The Intensivist April 2016

2. Lead Article5. President’s Report6. ANZICS Events8. Membership Report9. CTG Report10. CORE Report12. DODC Report13. Education Report14. Paediatric Report16. PricE Report17. S&Q Report19. Regional Reports

The IntensivistAPRIL 2016

The Australian and New Zealand Intensive Care Society (ANZICS) is the leading advocate on all intensive care related matters. The Society is devoted to all aspects of intensive care medical practice through ongoing professional education, the provision of leadership in medical settings, clinical research and analysis of critical care resources.

Become an ANZICS Member today for a great range of benefits including:

• Access to exclusive email lists:

Free subscription to regular email updates on Intensive

Care specific issues and information for all ANZICS Members.

• Discount to ANZICS Conferences:

Receive ANZICS Member only rates to the leading conferences,

inclusive of; the Annual Scientific Meeting, the ANZICS Safety

& Quality Conference, Singapore-ANZICS and other smaller

educational events.

• Access to software and reporting facilities:

Gain access to software, central processing and reporting facilities

for the provision of comparative reports on adult patient activity

and acuity – for both Adult and Paediatric Patients.

• Contribution to the Intensive Care Community:

Share in and contribute to the professional profile and identity

of Intensive Care Specialists in the healthcare and broader

community.

Join one of our many exciting Committees and immerse yourself in the Intensive Care Community.

To find out more information about ANZICS and joining us today, please visit: www.anzics.com.au

Advocate for Intensive Care Throughout Australia & New Zealand

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THE AUSTRALIAN & NEW ZEALAND INTENSIVE CARE SOCIETYAdvocate for Intensive Care Throughout Australia & New Zealand





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w: www.anzics.com.auAdvocate for Intensive Care Throughout Australia & New Zealand




free subscription to regular email updates on Intensive






educational events.






Share in and contribute to the professional profile and identity of

Intensive Care Specialists in the healthcare and broader community.

Join one of our many exciting Committees and immerse yourself in the Intensive Care community.






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The Intensivist - December 2015 Page 2

LEAD ARTICLE:MILITARY INTENSIVE CARE – PROVISION OF CARE IN A CRITICAL WORLD?

“Ask not what your country can do for you, ask what you can do for your country”. John F. Kennedy

It is a tremendous privilege to write for the Intensivist while deployed overseas and reflect on the contribution one can make as a Critical Care Physician in the Australian Defence Force. One feels a certain sense of apprehension, impending challenge and excitement while seated in a military transport aircraft: darkened cabin, sitting in a canvas sling seat, wearing body armour, a helmet and firmly holding your weapon, as we descend into the theatre of operations. Regardless of the number of times you have been down this road, the “buzz” is always hard to explain and the reward impossible to calculate. This is not my story, but rather the story of those relatively few Intensivists who serve in our defence force and in the process get to experience so much.

The last decade has seen Australia involved in a number of conflicts and provide care in humanitarian disasters, requiring the deployment of Intensivists to South East Asia, Micronesia, Afghanistan, Iraq and other areas within the Middle East. These deployments provide a remarkable opportunity to deliver world class care in an austere and at times demanding environment. Whether it is providing care in a mass casualty situation in a NATO Military Trauma Hospital in war torn Afghanistan or treating someone in the “state of the art” intensive care unit in one of Australia’s new Landing Helicopter Dock (LHD) ships, the sense of reward is always immense.

The journey to reach a position in which you are potentially suitable to deploy, is in itself an experience and challenge. From the moment you volunteer to commission in the defence force, so begins both the commitment and reward. Currently there are a number of mechanisms by which an Intensive Care Specialist or aspiring Specialist may serve, including as an active reservist, a full time defence force member on a specialist training pathway or as a full time Intensivist in the ADF medical specialist program.

The ability to have a fulltime, competitive, challenging and rewarding career in the ADF as an Intensivist is a relatively new innovation. Regardless of the scheme under which you join and indeed the service with which you choose to enlist, the process is remarkably similar.

Following your initial expression of interest, you will undergo an interview, psychological screening, physical fitness and medical testing. Don’t let age discourage you, defence will consider applications from Intensivists well into your 6th decade. There is inevitably a long and at times frustrating paper war, required to obtain the appropriate police clearances, security

classification and professional credentialing. Once selected an individual will find themselves on their way to one of the initial Officer Entry Schools for their introductory training, the time commitment will usually be in the order of four to six weeks.

In the case of the Navy this will be HMAS Creswell in Jervis Bay, the Army will be Duntroon, Canberra and the Airforce to RAAF Base East Sale in Victoria.

These courses are designed to equip the individual with the requirements to be an Officer, how to wear the uniform with pride, understand the traditions, reinforce leadership skills and learn a range of skills that may include bushcraft, survival at sea, weapons training and service writing. While at times physically challenging there is

“These deployments provide a remarkable opportunity to deliver world class care in an austere and at times demanding environment.“

NATO Role III, Kandahar, Afghanistan 2013

The author deploying 2016

professionals and often these individuals have a very advanced scope of practice. There are several military medical training establishments around the country with outstanding simulation facilities which allow for involvement in very high fidelity training. The hot desert sun beats down on the flapping canvas of the hospital tent and the dusty green palm tree branches gently sway in the wind, as I look out across a series of battered rocket shelters. I think back to previous exotic environments in which I have also been privileged to serve, be it the South Pacific Ocean, the snow-capped mountains of Afghanistan or a South East Asian jungle.

The feeling of camaraderie, service, pride and excitement doesn’t wane. You could say we are lucky or you could say to yourself my time has come to escape the routine of your daily life and put your hand up and be counted. I would be very happy to assist any interested colleagues should you decide this might be your next challenge.

CMDR Anthony Holley, RANR

certainly no requirement to be a greyhound or Clydesdale cart horse, all that is required is a desire to succeed and put your best foot forward. There are a remarkable and diverse number of courses available to an ADF Intensivist. The Rotary Wing Aeromedical course is professionally very satisfying, involving substantial amounts of time in the air frames and accompanied by the Helicopter Underwater Escape Training. Learning to care for the critically injured in the fixed wing environment is facilitated by undertaking the six-day Military Casualty Aeromedical Transport Course (MCAT). It may be that your interest lies in the marine environment, in which case the Medical Officer’s underwater medicine course could be right up your alley. These skills once acquired are very transferable to the civilian environment and serve as a prime example of how both the ADF and your civilian employer may benefit from your military career.

Service in faraway lands and hostile environments, not only provides unique clinical exposure, but also the opportunity to examine other systems and structures. A recent deployment to Afghanistan demonstrated an all-inclusive and robust morbidity and mortality process that could be very effectively translated to the civilian setting. The privilege and reward in caring for grateful service personnel is impossible to beat. The defence force also offers a range of valuable leadership and management courses that are readily accessible to the serving Intensivist.

