Fundamental Critical Care Support: Obstetrics

Janice L. Zimmerman, M.D., completed her medical training and residency in internal medicine, and a fellowship in critical care medicine at Baylor College of Medicine. Dr. Zimmerman previously was head of the Critical Care Division for the Department of Medicine at Houston Methodist Hospital. She was a professor of clinical medicine at Weill Cornell Medicine and the Institute of Academic Medicine at Houston Methodist Hospital and Texas A&M College of Medicine.

She is a Master of the American College of Physicians, Master of the Society of Critical Care Medicine and a Fellow of the Royal College of Physicians. She was awarded the Distinguished Service Award from SCCM in 2001 and 2013, the Joseph and Rae Brown Award in 2015, and the Safar Global Partner Award in 2017.

She served as the first woman president of the World Federation of Intensive and Critical Care from 2017 to 2021. She has been a member of the Surviving Sepsis Campaign Guidelines Committee since its inception. She was one of the originators of the Fundamental Critical Care Support course for SCCM.

In 2024, she was the recipient of the Lifetime Achievement Award, one of the highest honors of the Society of Critical Care Medicine. She regularly teaches at regional, national and international critical care meetings and board review courses and publishes peer-reviewed articles and book chapters.

Thursday, Oct. 24

9 a.m. – Welcome and Course Introduction

Continental breakfast will be provided.

9:35 a.m. – Physiologic Changes During Pregnancy

Physiology of normal pregnancy and how it differs from the nonpregnant state will be described, and how this may affect recognition and management of critical illness will be addressed.

10:15 a.m. – Hemodynamic Monitoring

Risks and benefits of various means of hemodynamic monitoring will be discerned.

Attendees will be able to identify situations where advanced monitoring techniques are indicated.

11 a.m. – Airway Management in the Pregnant Patient

Alterations in the airway during normal pregnancy and pathologic conditions such as preeclampsia; risk of, and approach to, the difficult airway in pregnancy; and management of mechanical ventilation during pregnancy will be discussed.

11:15 a.m. – Break

11:30 a.m. – Preeclampsia/Eclampsia

Attendees will be able to describe the hypertensive diseases of pregnancy, the underpinning causes, and management, including both medical/pharmacologic and obstetric management.

12:15 p.m. – Mechanical Ventilation

Etiologies for respiratory failure in pregnancy will be addressed along with mechanical ventilation techniques in pregnancy and management of ARDS in pregnancy.

1 p.m. – Lunch (provided)

1:30 p.m. – Maternal Mortality and Cardiac Arrest

Cardiorespiratory arrest in pregnancy requires consideration of not only the fetus but the role the gravid uterus plays in impeding CPR. Emergent cesarean delivery is a component of resuscitation for both the mother and fetus.

2:15 p.m. – Rotation of Three Skills Stations

• • • 2:15 p.m. – Skill Station: Mech Vent
    • 3 p.m. – Skill Station: Cardiac Arrest in the Pregnant Patient
    • 3:45 p.m. – Skill Station: Management of Severe Preeclampsia and Eclampsia

4:30 p.m. – Sepsis in Pregnancy

Sepsis, increasingly a factor in severe acute maternal morbidity and maternal mortality, may arise from obstetric or nonobstetric sources. Definitions, risk factors and management will be described.

5:15 p.m. – Closing remarks

5:30 p.m. – Adjourn

Friday, Oct. 25

8 a.m. – Thromboembolism Disease and Pregnancy

Continental breakfast will be provided.

Deep venous thrombosis, including lower extremity and pelvis, and pulmonary embolus, is a well-appreciated complication of pregnancy. Diagnosis, implications and management will be reviewed.

8:30 a.m. – Neurocritical Care in Pregnancy

9 a.m. – Obstetrical Hemorrhage

Antepartum and, especially, postpartum hemorrhage contribute significantly to maternal mortality figures. This lecture reviews risk factors, preparations if hemorrhage is anticipated, and treatment modalities, including pharmacologic, mechanical and surgical approaches.

9:45 a.m. – Cardiac Conditions in Pregnancy

10:15 a.m. – Pregnancy-related Acute Kidney Injury

Acute renal failure can be a consequence of a number of obstetric conditions. The precipitants, classification, diagnosis and management will be reviewed.

10:45 a.m. – Management of Delivery and Newborn

Delivery in the ICU, while not common, may occur. Management of delivery and the immediate steps of newborn assessment and care will be discussed.

