Critical Connections - CACCN Toronto Chapter

Fall 2015 Newsletter Critical Connections CACCN | Toronto Chapter Donec
5
“Anyone who stops learning is old, whether at twenty or eighty. Anyone who keeps learning stays young.” -­‐ Henry Ford In this issue: v Welcome from the President v Dynamics’ 2015 Recap v Pump Smart, Not Harder v ICU Diaries v Latest Research v Upcoming Events v ACLS Certifiction v Word Puzzles v Contact Info Greetings from the Toronto Chapter We would like to take this opportunity to welcome all new members to our chapter, as well as thank all of those who renewed their membership after expiration. We appreciate your continued support. The Canadian Intensive Care Week was a few weeks ago. A big thank you to all the critical care nurses across the nation for your commitmenet and dedication to providing care for the critically ill across the country. You play an invaluable role in maintaining the lives of Canadians. CACCN | Toronto Chapter Fall 2015 Newsletter A Message from the President Toronto Chapter Executive Members Ingrid Daley Interim President Raajpreet Sekhon Secretary Veronica Dekker Treasurer Teresa Robitaille Membership Coordinator Christine Wong Education/Evolutions Coordinator Natasha Yeates Pediatrics Coordinator Diana Heng Newsletter Editor Jo-­‐Ann Fernando Website Coordinator Greetings to our CACCN Toronto Chapter community of critical care nurse members. Fall is here and winter will be arriving soon. Your executive team is working hard to provide up to date critical care information to keep our members energized and rejuvenated. Please continue to access our Toronto Chapter page for updated information on conferences, critical care news and any general updates from National. Please join me in welcoming your 2015-­‐2016 Toronto Chapter Executive Committee: Diana Heng, Christine Wong, Teresa Robitaille, Veronica Dekkar, Natasha Yeates, Jo-­‐Ann Fernando & Raaj Sekon. We are looking forward as your Executive team to continue to engage your mind, bring awareness to our/your critical care community, and providing networking through our Facebook & Twitter page. Diana, our Editor Coordinator, continues to bring a fresh new look to our Newsletter, with educational and informational updates. Christine our Evolutions/Education Coordinator along w ith the rest of your executive team is in the early stages of planning our 2016 Evolutions Conference on Monday, May 2nd, 2016. Please stay tuned!! All of the Executive Committee members are working hard to ensure we captivate your attention in sharing of information, knowledge and ensuring our Chapter stays strong with continued growth. The Toronto Chapter Executive wants to continue to grow our membership, so please encourage your colleagues to visit our website at www.torontocaccn.ca and to consider joining. We are working towards Chapter of the Year at Dynamics 2016, so please encourage your colleagues to become a member as your Executive Committee continues to aim for excellence and increase knowledge so we can continue to advocate for our patients and families. I would like to take this opportunity to thank all our members and non-­‐
members in supporting our Toronto Chapter and the CACCN organization as a whole. It is with great pleasure that I am part of this critical care organization/community. Sincerely, Ingrid Daley “Teamwork -­‐ By working together, ordinary people can achieve extraordinary results” Page | 2 CACCN | Toronto Chapter Fall 2015 Newsletter CACCN Dynamics in Winnipeg, Manitoba Dynamics 2015 in Winnipeg, Manitoba kicked off with a glance of Metis culture from a heart-­‐racing performance by the Norman Chief Memorial Dancers. It was followed by an inspiration and emotional talk by Kristin Millar, a feisty 28-­‐year-­‐old that spoke about her experience with sudden heart failure, a series of strokes, having to be on LVAD as a teen, and eventually receiving heart transplant. I knew then and there that the next three days would be nothing short of innovative presentations, and a thrilling opportunity for Critical Care Nurses from all over the country to connect with one another, and share their experience and expertise. From management of gushing G.I. bleeds, to gruesome but yet captivating pictures of purulent sputum to demonstrate acute respiratory failure, the array of topics presented were endless! Let’s not forget about the controversial discussion surrounding physician-­‐assisted suicide in Canada, as it will be soon legal on February 6, 2016. Participants indulged in hor d’oeuvres at the ‘Imagine the Possibilities’ poster reception, allowing Critical Care Nurses from Canada, U.S.A., and even South Korea, to showcase their Quality Improvement, and professional practice projects. As we all know, nurses work hard, but they play hard as well! Those that attended the annual dinner ‘Rock the Peg’, as well as the Spacelabs social at Shannon’s Irish Pub had the opportunity to kick-­‐back, relax, and have some fun, and may have even danced a little! The closing speaker, Stephanie Staples, reminded us all that to do good, we must feel good, and we can only do so by having a good balance between work and life. The conference closed with a video invitation to Charlottetown, P.E.I., the town filled with kind spirited people, Victorian architecture, and delicious seafood. With much anticipation and enthusiasm, I hope to see all of you in Charlottetown, P.E.I. for Dynamics 2016! Sincerely, Christine Wong CACCN Member, Toronto Chapter Executive Page | 3 1
2
CACCN | Toronto Chapter Fall 2015 Newsletter “Pump Smart, Not Harder” This year, we at the CACCN Toronto partnered with Baxter for our complimentary Dinner and Learn 'Pump Smarter, not Harder: Smart Pump implementation at a Large Teaching Hospital'. The event kicked off with networking of our Toronto Chapter members over hor-­‐d'oeuvres and wine, allowing us to share our practice experience with different I.V. infusion devices at our own perspective hospitals. A delicious three-­‐course meal was served, with the star being the grilled New York strip and creme brûlée! Krista Shea, the Clinical Educator, of Critical Care at London Health Sciences, presented her experience, and the processes taken to facilitate the successful implementation of a Smart Pump hospital-­‐wide. Implementation approach, qualitative and quantitative data, and the strategies to facilitate progressive culture change was presented, along with perspective and ongoing quality improvement projects stemming from the implementation. I am sure all of you will agree that nothing is better than enjoying a complementary meal at a fine dining restaurant in Toronto, while learning about the use of technology to ensure more efficient and safe patient care! The event was truly a great success! Much thanks to all the Toronto Members that attended, as well as Baxter for partnering with us. Stay tuned for future exciting educational events! THANK YOU
FOR A FANTASTIC EVENING!