Operational deployments often deliver unique experiences that leave indelible memories. Whether it is caring for the trauma patient with injuries of a magnitude rarely seen in a non-conflict zone or the opportunity to be involved in the care of some unusual tropical disease, the learning is often phenomenal. While the clinical contribution is our principle reason for existing in these environments, the










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The Intensivist - April 2016 Page 3

non-clinical experiences bring an entirely new dimension to our lives. The privilege of working in an intensive care unit and witnessing badly wounded American soldiers receive their purple heart medals is unforgettable and extremely humbling.

We have seen some very exciting develop-ments in Defence Medicine over the last five years and the recognition of the need for defence research has resulted in the appointment of the inaugural Professor of Surgery and Military Medicine. This is a full time University of Queensland appointment, currently occupied by a Reserve Army Officer in the form of Colonel Reade (FCICM). This has created a wealth of opportunities for the ADF health care provider wanting to understand, study, publish and develop medicine within the military construct.

Again, the cross pollination between the military and civilian environment has been remarkable under the tremendous guidance of Colonel Reade. The military Intensivist also assumes an important role in the provision of education for a wide range of health

MILITARY INTENSIVE CARE – PROVISION OF CARE IN A CRITICAL WORLD?

“The defence force also offers a range of valuable leadership and management courses that are readily accessible to the serving Intensivist. “

Tarin Khat, Afghanistan 2012

Navy Medical Specialist Team, Taji, Iraq 2016

HMAS Canberra (LHD) with its “state of the art” 8 bed ICU. 2015

Critical Care Collaborative An exciting initiative by ACCCN & ANZICS

providing inter-professional education in an informal environment on the latest research &

best practice for all Critical Care Clinicians.

High quality presentations & interactive

sessions followed by drinks. And it’s affordable.

Friday 26 August, 2016

Rydges on Swanston 701 Swanston St, Melbourne

Become a member for the best rateswww.acccn.com.au www.anzics.com.au

PRESIDENT’S REPORT

Dear Membership

The last few months have been very busy indeed. Primarily, ANZICS has been liaising extensively with the Health Minister’s Office in providing opinion on the Organ Tissue Authority (OTA) who support a number of Intensivist positions in all states in Australia. The KPMG review of OTA makes for interesting reading. I have met with the new Acting CEO of OTA, Felicity McNeill, and urged for her not only to focus on optimising Organ Donation, but to also look into the on-costs of the Donation process e.g. ICU beds, Surgeon availability, etc. ANZICS put forward an opinion paper to Minister Nash and also the issue of an ‘opt-out’ system were mentioned. I would like to mention the outstanding efforts of A/Prof. Bill Silvester in the capacity of DODC Chair in dealing with these Government communications.

The PricE Committee Chair Mark Nicholls, represented the Society at the MBS meeting in Canberra in February, his report will follow in the newsletter. A personal observation is that of differing degrees of dysfunctionality and disharmony in bigger ICU’s in ANZ. As a Director of a 27 bed (1900 separation pa unit) I am concerned about this and I think PRicE should consider an “ICU Directors’ Corroboree” at an ASM. This is also very

relevant considering the pending results of the CICM Survey on Harassment and Bullying, which is probably more widespread in our units than we appreciate.

As I write this, the Noosa CTG Meeting is underway and I attended the CORE workshop on Monday. This meeting is of continued high quality and the concurrent Research Co-ordinator Meeting was also underway and well-attended. This takes me to the progress being made by Simon Erickson (Secretary) and Brent Kingston (Executive Assistant) with the planning and implementation of new membership categories. Please see the website for details and encourage any Intensive Care Healthcare provider to join ANZICS – we want to be representative of the Multidisciplinary Team that delivers Intensive Care. Thank you to Mr Tony Tenaglia, our GM, for your continued guidance in these issues.

ANZICS representation will be travelling to the United Arab Emirates in April to showcase ANZ Intensive Care excellence and offer assistance in Benchmarking and Quality initiatives that ANZICS is renowned for. Feedback will be provided. ANZICS supports the Women in Intensive Care Network (WIN) and provisions are

being made at the 2016 ASM in Perth for this subgroup to meet. The Perth ASM preparation is in full swing and promises to deliver an exciting scientific and social package. The 2017 ASM will be held at the Gold Coast from October 12-14 in 2017. Organising Committees are being formed and the long awaited return of the ASM to the East Coast will prove to be a “Bewdy, Mate”.

The upcoming International Meeting on Rapid Response and MET is in Melbourne on May 2-3, 2016 with an excellent programme. ANZICS is also committed to hosting the World Federation of Societies of Critical Care Medicine Conference in Melbourne in 2019.

On a closing note: ‘A Society’s strength lies in its membership’. I would like to thank all of you who give of their time and support to help our Society be the outstanding Intensive Care Representative that it is.

Yours sincerely.

Marc Ziegenfuss ANZICS President

PresidentMarc Ziegenfuss

Imm/Past PresidentAndrew Turner

Hon SecretarySimon Erickson

Hon TreasurerAnthony Holley

VIC ChairStephen Warrillow

NSW/PricE ChairMark Nicholls

SA ChairYasmine Ali Abdelhamid

QLD ChairRajeev Hegde

NZ ChairBen Barry

WA ChairBradley Wibrow

TAS ChairDavid Rigg

CORE ChairDavid Pilcher

CTG ChairCraig French

Paediatric ChairJohnny Millar

ANZICS BOARD MEMBERS 2016

PRESIDENT’S REPORTMARC ZIEGENFUSS

12th International Conference on Rapid Response Systems & Medical Emergency Teams

02 - 03 May 2016, Melbourne

http://www.isrrs2016.com.au/

CTG Winter Research Forum01 - 02 August 2016, Sydney, Australiahttp://www.anzicsctg.org

ANZICS/ACCCN Critical Care Collaborative Friday 26 August 2016, Rydges Hotel, Carlton http://www.anzics.com.au

41st ANZICS/ACCCN Intensive Care ASM and 22nd Annual Paediatric and Neonatal Intensive Care Conference 20 - 22 October 2016 Perth Convention and Exhibition Centre, Western Australia http://www.intensivecareasm.com.au

2017 SG-ANZICS Intensive Care Forum

21 - 23 April 2017 Suntec Singapore Further details TBC

ANZICS Events

http://www.anzics.com.au/events

www.intensivecareasm2016.com.au

Program Themes:Cardiac ResuscitationDisaster ManagementTransition to Adult CriticalCareCardiacCystic FibrosisNeurological DiseaseVentilation/Infection/FluPain and sedation in PICUTechnology/InformaticsRRT in childrenParent initiatedEnd of lifeQuality and safety

Keynote speakers:• Professor Stijn Blot• Professor Anne-Sylvie Ramelet• Dr Sam D Shemie• Ric Charlesworth

www.intensivecareasm2016.com.au

A total of 21 new applications have been received by the Society since the December edition of The Intensivist. Unfortunately the total membership has decreased due to largely outstanding fees. I would like to express my gratitude to all of our Members, Regional Chairs, LinkPersons and our Committee Members who have helped to promote and spread the word of ANZICS and the work it does for Australian and New Zealand Intensive Care Medicine.

