The period for CME/CE credit for this activity has expired.


Early Identification and Treatment Protocols in Managing Severe Sepsis


After completing the demographic questionnaire and the CME posttest and evaluation, a continuing education certificate will automatically be generated and should be printed or saved to your computer for your records.

Thank you for your participation.

CME/CE Information
Perspectives from Practice: Early Identification and Treatment Protocols in Managing Severe Sepsis

Enduring Materials Activity

Activity valid for credit 5/2008 – 5/31/2009

Jointly sponsored by the Center for Accredited Healthcare Education, the Institute for Medical and Nursing Education, International Medical Press, and VHA.

This program is supported by an educational grant from Eli Lilly and Company.

Activity Overview

Severe sepsis is an increasingly prevalent problem for critical care clinicians. Each year approximately 30% of patients who develop the condition die. The number of hospitalizations due to severe sepsis nearly doubled from 1993 to 2003, and more patients with sepsis are severely affected, experiencing dysfunction of more than 1 organ system. Early detection of severe sepsis, as well as development and implementation of management protocols, will lead to better patient care and clinical outcomes.

Early diagnosis requires that critical care clinicians appropriately monitor hemodynamic parameters, consider patient risk factors, and remain alert for indications of organ hypoperfusion and dysfunction. Once severe sepsis is recognized, prompt action is required. The recently updated Surviving Sepsis Campaign (SSC) guidelines provide recommendations regarding immediate actions for resuscitation and management of patients with severe sepsis and septic shock. Studies demonstrate that systematic implementation of the SSC guidelines improves clinical outcomes.

This program will feature discussions by leading experts regarding severe sepsis recognition and management in adult patients. Participants will learn about current and emerging methods for early identification of severe sepsis, benefits of protocols for managing the condition, and resources for protocol development and implementation.

Who Should Attend:

• Physicians: intensivists, critical care surgeons, anesthesiologists, emergency physicians, pulmonologists, infectious disease specialists, hospitalists, nephrologists, residents
• Critical care nurses
• Physician assistants
• Other clinicians with a role in the treatment of patients in the critical care environment

Learning Objectives (At the conclusion of this activity, the participant should be able to:

• Discuss tools and techniques that can facilitate earlier assessment of severe sepsis risk
• List evidence-based management guideline recommendations for actions to be taken within 6 hours and 24 hours of severe sepsis diagnosis
• Discuss the benefits of implementing severe sepsis treatment protocols in terms of treatment outcomes
• Identify resources for the development and implementation of severe sepsis treatment protocols

Topics to be covered

• Early identification of severe sepsis
• Guidelines, care bundles, and treatment protocols for severe sepsis
• Case studies
• Panel discussion

Panel Members:

Tom Ahrens, DNS, RN, CCNS, FAAN
Research Scientist
Barnes-Jewish Hospital
St. Louis, Missouri

Marin H. Kollef, MD, FACP, FCCP
Director, Medical Critical Care
Barnes-Jewish Hospital
Professor of Medicine
Department of Internal Medicine
Division of Pulmonary and Critical Care Medicine
Washington University School of Medicine
St. Louis, Missouri

R. Phillip Dellinger, MD
Head, Division of Critical Care Medicine
Director, Medical and Surgical ICU
Cooper University Hospital
Professor of Medicine
Robert Wood Johnson Medical School
Camden, New Jersey

Accreditation and Credit Designation Statements


This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Center for Accredited Healthcare Education (CAHE), International Medical Press (IMP), and (VHA). CAHE is accredited by the ACCME to provide continuing medical education for physicians.
CAHE designates this educational activity for a maximum of 1.75 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.


The Institute for Medical and Nursing Education (IMNE) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s (ANCC’s) Committee on Accreditation.
IMNE designates this educational activity for 1.75 contact hours (0.175 CEUs).
Accreditation by the ANCC’s Committee on Accreditation refers to recognition of educational activities and does not imply approval or endorsement of any product.

Guidelines for Receiving Continuing Education Credit

No fee is required for this activity. The participant should:

1) watch the entire broadcast;
2) sign-in or create a new username and password on ;
3) indicate you have read and understand the CME information;
4) fill out the Demographic Questionnaire;
5) take the post-test and complete and submit the continuing education registration and evaluation forms for credit.

This activity should take approximately 1.75 hours to complete. The expiration date for this activity is April 1, 2009. No credit will be granted after this date.

Continuing education credit is offered upon successful completion of the post-test with a passing score of 80% or higher. Certificates will be issued and available for printing to participants immediately upon completion of the post-test with a passing score.


