Dear Reader, Editorial Board. Dr Narendra Rungta MD, FISCCM, FCCM Editor, The Critical Care Communications President-Elect, ISCCM

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1 Critical Care Communications Book Your Dates for CRITICARE February 2011 New Delhi INDICAPS Next data collection date 13 th April 2011 Volume 5.6 Nov.-Dec., 2010 ISCCM News Headlines In this issue Critical Care Medicine recognized as a super-specialty by Medical Council of India. ISCCM News Headlines... 1 Editorial... 2 Gazette notification issued - path cleared for DM Course in Critical Care Medicine. From the Desk of the President... 3 Criticare 2011 at Vigyan Bhawan, New Delhi ready to receive you all. Hurry up! Register. Five day academic extravanza Message from International Personality - Dr. Pamela Lipsett, President SCCM Branch Activities... 4 Orations, debates, workshops, paper and poster competitions Top national and international faculty to give you the best in Critical Care Medicine Members' Achievment... 4 CRITICARE Do not miss!... 4 Scientific Program minute to minute - Criticare ISCCM day celebrated through out India with great enthusiasm - complete report inside Guest Author's Page - Trauma and Critical Care Preparedness...13 ISCCM DAY Celebrations ISCCM growth continues Advertisement Editorial Office Dr Narendra Rungta Head, Critical Care, Rungta Hospital Jaipur Phone : (R) , (O) s : drnrungta@gmail.com cccisccm@gmail.com Published By : Indian Society of Critical Care Medicine For Free Circulation Amongst Medical Professional Bldg. No.3, No.12, 5th Floor, Navjivan Commercial Premises Co-op. Society Ltd., Dr. D. Bhadkamkar Road, Mumbai Central, Mumbai Tel.: (022) Telefax: (022) We request our esteemed readers to send their valued feedback, suggestions & views at drnrungta@gmail.com

2 2 Dear Reader, On behalf of editorial board of the Critical Care Communication, I bring New years greetings to you all. The Society is moving into New Year with new ideas and aggressive approach with its aims and objectives well preserved. Education, training and Research remain three main constituents of ISCCM s fuel for growth We welcome the news of recognition of Critical Care medicine as an independent Super-specialty in its own right. MCI gazette notification of DM courses in Critical Care Medicine has generated quite a bit of excitement amongst Critical Care Professionals in India. This is the outcome of long run hard work, demand and expectation of ISCCM. On behalf of ISCCM, I wish to congratulate and thank MCI for giving the profession a wonderful new years gift. This will go a long way in saving millions of precious lives in our country in times to come. This will also offer great opportunity to the Indian Intensive care professional. ISCCM over the years have been able to develop a large teachers bank, guidelines, examination protocols and systems, research ideas, collaborations with International societies and groups. I am sure MCI will find all this very handy when takes this course, syllabus and related curriculum forward. ISCCM day celebration news have been very exciting and stimulating, We may have missed a few pictures because of late arrivals. Kudos to Dr Manish Munjal and his team for motivating the celebrations across the length and breadth of country, resulting in training of thousands in Basic Life Support This issue is being dedicated to the scientific programme of upcoming Criticare I hope this information will go a long way in helping member delegates and others to plan their conference attendance schedule. I am grateful to Dr Pamela Lipsset for writing exclusively for CCC and sharing her wisdom and thoughts with ISCCM members. The year 2010 as editor has been quite satisfying. I take this opportunity to thank my editorial board for helping me in preparing the contents, the authors for providing me with exclusive write ups and the executive of ISCCM and its branches for giving us timely information/news for publication and also the advertisers for support. Thanks to the printers M/S Urvi Compugraphics Mumbai too for doing a good job. I wish, the New year will bring in newer ideas, more information, newer people into the editorial board and the CCC gets a newer look in the coming year. I look forward to more information and greater participation from every one and every part of the country. Thanks Editorial Board Editor in Chief Dr. Narendra Rungta, Jaipur Dr Narendra Rungta MD, FISCCM, FCCM Editor, President-Elect, ISCCM drnrungta@gmail.com Associate Editors Regional Members Dr. Deepak Govil Gurgaon Dr. Manish Munjal Jaipur Dr. Sushruta Bandopadyaya Kolkata Dr. S. Joans Mangalore Dr. Kapil Zirpe Pune Dr. Kundan Mittal Rohtak (Pediatric Section) Dr. Sanjay Dhanuka

3 3 From the Desk of the President Dear Colleagues and Friends, I take this opportunity to wish you and your family a very Happy New Year and a great year ahead. It gives me great pleasure to inform you that ISCCM Day celebration on 27th November 2010 was a great success. I congratulate Dr. Manish Munjal, the chief coordinator of this programme and all the members who worked very hard to make this possible. Since there have been changes in the ACLS guidelines, the theme this year was decided to be "Learn CPR to save lives". On this day, Basic Life Support demonstrations were performed at about 100 locations across the country. These demonstrations were done for both medical personnel and general public at large. I am extremely pleased to share with you that the demonstrations attracted an overall good participation and it was quite a successful experience for everyone. You will be delighted to know that the INDICAPS study is progressing well. The third data entry will be in January I sincerely thank all the members who have participated in this landmark study and look forward to your continuous support in this marvellous endeavour. Society is also going to start MOSER( Multi-center Observational Study to evaluate epidemiology and resistance patterns of common ICU infections) study at 20 centres across India. This aim of MOSER study is to find out the incidence of ICU-related infections (VAP, CAUTI and CRBSI) in India and to explore the microbiology, resistance and treatment patterns of these infections.site selection is complete. Data entry will start in March-April As you know that the election of the society from the next year onwards will be through electronic mail. The date of the election will be in the first week of August Adequate confidentiality and security will be maintained by the webmaster through the design of the programme. Members can also check their ids and authorized mobile nos. on the official website of our society. Further, mock elections will also be conducted several times before the elections to test the software and to fine-tune the system, to ensure a successful function. If there is any change in your address and phone no. ; then please download the database form from the ISCCM website. Fill it, sign it and send us at the office in Mumbai to update your information in our database. You must understand that without your support and cooperation, we cannot bring out this historic change for the betterment of the society. Most importantly, I take this opportunity to invite you to attend our Annual Congress CRITICARE 2011 from 16th 21st February 2011 at New Delhi. The theme of this year s annual congress is Reaching New Heights in Critical Care Medicine. The organising committee has put in lot of efforts to make it a memorable event, not only rich in scientific content but also in entertainment activities. If you have not registered till now, you can visit our congress website and register online. For more details, please get in with the congress secretariat on Don't miss it! I am truly humbled by the kind of support and dedication you all have shown last year to strengthen and enrich this society to reach newer heights in the study and practice of Critical Care in India. It is indeed my privilege to specially thank everyone s family members Dr. Rajesh Chawla President, ISCCM drchawla@hotmail.com who have patiently stood strong along with you and have graciously contributed for the best interest of society. Once again, a big thanks to you! Wish you a healthy and the best New Year ever!

