Biography:

Tim Collins has 20 years of experience in Critical Care. He holds the position of Consultant Nurse, Lead Nurse, Charge Nurse, ICU Educator and Senior Lecturer. He is currently a British Association of Critical Care Nurses (BACCN) elected national board member and Editorial Board Member of Nursing in Critical Care Journal (Wiley). He has given a number of presentations at European & international conferences and has published a number of papers in peer reviewed journals and book chapters. He completed his Doctorate Degree and MSc in Critical Care. He is an Instructor in both Adult and Pediatric Advanced Life Support. His interests include Sepsis, Clinical Shock, Vascular Access, Resuscitation, Organ Donation and Hemodynamic monitoring. 

Abstract:

Overview: This presentation will use an interactive case study approach to discuss the use of delivering evidence based sepsis interventions through intraosseous (IO) access.  The presentation will evaluate the evidence behind the use of achieving fluid resuscitation, antibiotic administration and IO sampling in a hypotensive difficult vascular access critically ill sepsis patient. Published literature will be innovatively evaluated and woven into the clinical case study.  This will refer to the recently published 2016 revised International sepsis guidelines that recommend the use of IO in providing an alternative route for administering antibiotics and fluids that achieves comparable antibiotic plasma concentrations compared to IV.

Originality: Originality will focus on the use of achieving sepsis management through the IO route where conference papers nearly exclusively concentrates upon IV or central venous approaches in sepsis management. IO vascular access is traditionally viewed as an intervention reserved for cardiac arrest however this presentation will challenge this concept in providing novel approaches to delivering time critical sepsis treatment through the IO route.

Applicability to Critical & Emergency Care: Sepsis is one of the most frequent causes of clinical deterioration that often requires critical care intervention and admission.  All critical care & emergency providers need to have the knowledge and skills to effectively treat sepsis patients.  Sepsis patients require early vascular access and treatment and this presentation will share with practitioners that the IO route is an effective alternative to IV use in the critically ill patient with sepsis

Impact for improving patient care: Globally Sepsis is one of the major avoidable deaths. The evidence shows that delays in antibiotic administration & fluid therapy increases mortality.  In difficult vascular access situations, the IO route can provide a timely alternative to IV access to ensure that antibiotic and fluid resuscitation is commenced early that will provide direct improvements to patient mortality and morbidity from sepsis. The presentation will challenge practitioner’s perceptions that IO can provide an effective alternative to IV access in the critically ill. 

Biography:

Alessandra Falco has completed her PhD in Social and Personality Psychology from Padua University. She is now Researcher and Adjunct Professor of Work and Organizational Psychology at Padua University. Her research areas are: (a) work-related stress risk assessment, with particular reference to the development of “integrated” tools, based on subjective, objective, and physiological indicators; (b) the role of specific individual and behavioral dimensions (workaholism, negative affectivity, mindfulness, PsyCap resources, perfectionism, presenteeism) in the etiology of organizational well-being/disease; (c) social marketing, communication and change, with particular reference to traffic psychology.               

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Biography:

Alessandro De Carlo has completed his PhD in Organizational Psychology at Università Cattolica of Milan and Cardiff University. He coordinates the Master of human resources management at LUMSA University of Rome and is the President of the Veneto Region Board of Psychologists as well as the Secretary of the National Board of Psychologists and chair of the Europsy Certificate Awarding Committee.

His research areas are: (a) organizational well-being and work-related stress risk assessment, organizational interventions aimed at reducing organizational disease and increasing performance; (b) etiology of organizational well-being/disease, workplace bulling; (c) social marketing, communication and change.

