Brain Death Education for Neurology Residents
The purpose of the study is to investigate the variability to which residents are exposed to brain death during their training in ACGME-accredited Adult Neurology Residency Programs across the U.S. This survey will provide a needs assessment for standardization in resident brain death curriculum and competency evaluation. This survey will provide a needs assessment for standardization in resident brain death curriculum and competency evaluation.
Duration: <5 minutes
Audience: All Members
Contact: Rachel Beekman
Survey Closes: August 31, 2024
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Free VPA TDM Practices
Valproate (VPA) is commonly used in critical care, including both neurocritical care and in other critical care subspecialties. VPA has a narrow therapeutic index and can cause a number of important toxicities if patients are exposed to excessive VPA concentrations. A total VPA concentration goal of 50-100 mg/L is commonly used as a "therapeutic" range, but VPA protein binding is significantly altered in critically ill patients and patients may be excessively exposed to high free VPA concentrations within this total range. Despite rates of discordant free/total VPA concentrations (i.e. the qualitative interpretation of the free and total VPA concentration differs) in ICU patients being reported to be up to 70%, little evidence explores how ICU clinicians approach free VPA therapeutic drug monitoring (TDM) or if clinicians are even aware of the role of free VPA TDM in the ICU. This survey seeks to characterize current practices of free VPA TDM and ICU clinician opinions of the value of free VPA TMD in the ICU.
Duration: 12 minutes
Contact: Andrew Webb
Survey Closes: August 31, 2024
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Exploring the Impact of Medication Confounders on Determining Death by Neurologic Criteria: An International Survey Investigating Practice Variation
The purpose of this survey is to elucidate current practices and perceptions surrounding medication confounders in brain death determination. Specifically, this survey seeks to understand:
- Who may be the individuals assessing potential drug confounders in brain death determination.
- Whether there is a formal or informal guideline or institutional policy/procedure that encompasses potential drug confounders in brain death and how to account for them.
- Whether a requirement exists for medication review prior to brain death determination.
- Whether ancillary testing, reversal agents or serum drug concentrations are utilized in patients in whom a medication confounder may be a concern.
The targeted audience for this survey is physicians, advanced practice providers, pharmacists and nurses who practice at institutions where patients may undergo brain death determination.
Duration: 10 minutes
Contact: Devin Holden
Survey Closes: August 31, 2024
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How do you manage non-survivable head trauma?
While there is literature regarding communication with families and medical management of those who have been declared brain dead,
our purpose is to further investigate the way in which providers approach this unique situation of non-survivable patients, and how this
might affect downstream medical management.
Much of the existing literature focuses on strategies for providers to communicate with families whose loved ones have been declared
brain dead. While we are more focused on the gray zones of non-survivable injuries without the diagnosis of brain death, these
resources lay out a groundwork for counseling families of patients with the most extreme of neurological injuries. Therefore, we
designed our survey to include questions that explore how similar communication styles may play a role in management of these
patients. Additionally, because the physician’s own experience can impact their decision-making in these situations, we included
questions that explore physicians’ perspectives and comfortability in these situations. A key point we wanted to learn about is what
barriers may be in place between providers and patients’ families, and how this may play a role in overall patient care. We used
RedCap survey software to design a survey exploring these points of interest.
Duration: 10 minutes
Audience: Restrict to MDs, APPs, U.S., International, Trainees
Contact: Mackenzie Castellanos
Survey Closes: August 31, 2024
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Blood transfusion thresholds in patient with acute spinal cord injury: A national practice pattern survey
The primary objective of this study is to investigate the hemoglobin level target and transfusion practices in patients with acute spinal cord injury among different medical specialties involved in their care. The secondary objectives include evaluating MAP augmentation practices, monitoring spinal cord perfusion pressure (SCPP), and assessing the willingness of healthcare providers to participate in future clinical trials.
We have chosen a national survey design to evaluate the perspectives of various medical professionals involved in the acute care of SCI patients. This approach is appropriate given the paucity of prior research in this topic, as it will provide a starting point to proceed with further research and explore the awareness and practices of healthcare providers.
2 Primary Objective:
The primary objective is to investigate the hemoglobin level target and transfusion practices in patients with acute spinal cord injury among the different specialties involved in their care.
2.1 Primary endpoint:
- Hemoglobin level target in patients with acute SCI
2.2 Secondary objectives:
- MAP augmentation practices (due to similar pathophysiology)
- Monitoring spinal cord perfusion pressure (SCPP)
- Willingness of healthcare professional to randomize their patients in future clinical trials
Duration: 10 minutes
Audience: Restrict to MDs, Restrict to Trainees (fellows, residents, medical students)
Contact: Mohamed Alhantoobi
Survey Closes: August 31, 2024
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