4 ALL INDIA INSTITUTE OF MEDICAL SCIENCES 4 Message from International Personality - President SCCM 2011 Branch Activities DeefKeue Yeejleer³e Dee³egefJe&%eeve mebmleeve MejerjceeÐeb Keueg Oece&meeOeveced Dr. Pamela Lipsett MD, MHPE, 2011 President, Society of Critical Care Medicine plipsett@jhmi.edu As the incoming President of the Society of Critical Care Medicine (SCCM), I look forward to working with the ISCCM in the upcoming year. I am delighted to be able to attend Group photo of FCCS course held at Apex Trauma centre, AIIMS Delhi CRITICARE 2011 at Vigyan Bhawan, Delhi. This will be my first visit to India, and I am excited to learn more about your country and to continue the warm relationship between SCCM and ISCCM. As President of SCCM, my focus will be to break down the borders and boundaries in our thinking about Critical Care delivery to our patients, about training our workforce, and about relationships with our members and partners around the world. The use of information technology facilitates our communication and provides wider access to our educational materials. One of our greatest strengths is providing educational resources to our colleagues. At the SCCM Critical Care Congress in January, we debuted a new version of our web-based learning portal, LearnICU. This new system brings together knowledge and networking focused on improving Critical Care delivery around the world. We continue to encourage the use of the Fundamental Critical Care Support courses in India and would love to hear how these courses have helped in your hospitals. As we look ahead, SCCM has launched an international version of our popular board review course, with successful pilot programs in Important Events during Criticare 2011 Vigyan Bhawan Newdelhi Wednesday, 16th February, 2011 ISCCM Oration 9.35 am Inauguration & President's Address am Presidents Evening and Past Presidents Oration 6.30 pm Dinner 8.00 pm Korea. We anticipate working with Critical Care leaders worldwide to customize this course to match local needs. We hope to bring it to you in India in the near future. Finally, I will be appointing a task force to develop our approach to web-based simulation in critical care, and I will update you on our progress in the coming year. In the meantime, I look forward to meeting you. Main aapka tahe-dil se shukra-guzar hun. Thursday, 17th February, 2011 Hansraj Nayar Award am AGM 6.00 pm Banquet Dinner Tivoli Gardens 8.00 pm Members' Achievment Dr. Sameer Jog invited as speaker 31st ISICEM - Brussels Dr. Sameer Jog has been invited to 31st ISICEM which will be organised in Brussels from 22nd to 25th of March 2011 Dr Shiva Iyer appointed as Hon. Asst. Prof. in the Chinese University of Hong Kong Dr. Shiva Iyer Honorary Adjunct Assistant Professor in the Dept of Anesthesia and Intensive Care of the Chinese University of Hong Kong, Hong Kong. Dr. Prasad Rajhans honoured with a National Award Dr. Prasad Rajhans -Vice President of ISCCM, was awarded the 1st Lifeline Foundation-AAEMI [American Academy of Emergency Medicine, India] award in the individual category.

5 5 Scientific Program minute to minute - Criticare 2011 NEW DELHI th Annual Congress of the Indian Society of Critical Care Medicine (ISCCM) International Critical Care Congress 2011 In Association With Ministry of Health & Family Welfare (Govt. of Delhi) February 16-21, 2011 Vigyan Bhawan, New Delhi, India Main Congress February 16-18, 2011 Post Congress Workshop February 19-21, 2011 SCIENTIFIC PROGRAMME PLANNING COMMITTEE Dr. Praveen Khilnani Rajesh Chawla President ISCCM & Chairman Congress ORGANISING COMMITTEE Praveen Khilnani Organising Chairman Deepak Govil Organising Secretary Suninder S. Arora Organising Secretary

6 6 INTERNATIONAL CRITICAL CARE CONGRESS 2011 & 17th ANNUAL CONGRESS OF THE INDIAN SOCIETY OF CRITICAL CARE MEDICINE SCHEDULE OF EVENTS February 16th to 21st 2011, Vigyan Bhawan, New Delhi ISCCM WEDNESDAY, FEBRUARY Registration Chairpersons : B.K Rao, Rajesh Pande > How to Improve quality of care in your ICU? Jean Louis Vincent ISCCM Oration Presidential Address Pulmonary Embolism Chairpersons : Pankaj Kumar, Rajiv Goyal > Changing Diagnostic Strategies Rajesh Chawla > Management of Pulmonary Embolism Randeep Guleria > IVC Filters & DVT Yatin Mehta Pro-Con Debate Chairpersons : Yatin Mehta, Deepak Govil > Surviving Sepsis Guidelines is the Final answer to Management of Sepsis J. Divatia DAY 1 (Hall - A) Rajesh Chawla Pro - Mitchell Levy Con - Jean Louis Vincent Free Papers Session Chairpersons : Suninder Singh Arora, Jerry Zimmerman > End of life Issues- A world wide Perspective Charles Sprung > Prevention and Management of Nosocomial Infections Multi System Critical Care Chairpersons : Prakash Shastri, C. K. Jani > Emerging role of New Antifungal Agents V. Ramasubramaniam > N GAL-DIAGNOSING AKI at the earliest Sachin Soni > Mechanical Compression for optimum Prophylaxis of DVT in Critical Ill Bishu Panigarhi > E-ICU Bishu Panigarhi 1830 onwards President's Evening Past President Oration > Clinical Challenges in an ICU Patient in India 2000 Onwards Dinner at Vigyan Bhawan DAY 1 (Hall - B) Ventilator Associated Pneumonia Chairperson s : Raman Sardana, Atul Kulkarni > Diagnostic Technique - State of the Art G. C. Khilnani > Choice of Antibiotics & Optimal Duration of Treatment V. Ramasubramaniam > Can We Really Prevent VAP? Sudha Kansal Pro-Con Debate Chairpersons : Subhash Todi, Pinak Shrikhande > Steroids in Severe Sepsis and Septic Shock are Effective Pro - J Divatia / Con - Charles Sprung Pam Lipsett Shirish Prayag Free Papers Session Chairperson : G C Khilnani, Khusrav Bajan > Challenges in the Management of Invasive Fungal Infections William Hope > From Gaussian Variation to Chaos: Non-linear systems in Critical Care Ram Rajagopalan Ethics Chairpersons : Pam Lipsett, R.K Mani > Ethics in Clinical Research Charles Sprung > Ethics in Organ Transplant Srinivas Samavedam > Ethics in Intraction with Pharmaceuticals Industry Babu Abraham Year in Review > Cardiovascular and Hemodynamic Monitoring Vijaya Patil > Go to Hall A DAY 1 (Hall - C) Family Communication Chairperson s : N Ramakrishnan, Shyam Sunder > Family Conferences & Communication in ICU? Charles Sprung >How to Communicate Error to the Patient & Family Rajiv Goyal > Visiting Policy Strict or Liberal Narendra Rungta > Go to Hall A and B Free Papers Session Go to Hall A and B Nephro Critical Care Chairpersons : N P Singh, Arun Dewan > CRRT in Sepsis - Is It Useful or Harmful? Sanjiv Jasuja > Is Oliguria an indication to start renal replacement therapy? Jose Chacko > Drug Dosing in Renal Failure in ICU Vijay Kher

