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Report on the 6th world congress on intensive and critical care medicine
AUSTRALIAN CIUTICAL CARE
TEN:
Approximately every three to four years the World Federation of Intensive and Critical Care Medicine holds a congress for the purposes of providing an international forum at which member groups and delegates can showcase critical care at an international level. Meetings of the Council of the World Federation are held concurrently to amend rules, admit new members, promote position statements, elect new officers to the council and select future venues for world congresses.
In June 1993 I attended the sixth world congress in Madrid as president of CACCN Inc along with Lorraine Ferguson the then secretary of CACCN Inc and delegate to the Council of the World Federation of Societies of Intensive & Critical Care Medicine. We were present to see some very important constitutional and rule changes made which gave nurses better representation at this forum. The f i t item of interest for CACCN was the acceptance of our name change and the subsequent recognition of CACCN Inc as the representative organisation for critical care nursing in Australia. Only three other nursing organisations have gained such recognition, the British Association of Critical Care Nurses (BACCN), American Association of Critical Care Nurses (AACN) and also at this meeting the Spanish Association of Critical Care Nurses. The other issue of great importance to nursing at the assembly was the recognition of full delegate status to non physician societies (read as for nursing associations) allowing four delegates to vote. This gives us equal recognition with physicians societies. Along with this change was the acceptance of a permanent nursing position on the council of the world federation. Belinda Atkinson from BACCN was admitted to the council as the nursing delegate. Also of interest was the successful nomination of Rcfessor Malcolm Fisher from Royal North Shore Hospital, Sydney to President of the Society; all in all a big week for Australia! The scientific and professional side of the meeting ran over five days and was devoid of any time worn Spanish rituals such as siestas. Each day commenced with a p l e nary session at 8.30am and on many occa-
VOL 6 NO 4 1993
AND
sions continued on until after six in the e v e ning. Often up to nine concurrent sessions, workshops or post graduate courses were running simultaneously with up to 1800 people milling about. Even with the best planning only a small grasp of the entire meeting could be achieved. From the clinical aspect, the meeting saw many of the highly regarded "sunrise" treatments of the eighties quickly set, or at least be f i i y placed into perspective. Moncclonal antibody treatments have fallen significantly from grace, selective d e contamination regimens continue to attract many critics as has the recently developed technique of gastric tonometry. However not all was doom and gloom, with the emergence of Nitric Oxide therapy (just say "NO") showing great potential in r e ducing pulmonary shunting as an inhaled gas for severe respiratory failure. The place of NO in the biological sequence of events in the vasodilatory process also attracted much academic comment, but the jury remains "out to lunch" on the place of NO antagonists in the acute vasodilatory response, let alone any clinical application we may see in the near future. As one of my major interests is renal therapies and their application, I attended most of this component of the meeting and was pleased to see that in Australia our current practice is very much at the forefront of international convention. Scoring systems such as APACHE, SAPS and TISS were all discussed at great length by many well known faces in this field including Knaus, however the perfect system is still yet to be defined. The excellent utility of scoring systems in providing information about ICU and its outcomes was well demonstrated, however it seems that at this stage almost every one has a modified system they feel better represents their needs. Professionally, the meeting saw an almost continuous concurrent nursing program. Commencing with educational sessions for Spanish speaking nurses then diversifying into a mixture of clinical and professional free paper and lecture sessions.
One of the more controversial sessions discussed the area of non licensed practitioners in the intensive care unit. Standards across nations varied, not surprisingly however, in some of the more affluent countries, a warning came of nurses out-pricing themselves in the market place and fragmenting their stand on their definition of nursing practice. On the other hand, some less well d e veloped countries, such as Venezuela, have nurses not only exclusively staffing their ICUs, but often fulfilling the role of what we would describe as physician. After participating in this session, which was at times enriched by some novel translating (all major sessions were translated into three other languages simultaneously) I was left wondering how we ever managed to get agreement on anything considering our cultural diversity, let alone a document as broad as the "Madrid Declaration" (see Vo16 No2 June 1993 issue of ACC). Australian nurses were there in substantial numbers. There were approximately 50 Australian nurses in attendance. a commendable effort considering the distance and cost in attending such a meeting. Our voice was well heard at all major forums through both official representation and comments from the floor. Lorraine Ferguson presented three papers, both as an invited speaker and as a free paper session as well as cochairing an interesting multi lingual session on teaching and research. Kathy Daffurn presented her work on home CPAP and discharge follow-up of ICU patients. In concluding this report I would like to thank both the executive and membership of CACCN Inc for supporting my attendance at the congress which gave me the opportunity to promote our organisation as well as gain personally from the international comraderie that such a meeting generates. This report only touches on the overwhelming experience offered by these meetings. However, it is reassuring to see that the problems we face in this country are in fact encountered by many other nurses worldwide. It was also reassuring to find that the nursing care we deliver rates very highly in the global context.