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Biography:

Md Yunus is an Emergency Physician from NEIGRIHMS, Shillong. He is the Head of Department of Emergency Medicine & Traumatology. He has put forward all the efforts to initiate, develop and establish the Department of Emergency Medicine in this part of the Country. His goal in life is to make available the emergency patient-care services to all the citizens of this country and that emergency care should be equal without delay, efficient and reasonably cost effective. He has keen interest in Bio-Medical Research & Academic in Medical Sciences. He is a renowned Trainer & Researcher being as Dean (Research) & Coordinator of Department of Medical Education at centre of Excellence which is also known as AIIMS of North-East which is designated as Autonomous Tertiary care Super specialty Medical Institute known as North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences (NEIGRIHMS), Shillong, Meghalaya under the Government of India (Ministry of Health & Family Welfare).

Abstract:

Biography:

Andreas Fette is an active Clinical Consultant Pediatric Surgeon. He has been working for many years in abroad in the field of Pediatric Emergency Surgery in developing countries. He has published more than 80 original papers, contributed to 18 book chapters and has been serving as an Editorial Board Member of medical journals. Investigations on the traumatized pediatric airway have been a main topic of his master’s thesis for his professorship in Pediatric Surgery.

Abstract:

Lesions of the pediatric airway are considered to be rare but always serious and challenging injuries. In many cases, they are nearly invisible or hidden behind other more sinister and more obvious trauma conditions. In other cases, the child seems to be pretty stable, before it suddenly shows rapid, unexpected and sometimes even fatal deterioration. Sometimes the trauma (and its sequelae) to the airway is clearly visible, but in due course the resulting impact is less problematic and the recovery is unspectacular. Regardless if seen first by a junior or senior doctor, the trauma to the airway is overlooked on scene in a number of cases and the child therefore is not transferred directly to the (urgently needed) specialist care. There are extremely various mechanisms of accident and etiologies of airway trauma making recognition of the leading clinical signs and key symptoms especially in children nearly impossible. But significant compromise of the child`s airway has to be considered anytime and our resulting emergency management is of key importance either to save the patient`s life or at least to prevent life-long sequelae. In this communication, we would like to share our experience and management strategies out of our case series to stimulate a discussion about how to deal with these rare but complex emergency medical situations.

Biography:

Linda L Herrmann has more than 20 years of Clinical experience providing care to older adults with acute neurological injury. Her research and clinical practice are closely intertwined. Her research examines “Recovery of older adults following traumatic brain injury”. Findings from her work propose provocative insights into the factors contributing to the recovery of older adults following a mild to moderate traumatic brain injury. These findings offer new knowledge to geriatric trauma with implications affecting clinical management, outcomes and health care policy.

Abstract:

This study describes the impact of modifiable variables (discharge destination and intensity of rehabilitation) on early functional recovery of adults 65 and older following mild and moderate traumatic brain injury (TBI). Previous studies demonstrate that greater intensity of inpatient rehabilitation in TBI patients contribute to improved rates of functional recovery; however, studies are limited by exclusion of/limited number of adults over age 65, and inclusion of patients who only received rehabilitation in the inpatient setting. Functional recovery was measured by clinician rated functional independence measure (FIM^TM) and by participant self-report using the river mead head injury follow up questionnaire (RHFUQ). The sample consisted of 70 community dwelling adults aged 65 and older hospitalized for a mild or moderate TBI. A descriptive longitudinal cohort design was used to explore discharge destination and trajectory of early functional recovery; intensity of rehabilitative services and their relative contribution to early functional recovery at two and six weeks post discharge. Correlations, regression, and repeated measures analysis of covariance (ANCOVA) were used. Major findings from this study indicate that intensity of rehabilitation significantly and positively affected the trajectory of recovery of motor function over time; greater improvement in motor and cognitive function was noted in the high intensity group; and, patterns of self-reported difficulties varied by intensity of rehabilitation. Severity of TBI and presence of co-morbidities were significant predictors of discharge destination to home or skilled nursing facility. The trajectory of recovery of motor function and self-reported difficulties in older adults following mild and moderate TBI is significantly affected by intensity of rehabilitation. Additional research is necessary to examine rehabilitation intensity as it occurs in all settings and its longitudinal effect on the trajectory of motor, cognitive and psychosocial recovery and are essential if losses are to be integrated meaningfully into a person’s daily life.