Jim’s Story: How Evidence-Based Practices Can Stop the Domino Effect and Reduce ICU Complications

Jim’s Story: How Evidence-Based Practices Can Stop the Domino Effect and Reduce ICU Complications

I hate to say it, but what I’m about to tell you is nothing new. The unnecessary suffering I’m about to describe has occurred countless times due to a culture of habit in the intensive care unit, and a lack of support or investment in evidence-based practices. Regrettably, for many who end up in the

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Walking From ICU Episode 101- The ABCDEF Bundle in the Neuro ICU

Walking Home From The ICU Episode 101: The ABCDEF Bundle in the Neuro ICU

What does the ABCDEF bundle look like in neurocritical care? When patients suffer conditions such as intracranial hypertension that necessitate sedation and immobility, how does the ABCDEF bundle apply? Neurointensivist, Dr. Neha Dangayach, shares with us her team’s strong ABCDEF culture and practices in the neuro ICU. Episode Transcription Kali Dayton 0:06 In a recent

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ICU testimonialI stumbled upon Kali’s podcast midway through my anesthesia critical care fellowship in February 2021. At our institution, I got the impression that patients in the ICU either got better on their own or had a prolonged and complicated course to LTAC or death. In her podcast, Kali explained that LTAC was rarely the outcome for patients in the Awake and Walking ICU in Salt Lake City.

Their ICU survivors hardly ever got trached, PEGed, or sent to LTAC, and literally walked out of the hospital in condition as close to their previous health as they could be. Although the concept of using no sedation on ventilated patients was completely foreign to me, it made sense based on what I had read in the literature. I devoured all of the episodes from the beginning, many of them bringing tears and regret for my ignorance, followed by inspiration and hope in later episodes. Listening to her podcast has been one of the most profound experiences in my short, eight-year career in medicine.

After discovering the no sedation, early mobility practice at the Awake and Walking ICU, my focus shifted to bringing it to my own institution. I visited Salt Lake City in March to witness it with my own eyes. Since then, I’ve been in touch closely with Kali and Louise to learn the practical approaches to sedation wean and sedation avoidance for newly intubated patients in the ICU.

Mikita Fuchita, MD
Colorado, USA

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