In compliance with the ACCME and ANCC, it is the policy of CAHE, IMNE, and IMP to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All individuals involved in planning (eg, faculty, CME/CE staff, educational partner staff, and reviewers) are expected to disclose any significant financial relationships with commercial interests over the past 12 months. CAHE and IMNE also require that faculty identify and reference off-label product or investigational use of pharmaceutical agents and medical devices.
In accordance with ACCME and ANCC Standards for Commercial Support, parallel documents from other accrediting bodies, and CAHE and IMNE policy, identification and resolution of conflict of interest have been made in the form of external peer review of educational content. Disclosures will be provided in the program materials and announced at the beginning of the educational activity.


Tom Ahrens DNS, RN, CCNS, FAAN: speakers bureau: Eli Lilly. He does not discuss investigational products or unlabeled/unapproved uses of commercial products in this activity.

R. Phillip Dellinger, MD: formal advisor: B-R-A-H-M-S; research activities: AstraZeneca, B-R-A-H-M-S, Artisan; speakers bureau: Eli Lilly; consultant: Hutchinson Technologies. He does not discuss investigational products or unlabeled/unapproved uses of commercial products in this activity.

Marin H. Kollef, MD, FACP, FCCP: formal advisor: Bard Medical; research activities: Merck, Pfizer, Bard Medical; speakers bureau: Merck, Pfizer. He does not discuss investigational products or unlabeled/unapproved uses of commercial products in this activity.

Video Faculty

Courtney D. Harrison, RN, BSN
Nurse Educator, Emergency Services
Barnes-Jewish Hospital
Speaker’s Bureau: Edwards Life Sciences

John P. Kress, MD
Associate Professor of Medicine
Dir., Pulmonary and Critical Care Procedure Service
The University of Chicago Medical Center
Consultant: AstraZeneca

Jennifer A. Williams, APRN-BC, CEN, CCRN
Clinical Nurse Specialist, Emergency Services
Barnes-Jewish Hospital
No conflicts of interest to disclose

CME Providers and Educational Partner Staff

Philip Alapat, MD
CME Peer Reviewer
Assistant Professor, Division of Pulmonary, Critical Care, & Sleep Medicine
Baylor College of Medicine
Speaker’s Bureau: Boehringer Ingelheim

Amy Kline-Carbonara
Account Director
International Medical Press
No Conflicts of interest to disclose

Jason Ellis
Producer, vhatv
No conflicts of interest to disclose

Kimberly McFarland, PhD
Medical Writer
Spouse is employed by GlaxoSmithKline
Writer for the following commercial interests: Thomson Scientific Connexions, Meditech Media, Hemispherx Biopharma.
Stock Interests: Pfizer, Proctor & Gamble, GlaxoSmithKline, Stryker, Biovail, LifeCell, Sciele Pharma.

Darilyn Paul, RN, MS, CS, APRN-BC, CCRN
Nurse Planner/CE Reviewer
Critical Care Nurse Specialist
Somerset Medical Center
No conflicts of interest to disclose

John Pevoto
Director, vhatv
No conflicts of interest to disclose

Martin Quan, MD
CME COI Reviewer
Director, Office of CME
Geffen School of Medicine at UCLA
No conflicts of interest to disclose

Richard Thalmann, RN, BSN, CCRN
CE Reviewer
New York Presbyterian Hospital
No conflicts of interest to disclose

Steve Weinman, RN, BSN, CEN
Senior Director – IMNE/CAHE
No conflicts of interest to disclose


This activity is designed for healthcare professionals for educational purposes. Information and opinions offered by the faculty/presenters represent their own viewpoints. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information.
While CAHE and IMNE make every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision making before applying any information, whether provided here or by others, for any professional use.

Faculty Biographies

Tom Ahrens, DNS, RN, CCNS, FAAN FAAN is a Research Scientist at Barnes Jewish Hospital in St. Louis He has extensively published, including 5 books and over 100 papers. He has lectured both nationally and internationally on critical care topics. Dr. Ahrens is actively involved in technology application, particularly in terms of hemodynamic monitoring and capnography. He has been widely published in the application of technology to clinical practice. He organized a multi-center study that illustrated how end tidal CO2 could accurately predict survival following cardiac arrests. His book “Hemodynamic waveform analysis” is considered by many to be the finest clinical guide to the topic. His book “Essentials of Oxygenation” was an American Journal of Nursing Book of the Year. He was awarded the 1999 Presidential Citation by the Society of Critical Care Medicine and in 2004 was inducted into the American Academy of Nursing.