7 7 INTERNATIONAL CRITICAL CARE CONGRESS 2011 & 17th ANNUAL CONGRESS OF THE INDIAN SOCIETY OF CRITICAL CARE MEDICINE SCHEDULE OF EVENTS February 16th to 21st 2011, Vigyan Bhawan, New Delhi ISCCM > Year in Review - SEPSIS B. D. Bande Go to Hall A Chairperson s : Rajesh Pande, Pankaj Kumar > Examination of a Critically ill Patient in ICU Hemant Tiwari > Management of Multidrug Resistant Organisms Prakash Shastri Go to Hall A and B Free Papers Session Chairpersons : Sandeep Dewan, Suresh Koolwal > Hemodynamic Monitoring at Bedside Jean Louis Vincent > Management of severe septic Shock Mitchell M. Levy DAY 1 (Hall - D) Chairpersons : Deepak Rosha, Rakesh Chawla > COPD- Critical Care Issues Avdhesh Bansal > Severe Community Acquired Pneumonia Vivek Nangia > Management of severe hemoptysis Manoj Goel > Go to Hall A DAY 1 (Hall - E) Pediatrics- Sepsis and Septic Shock Chaipersons : Krishan Chugh, Bala Ramachandran > Newer Innovation in management of Sepsis / Septic Shock- Pediatric Perspective Brahm Goldstein > Optimizing fluids and Inotrops in Septic Shock Praveen Khilnani > Clinical Monitoring of Tissue Perfusion and Oxygenation Free Papers Session Pediatrics- Neuro Intensive Care Chairpersons : Soonu Udani, S Deopujari > Severe Traumatic Brain Injury Brahm Goldstein > Management of meningo encephalitis - Application of Neurointensive Care Sunit Singhi Pediatrics : Shock Chairpersons : Dinesh Chirla, Vikas Taneja > Dengue Hemorrhagic shock The Changed Guidelines Suchitra Ranjit > Beyond Common Cause of Shock Bala Ramachandran > Cardiogenic Shock Amit Varma > Go to Hall A Jerry Zimmerman Chairpersons : Subash Todi,Rajesh Chawla > Forgotten Factors in respiratory monitoring Chairpersons : Shirish Prayag, Abhiram Mallick > Harmful Threshold for mechanical ventilation- Stress & Strain Concept Luciano Gattinoni Hansraj Nayyar Award Paper Cardiac Critical care Chairpersons :Sumit Ray, Vijaya Rajkumari > ACLS Guidelines whats New? Sheila Nainan Myatra > Managing Post cardiorespiratory arrest syndrome Khusrav Bajan > New onset Arrthymia in critically ill Amit Varma Pro- Con Debate Chairpersons : Shirish Prayag, Sandhya Talekar > Low Tidal volume for everyone in ARDS THURSDAY, FEBRUARY 17 DAY 2 (Hall - A) John J. Marini Pro - John J. Marini Con - Luciano Gattinoni Fluids - Optimizing Management Chairperson : Amit Varma, Jeetender Sharma > Assessing fluid responsiveness in ICU - Current State of the Art Shirish Prayag > Wet v/s Dry- Getting the balance right in fluid therapy Atul Kulkarni Continued

