingart and Cliff Reid filling the room to capacity (even with the interruption of the fire alarm). Our inaugural Emergency Medicine SCCM Council representative was announced as Kyle Gunnerson, MD. Heatherlee Bailey, MD was elected to SCCM Council Secretary (placing her on the president-elect tract for 2019 Congress.... correct, the President of SCCM in 2019 will be an EM/CCM colleague). Julie Mayglothling, MD, FACEP was elected to the Board of Regents for the American College of Critical Care Medicine (ACCM).

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Highlight on Fellowships

RaghuSeethala2015Massachusetts General Hospital Surgical Critical Care Fellowship

Specialty certification pathway: Surgery

Length of fellowship: 2 years

Number of fellows
: 1 per year (for EM applicants)

Read More for curriculum sample schedule.


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