TEN:
Approximately every three to four years the World Federation of Intensive and Critical Care Medicine holds a congress for the purposes of providing an international forum at which member groups and delegates can showcase critical care at an international level. Meetings of the Council of the World Federation are held concurrently to amend rules, admit new members, promote position statements, elect new officers to the council and select future venues for world congresses.
In June 1993 I attended the sixth world congress in Madrid as president of CACCN Inc along with Lorraine Ferguson the then secretary of CACCN Inc and delegate to the Council of the World Federation of Societies of Intensive & Critical Care Medicine. We were present to see some very important constitutional and rule changes made which gave nurses better representation at this forum. The f i t item of interest for CACCN was the acceptance of our name change and the subsequent recognition of CACCN Inc as the representative organisation for critical care nursing in Australia. Only three other nursing organisations have gained such recognition, the British Association of Critical Care Nurses (BACCN), American Association of Critical Care Nurses (AACN) and also at this meeting the Spanish Association of Critical Care Nurses. The other issue of great importance to nursing at the assembly was the recognition of full delegate status to non physician societies (read as for nursing associations) allowing four delegates to vote. This gives us equal recognition with physicians societies. Along with this change was the acceptance of a permanent nursing position on the council of the world federation. Belinda Atkinson from BACCN was admitted to the council as the nursing delegate. Also of interest was the successful nomination of Rcfessor Malcolm Fisher from Royal North Shore Hospital, Sydney to President of the Society; all in all a big week for Australia! The scientific and professional side of the meeting ran over five days and was devoid of any time worn Spanish rituals such as siestas. Each day commenced with a p l e nary session at 8.30am and on many occa-
VOL 6 NO 4 1993
AND
sions continued on until after six in the e v e ning. Often up to nine concurrent sessions, workshops or post graduate courses were running simultaneously with up to 1800 people milling about. Even with the best planning only a small grasp of the entire meeting could be achieved. From the clinical aspect, the meeting saw many of the highly regarded "sunrise" treatments of the eighties quickly set, or at least be f i i y placed into perspective. Moncclonal antibody treatments have fallen significantly from grace, selective d e contamination regimens continue to attract many critics as has the recently developed technique of gastric tonometry. However not all was doom and gloom, with the emergence of Nitric Oxide therapy (just say "NO") showing great potential in r e ducing pulmonary shunting as an inhaled gas for severe respiratory failure. The place of NO in the biological sequence of events in the vasodilatory process also attracted much academic comment, but the jury remains "out to lunch" on the place of NO antagonists in the acute vasodilatory response, let alone any clinical application we may see in the near future. As one of my major interests is renal therapies and their application, I attended most of this component of the meeting and was pleased to see that in Australia our current practice is very much at the forefront of international convention. Scoring systems such as APACHE, SAPS and TISS were all discussed at great length by many well known faces in this field including Knaus, however the perfect system is still yet to be defined. The excellent utility of scoring systems in providing information about ICU and its outcomes was well demonstrated, however it seems that at this stage almost every one has a modified system they feel better represents their needs. Professionally, the meeting saw an almost continuous concurrent nursing program. Commencing with educational sessions for Spanish speaking nurses then diversifying into a mixture of clinical and professional free paper and lecture sessions.
One of the more controversial sessions discussed the area of non licensed practitioners in the intensive care unit. Standards across nations varied, not surprisingly however, in some of the more affluent countries, a warning came of nurses out-pricing themselves in the market place and fragmenting their stand on their definition of nursing practice. On the other hand, some less well d e veloped countries, such as Venezuela, have nurses not only exclusively staffing their ICUs, but often fulfilling the role of what we would describe as physician. After participating in this session, which was at times enriched by some novel translating (all major sessions were translated into three other languages simultaneously) I was left wondering how we ever managed to get agreement on anything considering our cultural diversity, let alone a document as broad as the "Madrid Declaration" (see Vo16 No2 June 1993 issue of ACC). Australian nurses were there in substantial numbers. There were approximately 50 Australian nurses in attendance. a commendable effort considering the distance and cost in attending such a meeting. Our voice was well heard at all major forums through both official representation and comments from the floor. Lorraine Ferguson presented three papers, both as an invited speaker and as a free paper session as well as cochairing an interesting multi lingual session on teaching and research. Kathy Daffurn presented her work on home CPAP and discharge follow-up of ICU patients. In concluding this report I would like to thank both the executive and membership of CACCN Inc for supporting my attendance at the congress which gave me the opportunity to promote our organisation as well as gain personally from the international comraderie that such a meeting generates. This report only touches on the overwhelming experience offered by these meetings. However, it is reassuring to see that the problems we face in this country are in fact encountered by many other nurses worldwide. It was also reassuring to find that the nursing care we deliver rates very highly in the global context.