8 8 INTERNATIONAL CRITICAL CARE CONGRESS 2011 & 17th ANNUAL CONGRESS OF THE INDIAN SOCIETY OF CRITICAL CARE MEDICINE SCHEDULE OF EVENTS February 16th to 21st 2011, Vigyan Bhawan, New Delhi ISCCM > Role of Echocardiography in Optimizing Fluid Management Ram Rajagopalan Chairpersons : R. K. Mani, Khusrav Bajan > Management of endotoxemia in severe sepsis & Septic Shock Pierpaolo Terragni > Pharmacokinetics in Critical Care J. Divatia Multisystem Critical Care Chairperson : Deepak Talwar, P. N. Kakkar > Improving patient outcomes in ICU with targeted Nutrition Pierre Singer > Implementation of Critical Care Nutritional Guidelines Stephen McClave > Management of Post Operative patient in ICU Prachee Sathe > Current Management of Severe Burns Kuldeep Singh Annual General Body Meeting (AGM) DAY 2 (Hall - B) Sepsis Management Chairpersons : R. K. Mani, Srinivas Samavedam > Stop Targeting blood pressure Jean Louis Vincent > Monitoring of tissue oxygenation to guide resuscitation Mervyn Singer > APC- Revisited Mitchell Levy Pro- Con Debate Chairpersons : J. Divatia, Shiva Kumar Iyer > There is no Place for PAC in the Mangement of Severe Sepsis Pro - Ram Rajagopalan Con - Michael R. Pinsky Management of Severe Trauma Chairpersons : Palepu Gopal, Rajendra Prasad > Resuscitation Targets - Optimal BP, Oxygen and Coagulation Prasad Rajhans > Management of Chest Trauma M. C. Misra > Head injury - Current guidelines Shiva Kumar Iyer Chairpersons : Pravin Amin, Ram Rajagopalan > Computerization Document System Today & Tomorrow > Enhancing survival in candida infections Subhash Todi Jose A Vazquez Multisystem Critical Care Chairpersons : M.S Kanwar, Samir Sahu > Consequences and Management of ICU Acquired Weakness Jean Louis Vincent > New Insight Into the Management of Skin and Soft Tissue Infection Omender Singh > Sleep in ICU M.S Kanwar > Expanding Role of Respiratory Therapist in ICU Elcee Conner Go to Hall A for AGM 2000 Onwards Banquet Dinner : Tivoli Gardens Tropical Infections DAY 2 (Hall - C) Chairperson s - Ashit Bhagwati, Samir Sahu > Dengue Hemorrhagic Shock Syndrome - Management M. Daga > Complicated Malaria Management D. Karnad > Leptospira Infection - Management Kapil Zirpe Pro- Con Debate Chairpersons : Jose Chacko, Mrinal Sircar > Steroids are Ineffective in ARDS Poisoning Chairpersons : Ashit Hegde, Sandhya Talekar > Insecticides J.V Peter > Bites & Sting Dhruv Chaudhary > Drug abuse Omender Singh Go to hall A and B Multisystem Critical Care Chairperson : Praveen Khilnani, Pradeep Bhatia > Hemolung: a Novel Extracorporeal Respiratory Assistance-the first two Human Applications R.K Mani > ECMO Avashjeet Singh > Adaptive Support Ventilation Graeme A'Court >Discussion Year In Review - ARDS Abhiram Mallick Go to Hall A for AGM 2000 Onwards Pro - Farhad Kapadia Con - Pravin Amin Banquet Dinner : Tivoli Gardens Continued

9 9 INTERNATIONAL CRITICAL CARE CONGRESS 2011 & 17th ANNUAL CONGRESS OF THE INDIAN SOCIETY OF CRITICAL CARE MEDICINE SCHEDULE OF EVENTS February 16th to 21st 2011, Vigyan Bhawan, New Delhi ISCCM DAY 2 (Hall - D) Chairpersons : Vikram Sarbhai, Prakash Shastri > Catheter Related blood stream infections Rajesh Chawla > Issues in Management of Organ Donor- Recent Changes in Guidelines N. Ramakrishnan Chairpersons - Babu Abraham, Ashit Bhagwati > Management of Pancreatitis Pam Lipsett > Current Trends In The Management of Upper GI Bleed Ashit Hegde Chairpersons : Rajiv Bhatia, Narendra Rungta > Transfusion Strategies in Critically ill Suninder Singh Arora > Recent Trends in Sedation & Analgesia in Critically Ill Sheila Nainan Myatra Go to Hall A & B Chairpersons : Tariq Ali, Pravin Amin > Assessment of Severity & Prognosis in Critically ill Subhash Todi > Acute Hepatic Failure Pravin Amin > Managing Metabolic Acidosis in ICU Mervyn Singer Go to Hall A for AGM DAY 2 (Hall - E) Pediatrics - Mechanical Ventilation Chairperson s : Praveen Khilnani, Brahm Goldstein > Conventional Ventilation to Newer Modes - Has it Made any difference? Soonu Udani > Recruitment Maneuvers in Pediatrics - What does the Evidence Say? Krishan Chugh > NIV in Pediatrics : International Perspective Rajiv Uttam What is so specific about disease Specific Ventilation Chairperson s : Praveen Khilnani > Cardiogenic Shock VSV Prasad > Asthma Partho Bhattacharya Pediatrics : Mixed Bag Chairperson s : R. N. Srivastava, Nishant Wadhwa > Renal Replacement Therapy Jerry Zimmerman > Current ICU Management of fulminant Hepatic Failure Pankaj Vohra > Management of Intra Abdominal Hypertension in PICU Mudit Mathur > Challenges In Management of Status Epilepticus in PICU Santosh Soans Pediatrics - Infections and Infestations Chairperson s : Arvind Taneja, Sunit Singhi > H1N1 Indian Scenario Anil Sachdev > Complicated Malaria PICU Perspective S Deopujari > Newer Antifungals in Pediatric Critical Care M Jayshree Go to Hall A for AGM 2000 Onwards Banquet Dinner : Tivoli Gardens FRIDAY, FEBRUARY 18 DAY 3 (Hall - A) Chairpersons : Maher J. Albahrani, Krishan Chugh > What Cause Multi Organ Failure & how do Failed Organ Recover? Mervyn Singer Chairpersons: Jerry Zimmerman, B. D. Bhande > Cardiovascular insufficiency with initiation & withdrawal of mechanical ventilation Michael R. Pinsky Anticoagulation Chairpersons : Farhad Kapadia, Kapil Zirpe > Complications of Anticoagulants Shyam Sunder > Heparin Induced Thrombocytopenia Rajan Barorker > Monitoring Coagulation in ICU Palepu Gopal Noninvasive Ventilation Chairpersons : Vijayan, Dhruv Choudhary > Failure of NIV - Why does it fail? Deepak Talwar > Overcoming Patient Ventilator a Synchrony During NIV G. C. Khilnani > NIV in hypoxemic failure J. C. Suri Panel Discussion - What have we learnt from H1N1 Pandemic - Indian Experience Moderator : Rajesh Chawla, Panelists : J. C. Suri, N. Ramakrishnan, Dhruv Choudhary, Deepak Talwar, Jose Chacko, Manoj Singh, Sumit Ray Investigations and Imaging Chairpersons : Atul Kulkarni, Ajay Gupta > Still a Daily Chest X-ray after each Insertion in ICU Daniel Lichtenstein Continued

