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The Unit: The Official Newsletter of the ACEP Critical Care Medicine Section - Summer 2014

PDF version of The UNIT Summer 2014 newsletter available here for download.

Early Goal Directed Therapy and Protocolized Sepsis Care

In 2014, is protocolized sepsis care necessary for the optimal care of patients with sepsis?

Yes - It's all part of the ProCESS: why protocolized care for severe sepsis and septic shock still matters.
By Nicholas Johnson, MD
No - Current sepsis care in 2014 is as good as protocolized care and uses fewer resources.
By Alfredo Urdaneta, MD, MAJ, USA, MC
When Dr. Rivers' landmark trial1 debuted in 2001, critical care for patients with severe sepsis and septic shock in the emergency department (ED) changed forever. Institu-tional and international guidelines were built upon the framework of "early goal directed therapy" (EGDT), and dozens of trials over the subse-quent thirteen years tested its validity and intricacies.The recent publication of the ProCESS trial has clearly demonstrated that strict adherence to protocol driven care of the septic patient offers no benefit to current standard practice. When the initial Early Goal-Directed Therapy (EGDT) study was published in 2001, Rivers was able to demonstrate that EGDT was able to reduce in-hospital mortality by 16%.

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Targeted Temperature Management Survey

Tell us about your hospital’s hypothermia protocol in light of Nielsen’s recent paper on Targeted Temperature Management! Watch your e-mail for a link to take you to the survey.

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Time To Think About It

Marcolini_9-13A consortium of American College of Chest Physicians, American Thoracic Society, and the Society of Critical Care Medicine published recently to encourage development of unified and coordinated internist training pathways that address current and future critical care requirements in the United States.1 While this document focuses primarily on the training and certification requirements for internists seeking critical care certification, there is much that we can take from it to consider the idea that the core curriculum of critical care is one that can be shared by many subspecialties, including medicine, surgery, anesthesia, neurology and emergency medicine.

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Too much to read! Electronic Tools for Knowledge Management

Litell_2014In an earlier newsletter contribution, I discussed the strong and growing presence of critical care and emergency medicine on the social media landscape. Of particular interest is the evolving discussion about the role of community peer review of content shared via social media. The phenomenon raises fascinating questions about how all of us--and especially trainees--access, filter, process, and retrieve information shared via these novel media. Part of what makes these new tools appealing is the sense of freshness and excitement they bring to our specialties, particularly for a new generation of trainees comfortable with engaging the world via social media.

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Finding Balance & the Prevention of Burnout

Emlet_2013“Do what you love, love what you do.”

Despite this, many physicians find themselves in the early and middle stage of their career wondering how they are experiencing burnout. Unfortunately burnout can happen despite an individual performing work that they love to do, and occurs at a greater frequency in high-intensity care-giving professions (examples: chaplains, physicians, nursing). EM-CCM physicians are simultaneously at risk for burnout due to often answering professionally to multiple bosses in 2 disparate clinical or administrative roles. At the same time, if balanced carefully, a dual career in EM and CCM can naturally protect against the burnout that might occur in 2 high-intensity fields. Physician wellness is an important consideration in the practice of EM, and has been long recognized in EM that education, practice, and attention in burnout prevention is necessary.

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Fellowship Review - Emory University Critical Care Medicine Fellowship

Specialty certification pathway: Anesthesia
Length of fellowship: Two years
Number of fellows: 1-3
Curriculum: (1 month blocks) 

Spotlight your Critical Care fellowship with us!
Contact Raghu Seethala

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Critical Care Board Exam Calendar

Critical Care Board Dates at a Glance! 

Application Cycle, Exam and Practice Path Dates for Internal Medicine, Anesthesia, Surgery and Neurocritical Care Pathways.

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The Unit Team

The editorial staff is looking for the following contributions for upcoming ACEP-CCM Newsletters:
•  News
•  Point-Counterpoint Articles
•  Tips and Tricks

Please send your story ideas to Raghu Seethala.

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