New SCCM Guidelines: Rapid Sequence Intubation, Recognizing Critical Illness Outside the ICU, and Glycemic Control for Children and Adults

Sunday, January 21, 2024

4:30 PM – 5:30 PM MT

Location: North-120A

CE: 1.0

Concurrent Session Moderator(s)

Mary Reed, MD, FCCM

Geisinger Medical Center
Catawissa, PA
Douglas Naylor, Jr., MD, FACS, MCCM

Staff Intensivist
University Hospitals of Cleveland Medical Center
Novelty
Michael Sirimaturos, PharmD, BCCCP, FCCM

Administrative Specialist - System Critical Care Services Leader
Houston Methodist Hospital
Houston, Texas

Controversies and practice variations exist related to pharmacologic and nonpharmacologic emergency airway management during rapid sequence intubation in critically ill adult patients. Guidelines were developed to provide current, evidence-based recommendations to guide clinical practice. The guidelines panel included pharmacists, physicians, a nurse practitioner, and a respiratory therapist with experience in emergency medicine, critical care medicine, anesthesiology, and prehospital medicine. Ten population, intervention, comparison, and outcome (PICO) questions were deemed most clinically relevant by the panel. Using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, the panel issued one recommendation, seven suggestions, and two best practice statements. The panel also identified literature gaps that might be addressed by future research.

Early identification and prompt response to clinical deterioration among patients hospitalized outside the ICU offers the best opportunity to improve outcomes. Healthcare institutions use a variety of means to promptly detect patients at risk for critical illness, including education of bedside clinicians on pathophysiology of early decline and use of early warning criteria and scores to activate a designated response team. Speakers discuss evidence-based recommendations to guide clinicians and institutional leaders in implementing processes for their rapid response system to improve patient outcomes. These new guidelines sponsored by SCCM were endorsed by the American College of Emergency Medicine, Society of Hospital Medicine, and International Society for Rapid Response Systems.

Glycemic control remains pertinent to patient management but target ranges have not been well defined. This presentation will highlight key topics in the 2024 Glycemic Control Guideline for Adults and Pediatrics and new PICO statements relative to the 2012 Insulin Infusion Guideline. The methodology, considerations for special populations, and literature gaps will also be presented.

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Congress features sessions on a record-breaking number of new journal articles, guidelines, and research from SCCM and other leading medical journals. Find details here.

Learning Objectives:

Outline current guideline recommendations related to pharmacologic and nonpharmacologic management of critically ill adult patients undergoing rapid sequence intubation (RSI)
Discuss applications of the guideline recommendations to clinical practice of critically ill adult patients undergoing RSI
Apply evidence-based guidelines and expert panel recommendations to the design, operation, and evaluation of a hospital system to detect and mitigate patient harm from clinical deterioration outside the ICU
Identify evidence gaps, controversies, and opportunities for future research related to earlier detection of critical illness and more effective responses to patients outside the ICU, leading to reduced morbidity and mortality and improved patient family experiences
Describe optimal approaches to managing dysglycemia in critically ill adults and children
Describe the essential components of an insulin titration protocol

Presentations:

Guidelines: Rapid Sequence Intubation
Guidelines: Recognizing Critical Illness Outside the ICU
Guidelines on Glycemic Control for Critically Ill Children and Adults 2024