10 10 INTERNATIONAL CRITICAL CARE CONGRESS 2011 & 17th ANNUAL CONGRESS OF THE INDIAN SOCIETY OF CRITICAL CARE MEDICINE > Frequency of Lab Investigations Farhad Kapadia > Ultrasound In a Trauma Patient Enrico Storti Chairperson : Prakash Shastri, Nirmal Jaiswal > Strategies To Prevent Antibiotic Resistance Paul Tulkins > Ideal ICU Design for ICU in India Mechanical Ventilation Chairperson s : J. Divatia, Jose Chacko > Non-ventilatory determinants of VILI John J Marini > Should we Apply Recruitment Maneuvers in ARDS Jose Chacko > Prone position- The Final Answer Luciano Gattinoni Gastro Intensive care SCHEDULE OF EVENTS Chairpersons : Ramesh Venkatramman, Hemant Tiwari > Liver Dysfunction in Intensive Care, Beyond Standard LFT'S Srinivas Samavedam > Approach to Acute abdominal distension in ICU Ajay Kumar > Intraabdominal Hypertension and Open Abdomen Krishnan Sriram Panel Discussion - Controversies in ARDS (PEEP, Recruitment maneuvers Proning) Moderator : Shirish Prayag Panelists : Luciano Gattinoni, John Marini Michael R. Pinsky, Farhad Kapadia Multisystem Critical Care Narendra Rungta (Pres. Elect.) Chairperson : Suninder Singh Arora, Manju Mani > Changes in Antibiotic Susceptibility Patterns in India Camilla Rodrigues Multisystem Critical Care > Leadership and Teamwork in Critical Care - Chairperson : Y. P. Singh, Tarun Jhamb Critical for success Aamir Sheikh > Particulate matter in IV Antibiotics-impact on Clinical Outcomes Kirk Patrick > Less is More Mervyn Singer > Compartment Syndromes - Head to Toe Shiva Kumar Iyer > Cardiorenal Syndrome - How real is the association Ramesh Venkatraman Chairperson : Ajay Lall, Anil Gurnani >Fungal Biofilms-rising threat in ICU,making antifungals ineffective Arunaloke Chokraborti Valedictory Session & Brief About Workshops > Challenges in the Management of Gram DAY 3 (Hall - B) Positive Infections Rajesh Chawla Multisystem Critical Care Chairperson : Hemant Tiwari, Abhinav Gupta > Management of Massive Bleed in ICU Mrinal Sircar > Neurological Prognosis after Cardiac arrest Manoj Singh > Evidence based medicine - What s new? Dhruv Chaudhary Administration DAY 3 (Hall - C) Chairperson : Arun Dewan, Sandeep Kantoor > Negotiations with Administrators: Do's & Don't's N. Ramakrishnan > Conflict Management A Baronia > Challenges in implementation of protocols & guidelines Sumit Ray Organization Chairperson : Manimala Rao, Pradeep Bhattacharya, > Handover in ICU Maher J Albahrani > Minimising errors in ICU Performance Atul Kulkarni > How to conduct an effective Audit in ICU Rajesh Pande Panel Discussion Resistant bacteria, Resistant fungus & untreatable virus - Are we really making Progress? Moderator : R. K Mani Panelists: Prakash Shastri, Pravin Amin, Arun Dewan, Harjeet Dumra, T. D. Chugh Multisystem Critical Care Chairperson : Pawan Gurha, Sanjay Dhanuka > Airways Management in ICU - Life Saving or Life Threatening J. Divatia > Volume Therapy in ICU-Beyond Just Volume Replacement Prof. James > Balance Lipid concept in Clinical Nutrition Axel R. Heller Go to Hall A and B February 16th to 21st 2011, Vigyan Bhawan, New Delhi IDCCM Exam ISCCM

11 11 INTERNATIONAL CRITICAL CARE CONGRESS 2011 & 17th ANNUAL CONGRESS OF THE INDIAN SOCIETY OF CRITICAL CARE MEDICINE SCHEDULE OF EVENTS February 16th to 21st 2011, Vigyan Bhawan, New Delhi ISCCM DAY 3 (Hall - D) Chairperson s: Sheila Nainan Myatra, Prachee Sathe > How I read Scientific paper? J.V Peter > Role of Ultrasound in ICU Luca Neri Chairpersons : Nirmal Jaiswal, Sanjay Sobti > Neurological Criteria of Brain Death Sandhya Talekar > Management of Heart Failure Mervyn Singer Chairpersons : Chand Wattal, Rajesh Mishra > Antibiotic Therapy - Role of antibiogram Camilla Rodrigues Critical Care Tutorial Chairperson : Vivek Nangia, Manish Munjal > Current Nutritional Guidelines Krishnan Sriram > Applied Understanding of Gas Exchange Abnormalities in Critical Illness Pardeep Bhattacharya Go To Hall A and B DAY 3 (Hall - E) Pediatrics-Critical Care : Newer Developments Chairpersons: Krishan Chugh, Santosh Soans > Neonatal ECMO Avashjeet Singh > Pediatrics ECMO Suneet Pooboni > New developments in Pediatric Critical Care in Past 5 Years Indira Jayakumar Panel Discussion - End of Life/ Medicoligal Issues in PICU Moderator : Narendra Rungta Panelists : Rajiv Uttam, Rashmi Kapoor, Partho Bhattacharya, Rajiv Chhabra,Urmila Jhamb, Anita Bakshi PICU Procedures : Common Pitfalls Moderator : Dinesh Chirla Panelists : Bala Ramachandran,VSV Prasad, Dhiren Gupta, Nameet Jerath, Prabhat Maheshwari, Jyotinder Kaur Pediatrics - Newer Developments in Infection Prevention Chairpersons : Rahul Nagpal, Ravi Shankar > ARDS/Pneumonia Survivor with Chronic Lung Disease : Which Vaccine and When? Shyam Kukreja > Current Recommendation : Vaccines for Immunocompromized Patient Anupam Sachdev > H1N1 Vaccine Current Status Amarjeet Chitkara Pediatrics- Multiple Trauma : Whats New? Chairpersons : Nameet Jerath, Prabhat Maheshwari > Pediatric Surgical Issues : Abdominal and Thoracic Injury Meera Luthra > Medical Management of Multiple Trauma Victim in PICU Rakesh Lodha DO NOT MISS! WEDNESDAY, FEBRUARY ISCCM Oration Presidential Address 1830 onwards President's Evening Past President Oration 2000 Onwards Dinner at Vigyan bhawan THURSDAY, FEBRUARY Hansraj Nayyar Award Annual General Body Meeting (AGM) 2000 Onwards Banquet Dinner : Tivoli Gardens FRIDAY, FEBRUARY Valedictory Session & Brief About Workshops Organising Chairman Chairman, Pediatric Section Organising Secretary Organising Secretary Register Today!

