FICE Accreditation – past, present and future

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Marcus Peck (@ICUltrasonica), Consultant Intensivist, Frimley Park Hospital, & FICE Chair, discusses the history and growth of FICE and what exciting developments will be coming in the future.  

The first time I saw a heart move I was captivated, and I knew immediately that echocardiography and ultrasound would make a huge impact on intensive care medicine.

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Advanced Critical Care Practitioners. Time for action.

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Carole Boulanger, an Advanced Critical Care Practitioner (ACCP), discusses the role and how regulation is as equally important to ACCPs as it is to Physician Associates, and therefore the best way forward for the profession.

The Advanced Critical Care Practitioner (ACCP) has become a workforce solution for critical care units and is fully supported by the Faculty of Intensive Care Medicine (FICM) and the Intensive Care Society (ICS). The role developed from clinical need and provides a career option for nurses and allied health professionals (AHPs) wishing to choose clinical progression, rather than management or education; thereby keeping experience at the bedside.

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JICS is listed in PubMed .

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 The Society’s journal, the Journal of the Intensive Care Society, has achieved the milestone of a PubMed listing.  Jeremy Groves considers the background and implications of the decision.

The Journal of the Intensive Care Society (JICS) has always had a bit of a place in my heart.  Not only has it published a couple of my articles (astute, discerning editors) but it is readable too.  The format is light and airy, it has a wide variety of papers and individuals from all the disciplines within our speciality contribute.

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#FiftyScansInFiftyDays – My journey through FICE Accreditation

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 Dr Nitin Arora (@aroradrn), Consultant Intensivist at Heart of England NHS Trust, discusses his journey in attempting to complete #fiftyscansinfifty days and offers advice to those undertaking the FICE accreditation.

Over the last few years, FICE has become the de-facto standard bedside focused echo accreditation for UK intensive care. Having tried and failed to complete my FEEL logbook as a registrar in 2012, I decided I’d try again as a consultant. After 2 years, a business case and having trialled various machines, our 2 new machines finally arrived in April 2017, and I immediately set about finding a FICE course.

Day 1 (FICE Course)

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The Beginning of the End?

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Dr Gary Masterson, President of the Society, reflects on how changes in the way critical care is commissioned may impact on critical care bed provision.

There have always been (and always will be) bed pressures in critical care. I don’t know about you, but I find this the most stressful aspect of my job. However, over the last 20 years of my working life as a consultant, when I have had the misfortune of stumping around my hospital’s general wards, I am always extremely glad to return home to my critical care unit. The general wards struggle: they’re jam-packed with elderly and frail patients with nowhere else to go, grossly understaffed, chaotic and little in the way of continuity of care. You know what I mean. In critical care, we don’t suffer these problems to the same extent and, since the advent of critical care networks and a more regional approach to managing critical care beds, we can usually cope when bed are short.

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The press, medical information, ethics and money

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Jeremy Groves reflects on some of the wider issues arising from the tragic case of Charlie Gard.

I have already written about something the adult critical care community can take away from the tragic case of Charlie Gard; however, I think there are several other issues that we can mull over.  Charlie and his parents’ plight captured the public’s attention and everyone had a view, as I discussed before, informed or otherwise.  To me it was striking how much of the discussion, and presentation of clinical information, took place in the press.

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Life support for critical care staff

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Dr Linda Jayne Mottram, Intensive Care Consultant at Belfast HSC Hospital discusses the crucial importance of maintaining clinicians mental wellbeing in the current medical culture.

Basic life support algorithms start with the premise that clinicians check for danger before approaching the patient.  The rationale being that if you are injured by something in the environment, you will be of little practical use to a patient in extremis.   The same logic applies to scene safety in prehospital medicine. No one questions your commitment to the patient by protecting yourself first, because it makes common sense to do so.  You have to be free from injury in order to provide any meaningful assistance.

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Rehabilitation after critical illness in adults

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Gillian Sharpe, Lead Critical Care Physiotherapist, Chesterfield Royal Hospital, welcomes the update on NICE Quality Standard CG83 and the increased focus on rehabilitation of the critically ill it will bring.

Historically, mortality rates have been the main indicator of success following critical illness. Healthcare professionals working with the critically ill however, have long recognized that many of those who survive are left with significant physical and non-physical morbidity and often face a lengthy convalescence.

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A lesson from little Charlie

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Dr Jeremy Groves reflects on one implication that the case of Charlie Gard has in adult critical care.

The Charlie Gard case has been the dominant medical story over the last few months.  One cannot but have extreme sympathy for Charlie’s parents who fought valiantly to give their son a chance in life. It was a personal tragedy, played out on social media and in the press, where the pope, presidents, politicians and pundits all had a view and expressed it, informed or otherwise.

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Fasting our patients in the critical care unit. How can we get it right?

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Ella Segaran, Advanced dietitian for Critical Care, Imperial College Healthcare NHS Trust and Chair of the NAHP committee of the ICS, considers barriers to achieving nutritional targets in critical care and proposes some solutions.

On average critically ill patients only receive 50-60% of their nutritional target. As a critical care dietitian this causes me considerable frustration. I perform a detailed nutritional assessment, develop a feeding plan only to find the system is working against me. Underfeeding is associated with more infections and longer ICU and hospital stay. We know if we get it right and achieve more than 80% of the target we decrease mortality and ventilator days.

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