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Clinical Focus Hypothermia on Demand

Now you can experience the educational content from the Society of Critical Care Medicine’s (SCCM) 2010 Clinical Focus hypothermia conference from the comfort and convenience of your home or office. Clinical Focus On Demand features the lectures presented in April 2010 at SCCM’s Clinical Focus conference, Keeping it Cool: How to Implement Hypothermia in Your Clinical Practice.

As a subscriber, you can access the entire Clinical Focus program as if you were there. With searchable slide presentations and synchronized speaker audio for every lecture, you can access one particular lecture or all the presentations from the meeting’s many distinguished faculty, as many times as you wish.

Course Overview

The American Heart Association has been recommending the use of therapeutic hypothermia since 2003. A growing percentage of hospitals around the world include hypothermia therapies in their standard practice of care for patients suffering from cardiac arrest. Many expert clinicians expect that all hospitals will eventually adopt this practice.

Although therapeutic hypothermia has many potential uses in critical care, from the adult to the newborn, it also poses many challenges. Optimized management of critically ill and injured patients who are cooled requires discussions related to timing, duration, re-warming, and the impact on coagulation, infection control, and drug metabolism and interactions. Furthermore, successful administration of therapeutic hypothermia requires precise interaction among the entire medical team, making it essential for all critical care practitioners to receive training and stay apprised of the latest advances in this treatment.

This conference will focus on the clinical aspects of developing, implementing and performing hypothermia protocols in adult and pediatric intensive care units (ICUs).

Learning Objectives:

• Determine when it is appropriate to use hypothermia on a critically ill patient
• Describe how to implement a hypothermia program
• Formulate a persuasive position to facilitate administrative buy-in for hypothermia use
• Develop hypothermia policies and procedures
• Recognize specific ICU clinician roles and protocols for patient care during and after hypothermia
• Discuss the application of different hypothermia devices
• Manage common complications arising from hypothermia in a critically ill patient
• Measure the effectiveness of outcomes when hypothermia is implemented
• Identify the tools used in hypothermia (e.g., insulin management, ventilation care, basic critical care management)
• Manage the setup a hypothermia unit

Presentations:

Therapeutic Hypothermia Introduction
Speaker: Stephen Trzeciak, MD
Description: This presentation provides an overview of the historical perspective of targeted temperature management (TTM)/therapeutic hypothermia (TH), its use as a potential mechanism for neuro-protection and its physiological effects, Emphasis is placed on the use of TTM/TH in cardiac arrest patients.
Run Time: 45 minutes

Who Should Be Cooled? Adult Patients
Speaker: Sergio L. Zanotti-Cavazzoni, MD, FCCM
Description: This presentation provides information and clinical trials that indicate which adult patients are most likely to benefit from TTM.
Run Time: 45 minutes

Who Should Be Cooled? Pediatric Patients
Speaker: Seetha Shankaran, MD
Description: This presentation provides information and clinical trials that indicate which pediatric patients are most likely to benefit from TTM. Specific cases are discussed that help to identify specific selection criteria.
Run Time: 45 minutes

Consensus Conference Findings on Therapeutic Hypothermia
Speaker: Mark E. Nunnally, MD
Description: This presentation provides an overview of the findings from the 11th International Consensus Conference (ICC), Therapeutic Hypothermia- To Cool or Not to Cool, held in February 2009 in Puerto Rico. The purpose of the ICC was to identify a systematical appraisal of available data, synthesize expert opinions, garner enthusiasm for the procedure, and generate a “state of knowledge” document. A status update on the “state of knowledge” document also is provided.
Run Time: 45 minutes

Induction of Hypothermia
Speaker: Samuel A. Tisherman, MD, FCCM
Description: This presentation discusses techniques and equipment (e.g., IV fluids, surface cooling devices and invasive cooling devices) that are used in the cooling procedure. Primary cooling methods (e.g., IV solutions and ice bags), surface cleaning (e.g., helmets and cooling blankets), the use of intravascular devices, and basic cooling parameters also are discussed.
Run Time: 40 minutes