12 12 REGISTRATION Congress registration is must for all the attendees including participants of post conference workshop. Payment of Registration fee should be made in favor of "Criticare 2011". To register for the congress & workshop and pay through our online process, please log on to. To register offline for the congress & pay through Demand Draft/Cheque/Cash, please log on to and download the offline registration form. Kindly fill all the information in the form and courier the form along with the payment to the Congress Secretariat address as mentioned below. CONGRESS REGISTRATION FEES S No CATEGORY PAID BEFORE 31st JAN & 30th Jan Spot Registration ISCCM Members Rs Rs Non Members Rs Rs Accompanying Person Rs Rs PG. Student Rs Rs Nurse / Physiotherapists Rs Rs POST CONGRESS WORKSHOP & COURSES FEES S.No. Workshop Max Date ISCCM Member Non Member Code Participants Feb ACLS - 01 Seats Full & Closed Feb Rs Rs FCCS - 02 Seats Full & Closed Feb Rs Rs FDM Feb Rs Rs ATLS - 04 Seats Full & Closed Feb Rs Rs UECC - 05 Seats Full & Closed Feb Rs Rs MV Feb Rs Rs HMEC - 07 Seats Full & Closed Feb Rs Rs CCN Feb Rs Rs BPIC Feb Rs Rs ASIC Feb Rs Rs AAM Feb Rs Rs MCT Feb Rs Rs BRC Feb Rs Rs BASIC Feb Rs Rs CRM Feb Rs Rs NCC Feb Rs Rs NUC Feb Rs Rs Congress Secretariat Mr. Aman Kalra - Congress Manager Room No 4162, 1st Floor,General OPD, Gate no.10, Indraprastha Apollo Hospital, Sarita Vihar, Delhi - Mathura Road, New Delhi , India Ph: , , , Ext : Telefax : congress@criticare2011.org ; info@criticare2011.org Website:

13 13 Guest Author's Page - Trauma and Critical Care Preparedness Without a doubt, India is on an upward trajectory in a number of areas: firing its soon to be successful first indigenous cryogenic rocket into space, mastering satellite technology, developing state-of-the-art supersonic-guided missile systems, boasting impressive economic growth at a time of ongoing global crises, and ostensibly existing as IT super power. But, there is one area that India is sadly lagging behind: In the area of disaster response, emergency preparedness and particularly trauma care response. Are we really doing our best? Earlier this year The Hindu on April 11, 2010, published an article Trauma system in India leaves much to be desired. The article discussed briefly current security threat in India and the need for combined civilian military trauma systems for India s counter terrorism response in both naxal-hit and other terrorist hot bed activity areas. The ongoing naxal violence and the bomb blasts, which have become common occurrences in the past few years in India, serve as a grim reminder of our deplorable inadequacies in providing basic trauma care for the injured and potentially salvable lives. This article aims to highlight some of the measures that India needs to take immediately. Although the National Counter Terrorism Center (NCTC) should have been slated to be in place after the December 2001 Parliament attack, it may now happen by the end of However, it can scarcely compensate for negligence that has existed for a decade, unfolding in recent events, such as the recent Dantewada and Mumbai terrorist attack, which sorely highlighted India s unpreparedness in dealing with trauma care in times of crises. The establishment of the NCTC creation is a first step in the right direction because it serves as a much needed meeting point for key units such as the intelligence agencies, department of defense, health, home, science and technology, energy, agriculture and finance. For every month and year we lose, in taking appropriate steps to modernize our trauma care facilities and disaster response infrastructure, our economic growth suffers and precious lives are lost, while local and state governments are thrown into disarray. To reach and even exceed the 10% economic growth that India desires, it must look to not just curbing the constant terrorist menace, but also ensuring that an efficient trauma and disaster response system is in place to save lives and economic costs. The role and jurisdiction of the health wing must be clearly defined under the NCTC. For instance, a prudent first step would be to set up combined civil military trauma centers in all seven states hit by naxals as well as terrorists in J&K. To accomplish this, all three armed force divisions would be required to establish strategic trauma centers that would serve in multi-dimensional capacities to cater to short-term and long-term needs in any war, conflict, or large-scale natural disaster. The focus of the initial phase should be on those states that suffer the most from terrorist activities with an eventual goal to establish two or three of these centers in each state, with small states having at least one civil military trauma center. The armed forces and central government should have equal responsibility for the workforce contribution of this central government run and supported project. The Pan Indian blueprint creation with leadership and organizational administration should be under the command of the NCTC health department wing. The view of trauma care in disasters as more of the same is a dangerous misconception. During a mass casualty event, trauma teamwork and decision making differ fundamentally from everyday trauma practice because a heavy casualty load has a profound effect on the way trauma care is delivered in the emergency department, operating room, or surgical ICU. I cannot emphasize enough from the Dantewada mass casualty event the important role that rescue Chinook helicopters could have played in the golden hours that would have helped the injured and may even have saved a few precious lives. We need combined civil military trauma centers equipped with air evacuation, heliports, search rescue triage missions, accompanied by light combat helicopters in kill zones to be conducted by military and available on demand Mass casualty events require that we strive for the greatest good for the greatest number to maximize casualty survival. For this, we would have to expand our defense budget and health care budget. But, isn t that the need of the hour? China has double the budget spending compared to ours in both these sectors. Identification of strategic sites in terms of states has to be conducted immediately where these combined civil military trauma centers can be created. Similarly, construction of these centers has to be undertaken simultaneously in different states, as one or two centers alone would not be able to provide efficient and adequate care in a mass casualty event when severely injured patients with high-velocity missiles arrive at the hospital together. In fact, a large trauma center with 250 ICU beds can also get overwhelmed with more than severely injured patients if arriving simultaneously. We have to achieve numbers higher than this for each of our trauma centers in order for them to be functional for many years to come. Responding to a full-scale disaster is a great Saurabh Jain MD challenge for any hospital and its medical staff. An effective disaster response requires structured cooperation and communication throughout the institution. Resources and a workforce of physician specialists should be increased in all three wings of armed forces. Moreover, existing UPSC medical service cadres have to be increased in sub-specialties and not just in primary care. Another important aspect is to create a large manpower of mid-level providers trained in planning and preparedness for different levels of trauma care and disaster response. This is where the HRD ministry can make a difference by bringing in new certificate, associate, BA and MA courses from abroad to our colleges in areas such as emergency medicine technical training, disaster management, counterterrorism, air warfare, asymmetrical warfare, cyber crime studies, and homeland security. We should not forget that time and again in India, hospitals also have been targeted by terrorists. Few fresh examples at Coimbatore on Feb 2006, at Ahmadabad on July and Oct 2008 and at Mumbai on Nov Therefore, foolproof security strategies for these centers must be factored into the plan. Awareness is the first step, followed by communication among emergency physicians, medical directors, hospitals administrators, hospital security directors, local law enforcement officers, and military police for planning and preparedness. These combined civil military trauma centers would then become state-of-the-art centers for higher specialization training of surgeons in Trauma, Acute Care, and Surgical Critical Care. Given the past terrorist activities occurring on the Indian soil, we remain largely unprepared for their most common form: conventional explosive events. Car bombs, terrorist shootings, and IED blasts are some examples for which we need trained surgeons who have encountered these unique injuries. There is a need for hundreds of multispecialty trauma and burn centers in India and must be the backbone of our nation s trauma and disaster response system for further large-scale terrorist events. By combining the casualty care and trauma systems expertise of the Indian military with the existing expertise at civilian trauma and burn centers, we can improve the care of all injured patients in our country, regardless of whether the injuries are caused by everyday traumatic events such as motor-vehicle crashes, by natural disaster, or by terrorist attacks. Dr. Saurabh Jain, M.D. is a Trauma and critical care surgeon based at Los Angeles, California USA and can be reached at jainsx@gmail.com