11:15 a.m. – Fetal Evaluation and Fetal Concerns in the Seriously Ill Pregnant Patient

The fetus may be a bystander when the mother is critically ill; concerns about fetal safety and well-being should not be allowed to delay care. Issues of fetal circulation, placental function, pharmacology, diagnostic imaging and stages of fetal development will be discussed.

Noon – Lunch (provided)

12:30 p.m. – Transport of the Critically Ill Pregnant Patient

Transport of a critically ill pregnant patient, by ground or air, with attention paid to team selection and to equity of maternal and critical care concerns will be addressed.

1 p.m. – Nonobstetrical Surgical Diseases in the Pregnant Patient

Surgical conditions may be encountered during pregnancy, such as trauma, acute appendicitis, pancreatitis, cholecystitis or bowel obstruction. Identification and management of these conditions may be hampered by the fact of pregnancy.

1:45 p.m. – Trauma in Pregnancy

2:30 p.m. – Rotation of Three Skills Stations

• • • 2:30 p.m. – Skill Station: Trauma
    • 3 p.m. – Skill Station: Postpartum Hemorrhage
    • 3:30 p.m. – Skill Station: Delivery and Neonatal Resuscitation

4 p.m. – Break

4:15 p.m. – Course Wrap-up and Post-test Discussion

5 p.m. – Adjourn

Lecture content is consistent with requirements of the Society of Critical Care Medicine.

Details coming soon!

Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by AXIS Medical Education and MHA Health Institute. AXIS Medical Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the health care team.

This activity was planned by and for the health care team, and learners will receive 5.0 Interprofessional Continuing Education (IPCE) credit for learning and change.

Credit Designation for Pharmacists
This knowledge-based activity is approved for 1.0 contact hour each of continuing pharmacy education credit.

PENDING

AXIS Contact Information
For information about the accreditation of this program, please contact AXIS at info@axismeded.org.

Disclosure of Relevant Financial Relationships
AXIS Medical Education requires faculty, instructors, authors, planners, directors, managers, peer reviewers and other individuals who are in a position to control the content of this activity to disclose all personal financial relationships they may have in the past 24 months with ineligible companies. An ineligible entity is any organization whose primary business is producing, marketing, selling, re-selling or distributing health care products used by or on patients. All relevant financial relationships are identified and mitigated prior to initiation of the planning phase for an activity.

AXIS has mitigated and disclosed to learners all relevant financial relationships disclosed by staff, planners, faculty/authors, peer reviewers, or others in control of content for this activity. Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation or activity. Disclosure information for faculty, authors, course directors, planners, peer reviewers, and/or relevant staff is provided with this activity.

The faculty reported the following relevant financial relationships or relationships they have with ineligible companies of any amount during the past 24 months.

Faculty	Relevant Financial Relationship(s)
Jim Eckler	Pending
Eugene S. Schneller, Ph.D.	Pending
Kari DiCianni	Pending
Linda Rouse O’Neill	Pending
Tim House	Pending
Steve Hoeger, CHEP	Pending
Greg Teale, PharmD., BCPS	Pending

 

The following directors, planners, managers, peer reviewers and relevant staff reported no financial relationships and no relationships they have with any ineligible company of any amount during the past 24 months.

Name of Directors, Planners, Managers, Reviewers and Staff

Margaret Alexander

Alex Shikles

Kara Amman-Kale

Robert Loseman

Greg Teale, PharmD, BCPS

Dee Morgillo, MEd, MT(ASCP), CHCP

Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information and comparison with recommendations of other authorities.

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.

Requirements for credit:  

• Attend/participate in the educational activity and review all course materials.
• Complete the CE Declaration form online by 11:59 p.m. ET Sept. 30, 2024. Instructions will be provided. If you do not enter the online portal by the above date, you will not be able to retrieve your statement of participation.
• Upon successful completion of the online form, your statement of completion will be presented to you to print. For pharmacists, your record will be automatically uploaded to CPE Monitor.

 

This educational activity is jointly provided by AXIS Medical Education and Missouri Hospital Association.

Please note that your registration request will be submitted to the organizer for approval. Upon approval, instructional materials will be sent to the email address indicated on the registration form.

A complimentary eBook also will be available upon registration and you may request a printed version by contacting Keri Barclay. 

If you have special needs addressed by the Americans With Disabilities Act, please contact the Missouri Hospital Association.

MHA Health Institute
P.O. Box 60
Jefferson City, MO 65102
Phone: 573-893-3700
Fax: 573-893-2809