The Society is devoted to its Members and would like to continue to encourage young professionals in our specialty to remain a part of ANZICS. Although we have always been successful in recruiting new Members, I must encourage all ANZICS Members

to continue promoting the Society and encourage people working within our specialty to join ANZICS. It is also important to encourage all Members to get involved in the Societies Committees and activities, as we need a variety of people in these roles to keep ANZICS growing. The Society is a reflection of its membership and the important work completed by ANZICS is dependent on them.

Following the recent expansion of Affiliate Membership, I would also encourage you to spread the word of ANZICS to all ICU staff in order for the Society to better represent the entire Intensive Care Community. While we have had regular membership application interest from new Members to the Society,

MEMBERSHIP REPORT

I would like to remind those Members with outstanding subscriptions to please make payment on these as soon as possible. Discounted rates have now been introduced for new Full Members and for New Fellows who are progressing from Trainee to Full Members.

Please see the ANZICS website for full details and prices. I’d like to take the opportunity to welcome the following new members.

Simon Erickson Hon Treasurer

Renee Battson Royal Brisbane & Women’s Hospital QLD

Stephen Luke The Townsville Hospital QLD Tal Gadish Royal Children’s Hospital, PICU VIC

Mahesh Ramanan Princess Alexandra Hospital QLD

Judit Orosz The Alfred Hospital VIC

Rangan Joshi Women’s and Children’s Hospital SA

Peter Marko ICU Taranaki Base Hospital NZ

Alexander Richardson Alfred Health VIC

Colin Barnes Hutt Valley Disctrict Health Board, NZ

Patrick O’Sullivan The Northern Hospital, VIC

Andrew Boyle Royal Adelaide Hospital, SA

Yee Yong Lee Canberra Hospital, ACT

Ramad Azad Coffs Harbour Health Campus NSW

Aniket Desai Austin Hospital, VIC

Clare Jamieson Caterbury District Health Board, NZ

Nandkumar Raut Fiona Stanley Hospital WA

Andrew Van der Poll Auckland City Hospital, NZ

John Zorbas Joondalup Health Campus WA

Please welcome the following new members:










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The 18th Annual Meeting on Clinical Trials in Intensive Care was held in Noosa from Monday 7th March until Thursday 10 March 2016. This year our invited International Speaker was Professor Danny McAuley from Belfast, Northern Ireland. Danny has a strong interest in both Preclinical and Clinical ICU Research with a particular focus on Acute Lung Injury. All presentations were excellent and showcased the best of new, current, and recently published research projects. The next five years will be exciting, stimulating, challenging, and busy!

The week commenced on Monday with the Research Coordinators meeting and CORE meetings. I was fortunate to attend a session of each. The Research Coordinators meeting was exceptionally well attended with over 100 registrants. The organisers developed a diverse and engaging program; this stimulated excellent discussion and it is clear that Research Coordinator initiated and led research is continuing to evolve at a rapid pace. The CORE Workshop was similarly well attended; a number of presentations highlighted how significant the APD is for the conduct of research in Australia and New Zealand. Thank you to the Organising Committees of both these meetings.

The Paediatric Study Group and the Preclinical Study Group held concurrent sessions during the “main” meeting. The quality of presentation and depth of discussion was again excellent. The CTG

Committee acknowledges the efforts of those who convene these sessions. An important issue canvassed at this year’s meeting is that of data sharing. In January the International Committee of Medical Journal Editors published a proposal that requires researchers to share de-identified patient level data.

This proposal raises many challenges: in particular ensuring the rights of trial participants, researchers and sponsors are respected and ethical and legal obligations complied with. The CTG will develop a formal response together with the Australian Clinical Trials Alliance (ACTA).

On behalf of the CTG I wish to thank our Executive Officer, Donna Goldsmith, and Executive Assistant, Simone Rickerby for their tireless work behind the scenes that ensures the success of the CTG and our meetings.. Craig FrenchChair, CTG

Committee Membership:

Chair: Craig French

Immediate Past Chair: Colin McArthur

Vice Chair: Sandra Peake

Treasurer: David Gattas

Secretary: Racheal Parke

NSW/ACT: Manoj Saxena

NZ: Paul Young

QLD: Jeremy Cohen

SA/NT: Adam Deane

TAS: David Cooper

VIC: Andrew Udy

WA: Ed Litton

IRCIG: Glenn Eastwood

PSG: Marino Festa CORE: David Pilcher

CLINICAL TRIALS GROUP (CTG)










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COMET coming soon!

Development is well underway with the new ANZICS CORE data collection system which will replace AORTIC. This will be called COMET: The CORE Outcome Monitoring & Evaluation Tool (COMET).

AORTIC has been the software program used by the majority of ICUs in Australia and New Zealand to collect data for over 20 years. Very few software products can claim to have lasted this long. However soon it will no longer be supportable by many of the Windows based IT systems in ANZ Hospitals. COMET has been developed so that it can run on modern IT systems. So COMET is needed soon!

This development has allowed us to update and do the first major changes to the ANZICS dataset in 10 years. Variables which are not used for reporting or risk adjustment, such as respiratory arrest and smoking, have been dropped. New variables such as a frailty assessment, and non-mortality outcomes such as delirium and pressure injury have been added. Information on therapies, which have been collected at many sites for a long time, will now also be sent centrally to ANZICS. These will allow us to provide comparative reports on the therapies (e.g. ventilation, tracheostomy, renal replacement) for the first time.

Feedback from the ANZICS CORE Workshop in Noosa

Thank you to all the speakers and attendees at the ANZICS CORE workshop in Noosa in March. The theme of the day was built around how best to use registry data for research. A number of projects were

presented with themes of ICU efficiency and linkage occurring commonly. Speakers included:

Michael Bailey (ICU coverage over the past 10 years – implication for studies using the APD),

Aidan Burrell (ICU efficiency – Development of a risk adjusted model of ICU length of stay),

Nudrat Rashid (Mortality adjusted analysis of organ donation rates in Australian ICUs),

Pooria Sarami (Evaluation of multi-organ failure in trauma patients in NSW),

Gerry O’Callaghan (The application of operational research methods to intensive care patient flow data provide solutions to capacity constraints),

Dashiell Gantner (CARETACK – Assessment of processes of Care within ANZ ICUs) &

Marino Festa (Insights from the ANZ Paediatric Registry).