14 14 Branch Reports ISCCM DAY Celebrations Agra Greetings from Agra. We celebrated ISCCM day in a big way with a lot of enthusiasm.in keeping with the theme, 'Teach BLS to general public', we appealed to the masses to attend this course in large numbers. To promote this event we partnered with 92.7 FM five days prior to 27 Nov Venue: Lecture Hall, Pushpanjali Hospital 11:00 am : 50 candidates 1:00 pm : 55 candidates This included public, attendants of the patients, nursing staff, ward boys, aayas, liftman, security guards etc. Feedback forms were collected and certificates issued. This event was covered very well in the media-newspapers and local TV channel. On 18 Nov. we conducted the same training programme for 120 ANMs at Kumher, near Bharatpur, Rajasthan. Dr. Diptimala Agarwal, Dr Ranvir Tyagi, Dr Rakesh Tyagi ISCCM Agra Chapter Amritsar Amritsar branch had organised a 2 day workshop on Nursing criticare & BLS course on NOV About 100 delegates got hands on training and BLS training on Nov. 27th for the general public. Dr. Raman Chatrath Secretary ISCCM, Amritsar Guwahati As per decision taken by ISCCM to impart BLS training, in NEMCARE hospital we had arranged BLS training with the help of manikin for 2 hrs this morning. We stressed more on the common public consisting of the patients' attendants, drivers and other service people & that is why I arranged in the reception lobby. The response was over whelming. Many of attendants tried their skill after demonstration. We were really happy with the response. We have put posters at different places in the hospital since yesterday. Hope we will be able many more things under the banner of ISCCM in future. Dr. Ajit Deka Guwahati G.N.R.C.Hospitals, Dispur reporting - It seems like an extended family, this kind of sharing and exchange of ideas. Am really appreciating the team effort to get 27th going as BLS day. Did half day of BLS in the hospital with ICU, floor people and casualty staffs some security people walked in so a gathering of 40 was there and not to forget the resident doctors from different departments. We enjoyed ourselves. Thanks once again Dr. Vandana Sinha G.N.R.C.Hospitals, Dispur, Guwahati Hyderabad Happy Festive season and Special Greetings to all Colleague intensivists on the Occasion of ISCCM Day. At Hyderabad we have commemorated Oct 9th as ISCCM Day by holding BLS/ACLS refresher courses at Apollo Health City under the Directorship of Dr Rajib Paul, Intensivist, Apollo Health City. About 40 delgates and several paramedical personnel participated in this programme. This was done in view of our City units ID CME which we held on 23rd and 24th of October, which also was a very successful event. I wish good luck to all units on the forthcoming ISCCM day events. Regards Dr Palepu Gopal Jaipur Shubh Hospital have celebrated ISCCM day on 27th November 2010 by providing BLS training to students of BNVP school 9th -10th standard and members of ROTARY CLUB, Jaipur Mansarovar, through power point presentation and practical demonstration on the manniquin with special attention given on initial steps of BLS with chest compressions and rescue breath on the manniquin. Dr. Sudhir Khunteta Director & Chief Intensivist, SHUBH HOSPITAL, Jaipur We at Fortis Escorts hospital celebrated this day by taking BLS course (recent update) for our employee (nursing and other staff). We also trained resident doctors for ACLS, local training before formal training course. Dr. Rajeev Lochan Tiwari HOD & Sr. Consultant Anaesthesia, Jaipur Kolkata You will be happy to know that we have organized more than 300 workshops on BLS with Concern for Kolkata, Police Training Centre, Rotary Club, Air Port Authority of India, Sports Authority of India, Kabadi Association, various Govt. and non-govt. Hospitals, Voluntary Organizations, Clubs, Boys Scout and Guide, Bagbazar Welfare Society & many other organizations all over West Bengal starting from Kolkata to remote rural areas. If necessary we are ready to offer our expertise for your noble mission. Thanking You. Dr. Saurabh Kole Pune General Report : On 27 th Nov ISCCM Pune Branch successfully celebrated the ISCCM foundation day in various prominent hospitals with help of ISCCM members in these hospitals to increase intensive care awareness and teach the lay public Basic Life Support according to the latest international guidelines and using the material provided by ISCCM. A week prior to the program a press conference was held which was addressed by Dr. Shirish Prayag, Dr. Shivakumar Iyer, Dr. Pradeep D Costa and Dr. Prasad Rajhans. This helped create public awareness about the ISCCM program. Across Pune city a total number of 469 people attended this program, out of which 251 were nonmedical, & 218 were working in the respective hospitals. The theoretical & practical training was provided to all delegates. They were given BLS protocol copies in Marathi and English and a demo CD which included a video demonstrating the latest CPR guidelines. All the hospitals used two mannequins & everybody had hands on practice. A certificate of participation was given to all delegates. Many demanded future such courses for community groups they work in. The names of the participating hospitals and the course directors are given in the table below. The Names Of Training Hospitals Aditya Birla Hospital, Chinchwad Bharati Hospital, Dhankawadi Deenanath Mangeshkar Hospital, Erandawana Jehangir Hospital, Pune Kem Hospital, Pune Niramaya Hospital, Chinchwad Ruby Hall Clinic, Pune Sahyadri Hospital, Karve Road Name of the ISCCM Course Director Dr. Jayant Shelgaonkar Total No of Trainee Hospital Staff Non- Medical/ Lay Public Dr. Jignesh Shah Dr. Prasad Rajhans Dr. Kayanoosh Kadapatti Dr. Pratibha Patel Dr. Sunita Varghese Dr. Anand Tiwari Dr. Shivakumar Iyer ISCCM day, Free BLS (Basic Life Support) workshop,conducted at Ruby hall clinic Pune ISCCM (Indian Society of Intensive Care Medicine), Pune, branch and Critical care department Ruby hall clinic, Pune, conducted a BLS workshop for common public as part of nation-wide ISCCM day celebration to increase intensive care awareness on Saturday, 27th November Dr. Kapil Zirpe, Dr. Anand Tiwari (course director) and critical care team organized the event at the venue. 50 FIFTY people participated in the workshop conducted at the 5th floor auditorium lecture hall at ruby hall clinic Hospital, Pune and were given a certificate after satisfactory completion, BLS protocol copies and a demo CD. It was really an encouraging event and participants expressed satisfaction and pressing need for such public awareness initiative to train public in Basic Life Support (BLS) skills. Many demanded future such courses for community groups they work in. Hope each can save a life now!! Critical Care Team Ruby Hall Clinic, Pune Rajahmundry Rajahmundry, East Godavari District, Andra Pradesh, has actively celebrated ISCCM DAY, on 27th NOV. We have conducted two BLS Pragrammes on this occasion. Programme 1: BLS for paramedics, we have trained 34 paramedics, hands on training with 2 manikins. Very active participation and interaction. Programme2: BLS for About 40. IMA Doctors of all specialities. Doctors did not show much interest to do hands on training, so we have made a demo on the dais. Active interaction from the audience. *Both the programmes conducted according to 2010 guidelines. *I specially thank Dr. Rajesh Chawla for sending the entire programme slides. This not only made our work easy but also helped to maintain uniformity in teaching 2010 guidelines. **We thank once again ISCCM Executive members, for the slogan "LEARN CPR To Save Lives" **Rajahmundry we are nearly15 Life members of ISCCM. We formed local CRITICAL CARE SOCIETY BRANCH in 2010 March. We are working out to make an official affiliation to ISCCM. RNLS Prasad Varanasi It was 8 th October 1993 when 15 enthusiastic Physicians/ Anaesthetists and other doctors, interested in Critical Care sat together and decided to form ISCCM.Thus ISCCM was born. It was their initiative and effort what ISCCM is today. Therefore, in all fitness of things it was decided to celebrate this day every year as ISCCM day and dedicate it to the founders of ISCCM. However, this year ISCCM day fell during the Common Wealth Games. Therefore it was decided to postpone it to 27 th November I had the honour and privilege of carrying out the responsibility with help of my committee colleagues in the most desired manner. I tried my best to have a fruitful celebration of the ISCCM day. On this day, this year we decided to do Basic Life Support demonstration ( 2010 guidelines) for medical personal and general public all over the country Theme floated by the PRESIDENT was LEARN CPR TO SAVE LIVES With the help & good wishes of all the members of ISCCM this day was a grand success, At more then 150 places our collegues conducted/demonstrated BLS for Doctors, Nurses, Hospital staff members, drivers, Security personnels, Students & general public. In all about 5000 persons learned basics of life support & I am sure they will save several precious lives. Special thanks to Dr Rajesh Chawla & Dr Narendra Rungta, President & President Elect of ISCCM for showing path & confidence in me. Many thanks to Dr Atul Kulkarni, Dr Dhuruva Chaudhary, Dr Deepak Govil, Dr Sheila Nainan, Dr Prakash Shastri, Dr Sumit Ray, Dr Kundan Mittal & Dr Sanjay Dhanuka for helping me organising this event. Few reports of ISCCM day celebrated across India Varanasi city branch have celebrated ISCCM day on 27th November 2010 by providing BLS training at SUNBEAM School students of 9th-12th standard and releasing antibiotic policy for ICU patients in IMS BHU Varanasi. AP Singh Gen. Secretary, Varanasi City Branch Once again thank you all, Dr. Manish Munjal National Coordinator Isccm Day Celebration Committe Secretary, ISCCM drmmunjal@hotmail.com

