For the past couple of days I have been busy taking a FCCS (Fundamental Critical Care Support) certificate course at Tampa General Hospital. It was a great experience in many ways. This course is directed towards hospital physicians who are non intensivist. The goal is to emphasize what needs to be done for patients who are in a critical state and what kind immediate critical support they need for survival in the first few hours when a critical care physician is not available. Dr Luis Llerena, a trauma surgeon conducted this course. His way of teaching was excellent and I would strongly advise other colleagues to attend his courses.
This is specially helpful for our group which is moving towards a 24/7 scheduling and with plans to be available for code blues and rapid response situations. I believe that in the next 5-6 months we should be able to provide this service. As I mentioned before in a previous post, that is is a natural progression of hospital medicine otherwise hospitalist would be glorified internist.
The picture above shows an algorithm based on a study Dr Emanuel River, dealing with goal directed therapy in the treatment of sepsis, published in New England Journal of Medicine. This study gives a very simple protocol for a very complicated problem. There are numerous times we see patient being treated for severe sepsis with vasopressors alone with intravenous fluid boluses.
All in all it was very educational and informative.