Prof Kathy Rowan from the UK also provided valuable insights into how ICNARC integrates registry data into clinical trials. Special thanks go to Shaila Chavan, Andrew Udy and Sue Huckson for putting the whole day together.

Publications – ANZICS CORE supporting research

Congratulations to the following authors who have all published papers using CORE

CENTRE FOR OUTCOME & RESOURCES (CORE)

data over the past year including Luregn Schlapbach, Eldho Paul, Andrew Udy, Bala Venkatesh, Masoumeh Sangou, and Jack Iwashyna, Rob Weinkove and Maija Kaukonen.

A special mention goes to Eldho Paul for his recent publication in Critical Care and Resuscitation looking at how ANZROD influences identification of outlier ICUs. For those of you, like me, who need help putting the stats into English, it showed ANZROD identified more outliers and these were more likely to be ‘real ones’ than when we used APACHE III!

Yours, Dave Pilcher and the ANZICS CORE Management Committee

CORE Management Committee:

Chair: David PilcherChair, CCR: Peter HicksChair, ANZPICR: Johnny Millar










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A collaborative meeting between ANZICS and the International Society for RapidResponse Systems is being held in Melbourne 2-3 May 2016.

There will be sessions related to:• general hospital patients • the emergency department• obstetric patients • deteriorating mental health status

• paediatric deterioration • end of life care

• meet the experts • training RRT responders

For further Information go to www.isrrs2016.com.au

12th InternationalConference onRapid Response

Systems and MedicalEmergency Teams

Melbourne – 2-3 May 2016

DODC Activity

Toward the end of 2015 the ANZICS DODC underwent a reformation. Following a call for expressions of interest and jurisdictional voting the new Committee members are: A/Prof. William Silvester (Chair), Dr Jorge Brieva (NSW), Dr Sarah Jones (NT), Dr James Judson (NZ), A/Prof. David Cook (QLD), Dr Stewart Moodie (SA), Dr Helen Opdam (VIC), Dr Nandkumar Raut (WA), Dr Ben Gelbart (Paediatric). In addition A/Prof. Mary White is the second ANZICS Representative on the Australian Organ & Tissue Authority (AOTA) Family Donation Conversation Steering Committee. Tasmania still requires DODC representation, if you are interested in this position or wish to nominate a representative please contact Jess Menzel-Armour; [email protected]

The DODC has recently published a statement on Circulatory Death Determination in response to an article on DCD heart transplantation published by the Australian Financial Review (AFR). This statement along with the ANZICS Statement on Death and Organ Donation edition 3.2 is available on the ANZICS website under Committees - Death and Organ Donation.

Most of you will be aware of the Australian Government announcement in 2015 to review AOTA’s organ donation and transplantation programme. At the time, ANZICS released a statement in support of AOTA and the organ donation and transplantation program and I attended the review at Ernst and Young along with

representatives of DonateLife Victoria, the Lions Eye Bank, the Victorian Tissue Bank, and kidney, liver and thoracic transplantation, the Transplant Nurses Association and CICM. The newly formed DODC has recently provided feedback to the Department of Health regarding the Ernst & Young review of the implementation of the national reform agenda on organ and tissue donation and transplantation. and I had the opportunity to discuss the review and its recommendations with the responsible Minister, Senator Fiona Nash.

End-of-Life Care Working Group (EOLCWG)

The ANZICS Statement on Care and Decision Making at the End-of-Life for the Critically Ill was released and endorsed by the ANZICS Board late in 2014. It has been publicised through Radio National’s Health Report with Dr. Norman Swan as well as via a podcast with Neil Orford. Additionally, the Statement lead to the publication of an article in the Australian Hospital and Healthcare Bulletin.

ANZICS also continues to receive regular requests to reference the Statement for the development of related educational resources. It will periodically be reviewed by the members of the EOLCWG to ensure it remains relevant and up to date and I encourage any comments or feedback to be submitted.

On behalf of the DODC and EOLCWG, I wish to thank the ANZICS membership for their vital input and support.

William Silvester Chair, DODC and EOLCWG

DODC Committee Membership:

Chair: A/Prof. William Silvester (VIC)

NSW: Dr Jorge Brieva

NT: Dr Sarah Jones

NZ: Dr James Judson

QLD: Dr Stewart Moodie

VIC: Dr Helen Opdam

WA: Dr Nandkumar Raut

Paediatric: Dr Ben Gelbart

FDC Representative: A/Prof Mary White

EOLCWG Committee Membership:

Chair: A/Prof. William Silvester (VIC)

Dep. Chair: Dr Stewart Moodie (SA)

NSW: Professor Malcolm Fisher

NSW: Professor Ken Hillman (Advisory only)

QLD: A/Prof. Brent Richards

NSW: A.Prof. Theresa Jacques, Dr Peter Saul, Dr Stephen Jacobe

NZ: Dr Stephen Streat, Dr James Judson

CICM: Dr Charlie Corke (VIC)

NT: Dr Penny Stewart

SA: Dr Dominic Wilkinson

DEATH & ORGAN DONATION COMMITTEE& END OF LIFE CARE WORKING GROUP










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www.health.gov.au/internet/main/publishing.nsf/Content/E4436A5F6124F0CDCA257F4C00352A31/$File/Review%20of%20the%20implementation%20of%20the%20national%20reform%20agenda%20on%20organ%20and%20tissue%20donation%20and%20transplantation.pdf

www.anzics.com.au/Downloads/Circulatory%20Death%20Determination.pdf

www.anzics.com.au/Downloads/ANZICS%20Statement%20on%20%20Death%20and%20Organ%20Donation%20Edition%203.2.pdf

www.anzics.com.au/Downloads/ANZICS%20Statement%20on%20Care%20and%20Decision-Making%20at%20the%20End%20of%20Life%20for%20the%20Critically%20Ill.pdf

www.anzics.com.au/Downloads/ANZICS%20Statement%20on%20Care%20and%20Decision-Making%20at%20the%20End%20of%20Life%20for%20the%20Critically%20Ill.pdf

www.abc.net.au/radionational/programs/healthreport/advance-care-planning-and-end-of-life-care/6160660

www.abc.net.au/radionational/programs/healthreport/advance-care-planning-and-end-of-life-care/6160660

https://www.crit-iq.com/Podcast

www.hospitalhealth.com.au/news/aged-care/intensive-care-decision-making-for-the-critically-ill/

Since the last edition of the Intensivist, the Education Committee has gained a new Queensland Representative, Dr Yogesh Apte, as well as a NZ Representative, Dr Alex Kazemi. Many thanks to outgoing member A/Prof Michael O’Leary, for his support and activity on the Education Committee.