Page | 4 1
2
CACCN | Toronto Chapter Fall 2015 Newsletter Have You Heard of ICU Diaries? The rise of reflective journaling/diary was first seen in the 1980’s in the Nordic states, such as Denmark and Sweden. Brief notes were jotted down regarding events that occurred within the critical care environment in regards to the patients status and day to day activities that occurred (Phillips, 2011). Nurses as well as patient’s family members often made these entries into the ICU diaries. The theory behind this intervention was to keep a note of chronically events that occurred to the ICU patient, as a form of evidence of events, this would allow patients to remember or fill in the gap of the “loss time” and “memories”, which they often experience post ICU discharge (Nortvedt, 1987). Research studies conducted by Griffiths and Jones (2007) noted that 25% of patients who are medically managed in the ICU have severe psychological problems. Often these ICU patients state no factual recall of their time in the ICU but suffered vivid delusional memories of ICU events. Granja et al. (2005)’s research indicated a connection between memory disturbance and impaired quality of life after a critical event. Moreover, Ringdale et al., (2006) found that individuals, who were delirious during their ICU admission often reported feelings of panic and anxiety after their hospital discharge. Recently, many programs have been development to focus on the long-­‐term psychological impact of ICU post traumatic stress disorder, some of these programs include ICU diaries (Combe, 2005; Roulin et al., 2007). Therefore, the use of written diary in the ICU, which has been adopted in many European countries, can serve as a therapeutic tool to help patients recover mentally and physically. By: Raajpreet Sekhon & Maria Haley MSICU nurses at Toronto General Hospital Page | 5 CACCN | Toronto Chapter Fall 2015 Newsletter The Latest Research in Critical Care Are you up-­‐to-­‐date with the latest research in critical care? Check out some of these articles below! NEUROSURGERY AND TRAUMA Hypothermia for Intracranial Hypertension after Traumatic Brain Injury Andrews, Sinclair, Rodriguez et al. (published October 2015) Trial assessing the benefit of hypothermia on functional outcomes for patients with increased intracranial pressure following a traumatic b rain injury. http://www.nejm.org/doi/full/10.1056/NEJMe1513921 CARDIOVASCULAR Isosorbide Mononitrate in Heart Failure with Preserved Ejection Fraction Redfield, Anstrom, Levine et al. (published November 2015) Nitrates are commonly prescribed to enhance activity tolerance in patients with heart failure and a preserved ejection fraction. This study compared the effect of isosorbide mononitrate or a placebo on daily activity in such patients. http://www.nejm.org/doi/full/10.1056/NEJMoa1510774 MEDICAL SURGICAL Trials of Interrupted or Continuous Chest Compressions during CPR Nichol, Leroux, Wang et al. (published November 2015) During cardiopulmonary resuscitation (CPR) in patients with out-­‐of-­‐hospital cardiac arrest, the interruption of manual chest compressions for rescue breathing reduces blood flow and possibly survival. This study assessed whether outcomes after continuous compressions with p ositive-­‐pressure ventilation differed from those after compressions that were interrupted for ventilations at a ratio of 30 compressions to two ventilations. http://www.nejm.org/doi/pdf/10.1056/NEJMoa1500704 PEDIATRICS Defining Why Cancer Develops in Children Maris (published November 2015) There have been more than 100 cancer-­‐predisposition genes identified and our understanding of how common and rare DNA variations influence cancer susceptibility has also grown exponentially through the use of genomewide association studies. However, fundamental questions remain, n ot the least of which is how to use this information to improve human health. Cancer genomics can be applied to address the question of why cancer develops in