Additional Considerations During Induction
Speaker: Clifton W. Callaway, MD
Description: This presentation continues the discussion of induction expanding on the special considerations, alternative treatment options, potential complications, and the treatment of these complications. Special emphasis is placed on controlling shivering and where to measure the temperature for the most accurate reading.
Run Time: 40 minutes

Important Factors to Consider During the Maintenance Phase of TTM
Speaker: Mark E. Nunnally, MD
Description: This presentation discusses the length of time patients should be cooled, the techniques and equipment essential for monitoring the patient during the cooling procedure and potential adjustments to the procedure and equipment if complications arise.
Run Time: 40 minutes

Pharmacological Considerations in the Patient Undergoing Therapeutic Hypothermia
Speaker: Samuel M. Poloyac, PharmD, PhD
Description: This presentation discusses the clinical applications to TTM, the pharmacokinetics and pharmacodynamics approaches to TTM and the implications these drugs may have on the patient from induction through re-warming.
Run Time: 40 minutes

Re-Warming Patients After TH
Speaker: Clifton W. Callaway, MD
Description: This presentation describes the steps used in the process of re-warming the patient to prevent complications. The presenter stresses the importance of re-warming slowly and in a controlled environment.
Run Time: 40 minutes

Neurological Prognostication in the Era of Therapeutic Hypothermia
Speaker: Sergio L. Zanotti-Cavazzoni, MD, FCCM
Description: This presentation provides information on the neurological prognostication post-cardiac arrest using hypothermia.
Run Time: 40 minutes

Kids Are Not Little Adults
Speaker: Seetha Shankaran, MD
Description: This presentation describes the differences between TTM techniques performed on children versus those performed on adults. Specific information is presented regarding drug interactions, duration and re-warming techniques.
Run Time: 40 minutes

Development and Implementation of a TH Program in Your Institution: Physician Perspective
Speaker: Clifton W. Callaway, MD
Description: This presentation provides physician-related specific elements that should be included in the protocol development (e.g., what rhythm will be cooled, where will cooling be implemented, what is the goal temperature, what is the cooling duration) Within each element parameters are given that each individual institution can use as a definer for the elected protocol element. This is a follow-up to the workshop session presented at the live event entitled, Development of a TH Protocol.
Run Time: 30 minutes

Development and Implementation of a TH Program in Your Institution: Nursing Perspective
Speaker: Nicole L. Kupchik, CCRN, RN, MN
Description: This presentation provides nursing-related specific elements that should be included in the protocol development (e.g., what rhythm will be cooled, where will cooling be implemented, what is the goal temperature, what is the cooling duration) Within each element parameters are given that each individual institution can use as a definer for the elected protocol element. This is a follow-up to the workshop session presented at the live event entitled, Development of a TH Protocol.
Run Time: 30 minutes

Post-Cardiac Arrest Care: Adjuncts to TH
Speaker: Stephen Trzeciak, MD
Description: This presentation is specific to the use of TTM after a cardiac arrest event. Discussion focuses on the use of hypothermia to improve neurologic outcomes in comatose cardiac arrest survivors and to decrease mortality.
Run Time: 30 minutes

New Horizons in TH
Speaker: Samuel A. Tisherman, MD, FCCM
Description: This presentation discusses potential future uses for hypothermia in areas of brain injury, trauma, spinal cord injury, hemorrhagic shock, and more. Included in this presentation is information on Emergency Preservation and Resuscitation (EPR).
Run Time: 30 minutes

Clinical Focus on Demand is available for purchase in the SCCM online store. The registration rate for SCCM members is just $145 ($195 for nonmembers). Once you’ve purchased Clinical Focus on Demand you will access it by logging into My SCCM with your User ID and Password.