15 15 Photo Coverage Dr Ranvir & Dr Dipti with Big FM on ISCCM day at Agra Dr R Bhagchandani Teaching BLS at Bhopal BLS teaching in full swing at CMC, Bhopal BLS teaching to staff members at CMC, Bhopal ISCCM Day Celebration at Chirau Medical College, Bhopal Security Guards learning skills of BLS at CMC, Bhopal All in action at NRI Hospital, Guntur learning BLS Doctors of NRI Hospital, Guntur teaching BLS 1 Doctors of NRI Hospital, Guntur teaching BLS Great Day Celebration at Guntur Dr Trishila at Bombay Hospital, Indore Celebrating Great Day ISCCM Day celebration at Jaipur Dr Sudhir Khunteta teaching BLS Dr. Tanuraj Sirohi speaking to delegates Dr YP singh teaching BLS at Subharti Medical College, Meerut Inline for learning BLS at Meerut ISCCM Day Celebration at Subharti Medical College, Meerut, UP Principal Medical College at Meerut Inaugurating ISCCM Day ISCCM Day Celebration at Fortis Hospital New Delhi Teaching BLS at Fortis Hospital New Delhi BLS Training at Ruby Hall Clinic, Pune BLS Training at Ruby Hall Clinic, Pune Rajamundry Branch Celebrating ISCCM Day Rajamundry Branch Celebrating ISCCM Day Rajamundry Branch Celebrating ISCCM Day Rajamundry Branch Celebrating ISCCM Day Newspaper Clipings Published By : Indian Society of Critical Care Medicine For Free Circulation Amongst Medical Professional Bldg. No.3, No.12, 5th Floor, Navjivan Commercial Premises Co-op. Society Ltd., Dr. D. Bhadkamkar Road, Mumbai Central, Mumbai Tel.: (022) Telefax: (022) Printed at : urvi compugraphics urvi@urvi.cc Editorial Office Dr Narendra Rungta Head, Critical Care, Rungta Hospital Jaipur Phone : (R) , (O) s : drnrungta@gmail.com cccisccm@gmail.com

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