children, especially in those without a family history of the disease. http://www.nejm.org/doi/full/10.1056/NEJMe1513921 Page | 6 CACCN | Toronto Chapter Fall 2015 Newsletter Upcoming Critical Care Conferences Jan. 10 – 15, 2016 5th Annual Winter Symposium in Intensive Care, Anaesthesia & Emergency Medicine Vail, Colorado, USA Mar. 1 – 5, 2016 13th Annual Canadian Critical Care Conference Whistler, BC Feb. 25, 2016 Interdisciplinary Trauma Conference U of T in partnership with St. Michael’s, Sick Kids & Sunnybrook Toronto, ON May 2, 2016 CACCN Toronto Chapter’s Evolutions Conference Toronto, ON May 17 – 21, 2016 National Teaching Institute (NTI) Critical Care Exposition New Orleans, Louisiana, USA May 21, 2016 William Osler’s Critical Care Strategies for the 21st century Brampton, ON June 2 – 3, 2016 Canadian Critical Care Review Program Toronto, ON Sept. 25 – 27, 2016 CACCN Dynamics Charlottetown, PEI Page | 7 CACCN | Toronto Chapter Fall 2015 Newsletter Are You ACLS Certified? ACLS certification will teach you how to: •
Provide effective basic cardiac life support, including optimal chest compressions and use of automated defibrillators •
Choose appropriate ACLS algorithms to manage patients with no pulse or those with unstable/stable bradycardia and unstable/stable tachycardia; •
Maintain a patent airway using basic and advanced techniques and equipment; •
Operate manual defibrillator/pacing devices in a safe manner; •
Act effectively as a resuscitation team member and leader. SIGN UP TODAY AT ANY OF THE ABOVE INSTITUTIONS! Page | 8 CACCN | Toronto Chapter Fall 2015 Newsletter Can you spot the word? Do the word search below! ADENOSINE
ANALGESIA
ANEURYSM
ATROPINE
CARDIOVERSION
DOBUTAMINE
EPINEPHRINE
FENTANYL
HEARTBLOCK
HEMORRHAGE
IMMUNOSUPPRESSION
INFECTION
MIDAZOLAM
PARALYSIS
PROPOFOL
ROCORONIUM
SEDATION
SEPSIS
TRANSPLANTATION
VENTILATOR
Page | 9 CACCN | Toronto Chapter Fall 2015 Newsletter Up for a Challenge? Complete the crossword below! Across
3. the tricuspid area and mitral area auscultation
4. pain signal is processed by the sensory cortex
of the parietal love
8. burn that involves the avascular epidermis
composed of stratified epithelial cells
12. protective measures developed by the CDC
13. the mechanical, thermal, or chemical stimuli that
damage tissues
16. the contraction period of the heart
17. accumulation of secretions and debris from an
injured pancreas
Down
1. the relaxation period of the heart
2. burn that involves the epidermis and part of the dermis
5. burn that involves the entire epidermal and dermal
layers
6. located between each rib
7. the secondary muscles of respiration
9. decreased fremitus indicates this
10. begins with the release of endogenous opioids, which
inhibit through the descending pathways, the
transmission of pain sensatio
11. used to determine the extent of burn wounds
14. complete absence of heart electrical activity
15. reverses opiod overdose
ANSWERS: 1. diastole 2. second degree 3. erbs point 4. perception 5. third degree 6. intercostal muscles 7. accessory
muscles 8. first degree 9. pneumothorax 10. modulation 11. rule of nines 12. universal precautions 13. transduction 14.
systole 15. naxolone 16. systole 17. pseudocyst
Page | 10 CACCN | Toronto Chapter Fall 2015 Newsletter CACCN Dynamics 2065 Conference at The Delta Prince Edward in Charlottetown, PEI Page | 11 CACCN | Toronto Chapter Fall 2015 Newsletter Toronto Chapter Executive Contact Information Interim President: Ingrid Daley Ingrid.Daley@uhn.ca Secretary: Raaj Sekhon Raaj.Sekhon@uhn.ca Treasurer: Veronica Dekker vdekker@haltonhealthcare.com Education/Evolutions Coordinator: Christine Wong christinewong33@gmail.com Membership Coordinator: Teresa Robitaille gtrobitaille@rogers.com Newsletter Editor: Diana Heng Diana.Heng@uhn.ca Pediatrics Coordinator: Natasha Yeates natashayeates77@gmail.com Website Cooordinator: Jo Ann Fernando Jo-­‐Ann.Fernando@nygh.on.ca CACCN Toronto Chapter P.O. Box 79660 1995 Weston Road Toronto, ON, CAN Page | 12