He is a strong advocate for hospitalized families. He has published a research paper that demonstrated how improving communication with high risk patient families can improve both outcome and costs control. He has helped design communication programs to aid clinicians and published how nursing can lead the way to better matching patient/family wishes with the plan of care. In 2006 he was selected as an Edge Runner by the Academy, which is designated “for those people who are developing innovative solutions that eventually become mainstream solutions”, for his work with families of hospitalized patients

R. Phillip Dellinger, MD is Professor of Medicine at Robert Wood Johnson Medical School, University of Medicine and Dentistry or New Jersey. He is Head, Division of Critical Care Medicine; Director, Medical/Surgical ICU; and Program Director of the Critical Care Medicine Fellowship training program at Cooper University Hospital, Camden, New Jersey. He is a fellow of the American College of Critical Care Medicine. He was previously the ACCP governor for both Texas and Missouri and gave the ACCP Roger C. Bone Honor lecture in 2001. Dr. Dellinger was president of the Society of Critical Care Medicine (SCCM) from 1998-1999.

He is currently a senior editor for the SCCM’s journal, Critical Care Medicine. He is the creator of the SCCM Fundamental Critical Care Support (FCCS) course. Dr. Dellinger has authored over 300 journal articles, films and book chapters in the fields of critical care medicine and pulmonary disease, featuring both laboratory and clinical research. He has edited over a dozen books and journal issues with emphasis on sepsis and acute respiratory distress syndrome. He co-edits the annual publication of the Yearbook of Critical Care Medicine and

co-edited the second and recently published third edition of the major critical care textbook, Critical Care Medicine (Mosby). He has received numerous awards and honors, to include induction into the Baylor College of Medicine Teaching Hall of Fame and the SCCM’s Distinguished Service Award.

Dr. Dellinger was an associate chair of the 1992 consensus conference that created the first definitions for sepsis and chaired the 1997 National Institutes of Health/American College of Chest Physicians workshop, “The Future of Sepsis Research”. He is past chairman of the International Sepsis Forum. He serves on the executive committee of the Surviving Sepsis Campaign (SSC). He co-chaired the committee that created the 2004 SSC International Guidelines on the Management of Severe Sepsis and Septic Shock and chaired the first revision in 2008. He was the recipient of the Bronze Star and Purple Heart while serving in Vietnam.

Marin H. Kollef, MD, FACP, FCCP is Professor of Medicine at Washington University School of Medicine and Director of the Medical Intensive Care Unit and Respiratory Care Services at Barnes-Jewish Hospital in St. Louis, Missouri. He is a fellow of the American College of Physicians and the American College of Chest Physicians. He is also a member of the American Thoracic Society, Society of Critical Care Medicine, American Association for Respiratory Care, and American Society of Clinical Investigation. He has served as chairman for the Academy of Infection Management (2003-2004) and as co-chairman for the Ventilator-Associated Pneumonia (VAP) Outcomes Scientific Advisory Group (2000-2002) and the Assessment of Local Antimicrobial Resistance Measures (ALARM) study group (2003-2004).

Dr. Kollef has lectured extensively on topics crucial to critical care medicine including fungal infection, ventilator-associated pneumonia, antibiotic resistance, and optimization of antibiotic therapy. In 2005, he delivered the Surgical Infection Society’s Twenty-fifth Annual William A. Altemeier Lecture on The Intensive Care Unit as a Research Laboratory: Developing Strategies to Prevent Antimicrobial Resistance. Dr. Kollef has authored over 350 peer-reviewed manuscripts, letters, case reports, editorials, and invited publications. He is currently on the editorial boards of Respiratory Care, Annals of Internal Medicine, Critical Care, Critical Care Medicine, Informed Decisions/Clinical Strategies, and Journal of Surgical Infections and reviews manuscripts for numerous periodicals including Chest, JAMA, and the New England Journal of Medicine. Dr. Kollef’s current research focuses on optimal antimicrobial treatment of VAP, the epidemiology of Candida infections in the ICU, and identification of a sepsis prediction tool.

Dr. Kollef is the recipient of many honors and awards including selection to “Best Doctors in America”, Central Region (1996 - present) and Barnes-Jewish Hospital Team Awards for Quality Improvement for programs directed to VAP prevention (2001), bloodstream infection prevention (2003), and the “Surviving Sepsis Initiative” (2006). His awards for military service with the First Infantry Division (Mechanized) during Operation Desert Storm include the Bronze Star, Meritorious Service Medal, and Combat Medical Badge in Support of Combat Operations.
 I have read and understand the CME Information indexed above.

    • Demographic Questionnaire - This portion of the activity allows us to evaluate the types of healthcare professionals who are participating in the activity. This information will also be used to develop needs assessments for future educational programs on this topic. Thus, to the best of your ability, please respond with what you feel is the most accurate answer. After completing this section, you will be directed to the patient case study section.
    • CME Posttest and Evaluation - This should be completed after the demographic questionnaire.

    You can click on each section to preview this activity but you must be signed in to participate and receive CME credit. New to Click here to register.