The Committee has had one meeting in 2016 so far, with major outcomes including supporting the development of the 2016 ASM program based on delegate feedback and past content, development of the Foundation Course for the New Intensivist to be held at the 2016 ASM, and future ANZICS involvement in the Eastern Health ICE Course which received highly positive feedback in 2015.

The Education Committee has an advisory role in the development and delivery of the ICE course at Eastern Health. Convener, Dr Max Moser and his team put together a practical, pragmatic, immersive curriculum that allowed trainees to safely develop their own confidence and competence in a wide range of potentially confronting scenarios.

The Communications and Social Media Working Group (CSMWG), has also had a number of meetings since its formation in mid-2015 and is in the process of further developing effective social media strategies and related materials. The strategies will look to improve ANZICS’ social media presence and ensure that ANZICS remains the front running advocacy group for all of critical care practice.

Throughout 2016, the Education Committee along with the CSMWG will further develop the online education system. To date, content has been taken from a variety of areas such as past ASMs and Safety and Quality, and has been made available online. Material will continue to be added

from future ASMs and events as well as from other Committees of the Society which will provide the membership with access to high quality presentations from previous ANZICS conferences.

Sam RadfordChair, Education Committee


Chair: Sam Radford (VIC)

Vice Chair: Stephen Warrillow (VIC)

Paediatric/QLD: Scott Simpson

QLD: Yogesh Apte

NSW: Charudatt Shirwadkar, Dhaval Ghelani, Elizabeth Fugaccia,

NT: Rajendra Goud

NZ: Alex Kazemi

SA: Mary White

TAS: Andrew Turner

WA: Anthony Tzannes

Communication and Social Media Working Group:

Chair: Peter Harrigan

NZ: Kirsten Bond

NSW: Nurdat Rashid

NSW: Craig Hore

VIC: Tom Rozen

VIC: Elizabeth Skinner

EDUCATION COMMITTEECommittee membership

Immediate Past Chair, NSW Angus Carter

SA Arthas Flabouris

NSW Deepak Bhonagiri

CICM Mary Pinder

ACCCN Bernadette Grealy

WA Simon Towler

NZ Alastair (Craig) Carr

QLD John Gowardman

VIC Jonathan Barrett

Paediatric Christopher James










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ANZPIC Registry

The ANZPIC Registry component of the CORE Enterprise Reporting System (CERS) was launched in late 2015 after an enormous amount of work on development, data loading and checking. Data are now available on the CORE portal, where a suite of customizable reports and charts are viewable. The reporting capacity of the portal is set to increase in coming years and feedback from sites is welcome.

The 2014 Annual Report has been published on the ANZICS website and details the ongoing growth and excellent performance of paediatric intensive care in our region. The Report records more than 11,500 admissions of children to ICU, the highest annual number in the Registry’s history.

Several prominent publications have ensued from the analysis of ANZPICR data over the last 12 months. Requests for data and research proposals are always welcomed by the Registry, and the process for data application and use is described on the ANZICS website.

Paediatric Studies Group

Congratulations are due to Rino Festa, from Westmead Children’s Hospital, who won a contested election to chair the Paediatric Studies Group. Rino chaired his first PSG meeting at the Noosa CTG meeting earlier this month. Rino has taken over from Simon Erickson, who is the Immediate Past Chair of the group. Under Simon’s leadership the

PSG has significantly advanced its profile, both locally and internationally, and we thank him for the hard work and energy that he has brought to the group over the last 3 years.

Progress of ongoing studies and proposals for several new projects were discussed in Noosa. A pilot study of early goal-directed sedation in PICU is nearing completion, being led by Simon Erickson (Princess Margaret, Perth) and Deb Long (Lady Cilento Children’s Hospital, Brisbane). The SAFE-EPIC project looking at fluid resuscitation in PICU in more than 120 units around the world has been completed and is in the process of manuscript preparation. This impressive effort was lead by Rino Festa (Westmead Children’s Hospital, Sydney). A proposal for a novel design trial of colloid vs crystalloid resuscitation fluid is under development. In the last few weeks the group has submitted an NHMRC funding application for a trial of nitric oxide in paediatric cardiopulmonary bypass, which is being headed by Andreas Schibler from the Lady Cilento Children’s Hospital in Brisbane.

ASM

We are looking forward to this year’s ASM in October in Perth. Simon Erickson has been organising the medical scientific programme and has secured several prominent international and Australasian speakers for what promises to be an excellent meeting.

Johnny MillarChair, Paediatric Committee

PAEDIATRIC COMMITTEE

Committee membership

VIC/Chair Johnny Millar

NSW Andrew Numa

QLD Andreas Schibler

WA Geoff Knight

SA Ranjan Joshi

TAS Hamish Jackson

General ICU Resy van Beek










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ANZICSHouse

10IeversTerrace,CarltonVIC3053

A one-day course for CICM primary examination candidates

Small class size Focus on study technique, exam preparedness & topics of difficulty

Includes draft written questions and mock viva stations

COST: $400

2 streams: Primary exam candidate stream

for CICM primary exam candidates Primary exam teaching stream

for CICM fellows assisting trainees with the primary exam

Faculty Primary examiners, recent successful candidates, intensivists and senior registrars

Formoreinformationpleasevisitvpecc.weebly.comRegisterat:vpecc2016.eventbrite.com.au

#vpecc@vpeccteam

VPECCTheVictorianPrimaryExaminationCourseforCICM

Saturday6thAugust20160800-1730hrs










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Department of Health MBS Item Reviews

The most pressing issue for the Price Committee is the MBS Review. Details about the MBS review and the process involved can be found on the MBS taskforce website. http://www.health.gov.au/internet/main/publishing.nsf/Content/MBSReviewTaskforce.

The AMA held a second MBS Review Forum on the 11th of February in Canberra. More than 70 people representing 45 organisations attended the forum. The speakers were A/Professor Brian Owler, AMA President, Professor Bruce Robinson, Taskforce chair, Professor Michael Permezel, Chair Obstetrics Clinical Committee and Dr Patrick Guiney, Chair ENT Clinical Committee.

From the presentations and discussion it became apparent that the Department of Health will limit the MBS items for review and that they are targeting low use items and items with high geographical variability. The scope of the MBS review has also changed to included new items. Each clinical committee can now recommend to retain, abolish, amend or suggest new MBS items. The rules associated with MBS Items may also be reviewed.

