Walking Home From The ICU Episode 131: Occupational Therapists as Leaders In the ICU
When Brenna’s ICU set out to become an “Awake and Walking ICU”, Brenna, OTR/L, accepted the challenge. She shares with us her journey to leading her team to have the skills and culture to optimize mobility during critical illness. Episode Transcription Kali Dayton 0:13 A few years ago, I spoke at a conference and I
Walking Home From The ICU Episode 130: Becoming an Awake and Walking ICU With Dr. Bellucci
After visiting the original Awake and Walking ICU, how did Dr. Brian Bellucci help bring these changes to his ICU? What is the physician’s role in supporting a team’s sedation and mobility practices? How can we increase physician buy-in? Dr. Bellucci shares with us his team’s journey to becoming an Awake and Walking ICU. Episode
Walking Home From The ICU Episode: 129: Cognitive Rehabilitation After ICU With Dr. Jim Jackson
When patients suffer from delirium in the ICU, what resources are available to them to support their cognitive rehabilitation Psychologist, Dr. Jim Jackson, from episode 51, returns to the podcast. He shares with us his journey to writing his new book, “Clearing the Fog” as a roadmap to recovery for survivors. Episode Transcription Kali Dayton
Walking Home From The ICU Episode: 128: Delirium Severity By ICU and Race
Let’s talk about delirium severity. Does the severity of delirium vary by ICU specialties or by ICU treatment? What role does sedation play in delirium severity? What role does race play in delirium severity? Dr. Damaris Ortiz shares with us key findings from her important research. Episode Transcription Kali Dayton 0:00 Yeah. Dr. Ortiz, welcome
Learn More > from Walking Home From The ICU Episode: 128: Delirium Severity By ICU and Race
Over the last few years I have become aware of the PICS (post-intensive care syndrome) condition and the very serious negative impact that it has on our ICU survivors. I have become much more aware of the potential negative impact of anxiety, depression, PTSD and cognitive dysfunction. Many patients whom we consider saves in the sense they leave the ICU alive have many issues that most people would consider far from a successful experience. Their lives are often dramatically changed in a very negative fashion.
I am a professor of medicine and have been an ICU director for over forty years. What I find very disturbing in my own experience and that of many other intensivists is that this outcome is generally considered acceptable; the patient survived and will get better with time. We have little access to these patients and almost zero information about their condition unless they are unfortunate enough to return to our ICUs. Very few of us have a PICS clinic where we would have a chance to better understand the challenges that some of our patients encounter, and there are very few systems in place to provide feedback to us as ICU clinicians. Therefore, we are blissfully ignorant of the many challenges that a substantial number of our survivors encounter. This is a major problem. The vast majority of ICU survivors and their families will experience cognitive, emotional and physical symptoms which often have devastating impacts on their lives. At this time, with PICS clinics being a rarity, there is no reasonable mechanism for intensivists to have a solid perspective on the frequency and severity of this condition.
How patients and their families are treated in the ICU often has a major impact on how the patient and families survive post discharge. It is generally agreed that most sedation infusions, particularly benzodiazepines, frequently have higher incidences of delirium and post-discharge dysfunction. There are a few hospitals in this country where sedative infusions are rarely used and the incidence of the complications described above are dramatically decreased. I have visited one of these hospitals and was amazed to see how effectively patients on maximum ventilator support can be managed, even walking without sedative infusions. In an effort to explore this treatment option in greater detail I have identified Kali Dayton. She is a nurse practitioner who has practiced in this Awake and Walking ICU for many years and is an amazing source of information on this topic. After extensive discussion with many colleagues, administration and many others, and reviewing the major potential benefits of the program for our patients, we have decided to introduce this program into our hospital.
Peter J. Murphy, MD, FCCP, MRCPI, BSc
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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