The key points from the forum relevant to intensive care are;

• that Intensive Care are in the second group of reviews.

• Intensive Care will be in a combined Intensive Care/ED Clinical Committee and the Chair will be Sally McCarthy

• and ANZCA/ASA will have representation in the Intensive Care/ED Clinical Committee.

At the time of writing the CICM and ANZICS have not heard from the MBS review taskforce about the formation the ICU/ED Clinical Committee. As we move closer to the review process we will send out regular email updates via ANZICS and the CICM. We have made no progress with MSAC over the last 10 years. This could be an opportunity for new items that reflect our current scope of practice. Any comments or suggestions please forward to either George Skowronski via the College or myself via ANZICS.

Private Health Funds

As some of you may be aware there were issues between Medibank Private and Calvery. The matter has been settled, unfortunately Medibank Private has refused

PRICE COMMITTEE

to release details of the final contract with Calvery. The AMA recently released a Private Health Insurance Report Card. It is a table that shows what health insurers pay for 22 common procedures.

The report can be found here. https://ama.com.au/ama-private-health-insurance-report-card-2016

Mark Nicholls Chair, PricE Committee


Chair/NSW: Mark Nicholls

Deputy Chair/VIC: Stephen Bernard

Past Chair/WA: Ian Jenkins

NZ: Ywain Lawry

QLD: Ranald Pascoe

SA: Nick Edwards

TAS: David Rigg

WA: Greg McGrath

Paediatrics: Warwick Butt

https://ama.com.au/ama-private-health-insurance-report-card-2016

ttps://ama.com.au/ama-private-health-insurance-report-card-2016

http://www.health.gov.au/internet/main/publishing.nsf/Content/MBSReviewTaskforce

http://www.health.gov.au/internet/main/publishing.nsf/Content/MBSReviewTaskforce

ANZICS and CICM are continuing to work together to develop a combined position statement on The Role of Intensive Care within Rapid Response Systems (RRS). The overall aim is to produce a high quality document which will provide guidance for intensive care units across Australia and New Zealand in the provision of care to the deteriorating ward patient. It is anticipated that the document will be completed by the end of 2016.

The Committee is continuing to con-versations with key stakeholders in regards to the feasibility of a national Rapid Response Team Database. The Committee recently distributed a survey to ICU Directors to determine the level of support for such a database, gain an understanding of RRT variables currently collected and to determine what ANZICS members believe a minimum data set should include.

ANZICS and the International Society of Rapid Response Systems will host the 12th International Conference on Rapid Response Systems and Medical Emergency Teams in Melbourne on May 2 – 3, 2016. The Conference will be held at the world class Melbourne Convention and Exhibition Centre with a black tie inspired by the 1920s dinner at Myer’s Mural Hall. This is the largest international conference supporting Rapid Response Systems across the globe.

The Organising Committee for this year’s conference have developed a thought provoking and challenging scientific program delivered by inspirational global and local speakers. We have expanded the scope of the conference beyond Rapid Response Systems to the broader concept of deteriorating patients. In addition, the program will explore innovative ways to detect and respond to all deteriorating patients including the emergency department, mental health, obstetric, paediatric and general wards. There will be a strong emphasis on technology, team training and improving processes of care.

Further information is available from the Conference website http://www.isrrs2016.com.au

The Committee has decided not to host a Safety and Quality Conference this year due to International Conference on Rapid Response Systems and Medical Emergency Teams being held in May and the ANZICS/ACCCN Annual Scientific Meeting in October.

Your Regional S&Q Representatives include John Gowardman (QLD), Deepak Bhonagiri (NSW) Arthas Flabouris (SA), Jonathan Barrett (VIC), Simon Towler (WA), Craig Carr (NZ), Christopher James (Paediatrics), Mary Pinder (CICM).

SAFETY & QUALITY COMMITTEE










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Committee Membership

Immediate Past Chair, NSW Angus Carter

SA Arthas Flabouris

NSW Deepak Bhonagiri

CICM Mary Pinder

ACCCN Bernadette Grealy

WA Simon Towler

NZ Alastair (Craig) Carr

QLD John Gowardman

VIC Jonathan Barrett

Paediatric Christopher James

Jennifer Holmes, ANZICS Safety & Quality Executive OfficeOn Behalf of the Safety & Quality Committee

http://www.isrrs2016.com.au

http://www.isrrs2016.com.au

Intensive Care Foundation News

2016 Foundation Research Grant Program in progress The Foundation’s Research Grant round opened on 1 March and we were very pleased at the number of Expressions of Interest received. Our Scientific Review Committee is now assessing those EOIs and Invited Applicants will be contacted at the beginning of May. During June and July our fantastic team of volunteer reviewers will score the applications in preparation for the scrutiny of the Scientific Review Committee.

We look forward to announcing the Grant Awards late in October at the ANZICS/ACCCN Annual Scientific Meeting gala dinner, to be held in Perth. Since 2000, the Foundation has granted over $3 million to researchers in Australia and NZ, funded through a combination of public donation and corporate sponsorship. This year we are once again offering Trainee Formal Project Grants to a maximum of $5000 each. These Grants are specifically targeted to trainees undertaking a Formal Project through the College of Intensive Care Medicine and will be announced at the CICM Conference in June 2016.

The Foundation gratefully acknowledges the valuable contributions of our Scientific Review Committee and reviewers without whose time and expertise our Grant program would not be possible.

www.intensivecarefoundation.org.au

Check out the new Foundation website Our new website contains lots of new information including a special section explaining a little about the ICU environment and addressing the needs of friends and family visiting ICU patients. There is also a section for the patients themselves, answering some of their questions as they navigate the long journey of recovery which is life after intensivecare. We have also included information about diferent ways people can support the Foundation - including workplace giving and bequests. With end of financial year looming we hope this is the ideal time to ask for your help… All donations are tax deductible and will be gratefully received. Please donate online at: intensivecarefoundation.org.au

Or telephone us and donate: 03 9340 3444

There are planned meetings (inclusive of dinner) with a non-medical emphasis, focusing on the Business of Medicine. Funding has become uncertain and is still in negotiation. I am hoping to have the first meeting in late April. I wish to congratulate two new NSW Reps to the NSW Committee. Danielle Austin as the Vice-Chair position and Jorge Brieva as DODC Representative.

The NSW Intensive Care Coordination and Monitoring Unit (ICCMU ) and the Intensive Care Service Network (ICSN) has been approached by Ministry of Health and Health Planning Advisory (HPA) to consult on development of IC (intensive care) activity projections as part of the review of the NSW Service planning methodology. The Ministry and HPA wish to present the draft IC and HD (high dependency) projections to representatives of the NSW IC community. The Health Planning Advisory presented

At the time of writing this article, we are in the final lead up to this years New Zealand Annual Scientific Meeting in Rotorua. The theme of the meeting is “Should I stay or should I go?” Jonathan Albrett from New Plymouth is Medical Convenor for the event, to be held at the Novotel Rotorua from Wednesday 30th March to Friday 1st April. We are hoping for good attendance, not just from the local Taranaki, Rotorua and Bay of Plenty Hospitals but from around the country.

I have heard there are also several delegates coming from across the Tasman, presumably looking to enjoy some of what Rotorua has to offer by way of outdoor pursuits before and after the meeting. This will be the first NZ ANZICS meeting since the NZNO Critical Care Nurses Section transformed into the New Zealand College of Critical Care Nurses, another reason to celebrate. The NZ branch of the Intensive Care Network was set up last year with a grant from the NZ ANZICS funds, continues to thrive. At the latest meeting, held in Auckland, Tony Smith provided an informative talk on outcomes of out of hospital cardiac arrest in New Zealand.

There is a wide range of podcasts available on the ICN website, including of previous meetings. The 6th Wellington Intensive Care Medicine Exam Course, another cause supported by NZ ANZICS, will be held on Tuesday 28th June to Friday 1st July 2016. This Course has become a highly sought after preparation for the Second Part Exam, with candidates coming from Australia and Hong Kong as well as New Zealand. Unfortunately registration is now already closed for this year as places are strictly limited; but this course looks to be set to continue as an annual event, so be ready to register early.

New Zealand continues to contribute much to critical care research, especially through the ANZICS CTG. As a result, we are fortunate to be able to hear world class researchers speaking at local meetings, both here in New Zealand and in Australia. As well as the upcoming meeting in Rotorua, New Zealand speakers were evident at the recent CTG Meeting in Noosa and will allso feature at the International Rapid Response Systems and Medical Emergency Teams Conference in Melbourne in May.

the methodology and draft projections to the ICSN Executive, representative of the CICM and ANZICS on the 17th March. The projections may have important implications for how IC services are configured and IC medicine is practiced in NSW into the future. We will keep you update in future newsletters

An AMA (NSW) Private Health Insurance Information Night will be held on the 4th of May. The CEO of the Doctors’ Health Fund, Peter Aroney, will be discussing current issues in health insurance and how they affect Doctors. More information and bookings can be made by contacting the AMA. A strong members base increases the strength of ANZICS as an advocate for intensive care. Please do not hesitate to contact me or anyone of the Committee if you have any questions, comments or concerns.

Mark Nichols, Chair, New South Wales


Chair: Mark Nicholls

Deputy Chair: Vacant

Secretary: Vacant

S&Q: Deepak Bhonagiri

PricE: Mark Nicholls

Paediatrics: Andrew Numa

Education: Elizabeth Fugaccia, Dhaval Ghelani, Charudatt Shirwadkar

CTG: Manoj Saxena, David Gattas

DODC: Jorge Brieva

I hope that you will take the opportunity to attend these meetings if you can, supporting and contributing to New Zealand’s part in the continuing development of critical care.

Ben Barry, Chair New Zealand Regional Committee

Committee Membership: Chair: Ben Barry

Vice Chair: David Knight

Secretary: vacant

Treasurer: Nic Randall

Abstract Review: Paul Young, David Knight, Ben Barry

CTG: Paul Young

Paediatrics: vacant

PricE: Ywain Lawrey

DODC: James Judson, Stephen Streat

Safety & Quality: Craig Carr

Education: Alex Kazemi

NEW SOUTH WALES

NEW ZEALANDThe Australian and New Zealand Intensive Care Society (ANZICS) is the leading advocate on all intensive care related matters. The Society is devoted to all aspects of intensive care medical practice through ongoing professional education, the provision of leadership in medical settings, clinical research and analysis of critical care resources.









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At the outset, I would like to congratulate Queensland ANZICS member, Dr Yogesh Apte for his election to the Education Committee of ANZICS. I am certain, knowing Yogesh’s background, he will contribute positively to the activities of the Education Committee.

I am also excited to announce that the Annual Scientific Meeting of ANZICS/ACCCN will be held at the Gold Coast in October 2017. At the time of writing this, an email is scheduled to be sent to all Queensland ANZICS Members requesting expressions of interest for participation in the Organising Committee. I would encourage those who are interested to actively participate in this important event for Queensland. I would like to make this “ the best” ANZICS conference ever.

I will keep the membership updated on a regular basis. In the last issue of the Intensivist (December 2015), I had written about the MOCA 4, how active the ANZICS was and our success in dealing with the “extended hours clause”. I am happy to inform you that the MOCA 4 has now been implemented since December 2015. However I request that all the members remain alert on this issue. It is speculated that there is a draft business case about “Acute inpatient review” which may have significant implications for Intensive care as a specialty and Intensivists as Doctors.

This extended outreach model has a potential to make “Intensivists” into “Hospitalists” with all the extra responsibilities with minimal financial benefits. It is important to note that significant number of ICU

Specialists are from overseas and do not possess general registration but have only specialist registration with the Medical Board of Australia. This may also have medico legal implications as far as hospitalist role is concerned.

Rajeev Hegde Chair, Queensland Regional Committee


Deputy Chair: Siva Senthuran

DODC: David Cook

S&Q: John Gowardman, Angus Carter

Education: Scott Simpson, Yogesh Apte

CTG: Jeremy Cohen

PricE: Ranald Pascoe

QUEENSLAND

There’s plenty happening in the Victorian intensive care community right now, with a strong focus on collaborative practice. This is best exemplified by the upcoming Critical Care Collaborative meeting that will be jointly hosted with the ACCCN on August 26 in Melbourne. This one-day event follows on from last year’s very well received meeting, which explored themes such as multidisciplinary team-based care, fast-track mobilization, infection control, clinician self-care and critical care deployment during epidemics of haemorrhagic fever in the developing world. During the meeting this year, there will be an in depth exploration of the patient experience, critical appraisals of current research findings, a review of the future of resuscitation practice and practical hands-on ventilation coaching. For further details, see http://www.anzics.com.au/Lists/Events/calendar.aspx and navigate to August for additional information.

Another highlight for Victorian Intensivists is the work undertaken by the Women in Intensive Care Network (WIN), with the support of ANZICS. This group was established last year with the goal of supporting women to achieve their full potential both as Critical Care Trainees and

Intensivists. Through a series of events, the group has identified a range of challenges and potential solutions for the intensive care community. While WIN is primarily concerned with the specific issues relating to female Intensivists, it is clear that many of the challenges identified are highly relevant to the specialty more broadly. These include access to professional development, work-life balance issues, self-care and engagement in non-clinical portfolios. Following on from significant leadership in Victoria, it is pleasing to see similar efforts now established in other states, once again led by a combination of experienced senior female Intensivists and highly enthusiastic younger Consultants and Trainees. For details, take a look at http://www.womenintensive.org/.

The Victorian Intensive Care Education Network (VICEN) is now a collaboration of fifteen hospitals across metropolitan Melbourne and provides monthly educational events for Critical Care Trainees. Whilst mainly focused on the needs of CICM advanced Trainees, the network also supports attendance by emergency medicine, physician and anaesthetic trainees who are working in ICU on rotation. Over each year, participating sites cover all aspects of intensive care practice, including adult

general ICU, transplant medicine, trauma, spinal care, cardiothoracic ICU, neurocritical care, paediatric critical care, obstetric critical care and private hospital critical care. Each day of education general incorporates a combination of didactic teaching, hands-on training, simulation and exam practice sessions. For details on VICEN, see http://vicen.org.au/. Stephen Warrillow Chair, Victorian Regional Committee


Chair: Stephen Warrillow

Deputy Chair: Ben Gelbart

Secretary: David Ku

DODC/EOLCWG: William Silvester, Helen Opdam

ARC: Ravi Tiruvoipati

Education: Sam Radford

CAC: Graeme Hart

CTG: Craig French & Andrew Udy

CORE: David Pilcher, Owen Roodenberg & Jonathan Barrett

VICTORIAThe Australian and New Zealand Intensive Care Society (ANZICS) is the leading advocate on all intensive care related matters. The Society is devoted to all aspects of intensive care medical practice through ongoing professional education, the provision of leadership in medical settings, clinical research and analysis of critical care resources.









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http://www.anzics.com.au/Lists/Events/calendar.aspx

http://www.anzics.com.au/Lists/Events/calendar.aspx

http://www.womenintensive.org/

http://www.womenintensive.org/

http://vicen.org.au/

http://vicen.org.au/

South Australia is currently at a key transition point, with the Transforming Health Reform Initiative impacting significantly on all South Australian Hospitals. There has been major restructuring of multiple services state-wide and the opening of the new Royal Adelaide Hospital is planned for later this year. This is occurring alongside the ongoing roll-out of the Clinical Information System, EPAS. This is a time of significant change and the practical implications of Transforming Health for the daily operations of our hospitals, and our ICUs, remain to be seen.

In SA, we hope to continue to focus strongly on local ANZICS educational activities. The Annual ANZICS Tub Worthley Travelling Scholarship for Intensive Care Registrar Research Presentations is planned for 23rd May. This should be an enjoyable evening and will represent a great learning opportunity for our intensive care registrars. Thank you to Mary White and Adam Deane for their ongoing coordination of this event.

SOUTH AUSTRALIAAlso planned for May is a multidisciplinary ANZICS educational dinner featuring guest speaker Professor Steve McClave, when he visits from the United States. The biannual SA Intensive Care Association/ANZICS registrar lecture series will also continue to be a feature on the educational calendar.

I would like to thank all SA Clinicians who continue to support local ANZICS activities. Finally, I would also like to thank the outgoing SA Chair, Stewart Moodie, who served in the role with ANZICS for over 4 years. His years of representation and his ongoing support during my transition to the role are much appreciated. I look forward to serving in the role of SA Chair and to continue working towards achieving representation from all hospitals within South Australia for ANZICS SA.

Yasmine Ali AbdelhamidChair, South Australia


Chair: Yasmine Ali Abdelhamid

Secretary/Treasurer: Adam Deane

CTG: Sandra Peake, Adam Deane

Abstract Review: Matt Maiden, Adam Deane

PricE: Nick Edwards

Safety and Quality: Arthas Flabouris

Education: Mary White

CORE: John Moran

DODC/EOLCWG: Stewart Moodie

Australian Resuscitation Council: Stuart Baker

Paediatric: Ranjan Joshi

WESTERN AUSTRALIA

Tertiary healthcare has been prominent in Western Australia media over the last few months- mainly for the wrong reasons and largely revolving around ongoing issues and unhappiness at the new(ish) Fiona Stanley Hospital. As alluded to in the last edition of The Intensivist, most problems relate to shrinking State revenue and expanding health costs- there is now a concerted effort to reduce expenditure by way of reducing staffing, based on the premise that WA must bring costs per unit of activity in line with its Eastern States’ counterparts.

ICUs at several of the hospitals have not been immune from the cutbacks, with reduction in junior medical staffing- both number-wise and in overtime worked, and, with a freeze on new appointments, other than with Ministerial and Treasury approval, an effective sinking ceiling on the senior medical workforce. It is indeed tough times for freshly minted CICM Fellows, trying to find employment. The recent reorganisation that has made Fremantle Hospital a virtual annex of Fiona Stanley Hospital, certainly administratively at least, has been unsettling. As I write, we await

a decision about the future of the small and under-utilisd HDU/Level 1 ICU still in existence at Fremantle Hospital.

I must admit there has been little educational activity organised by ANZICS (WA) occurring in the last four months- however detailed planning is well underway for this year’s ANZICS/ACCCN ASM which we are hosting in Western Australia in October. Anthony Tzannes is the Medical Convenor, whilst Simon Erickson is leading the Paediatric organising group. It promises to be a superb meeting, with the usual exciting social programme. Last year the Intensive Care Network (ICN) convened two excellent evening meetings, and just as at national level I look forward to cooperating at a local level with ANZICS (WA) to continue this excellent initiative. We’re a small community and the same people wear hats in both groups.

After far too long as ANZICS (WA) Board Representative- my first Board meeting was in 1998 (although the stint has been far from continuous- with the Presidency from 2005-2007 and Past Presidency from 2007-2008 intervening), I am stepping down

from the Board. ANZICS received only one nomination from members for my successor; I have pleasure in announcing that Brad Wibrow, based at Sir Charles Gairdner Hospital, is now the ANZICS (WA) Chair. I’m sure there will be some reinvigoration to the local group with Brad’s appointment and I wish him all the best in his new role.

Ian Jenkins, Past Chair Western Australia Regional Committee

Committee Members

Chair: Bradley Wibrow

CORE: Vacant

PricE: Greg Mcgrath

Paediatric: Geoff Knight

CTG: Ed Litton

ARC: Geoff Dobb

DODC: Nandkumar Raut

Safety & Quality: Simon Towler

Education: Anthony TzannesThe Australian and New Zealand Intensive Care Society (ANZICS) is the leading advocate on all intensive care related matters. The Society is devoted to all aspects of intensive care medical practice through ongoing professional education, the provision of leadership in medical settings, clinical research and analysis of critical care resources.









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The Intensivist April 2016

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