Why ICU Culture Is a Barrier to Early Mobility
While it’s clear that the ABCDEF Bundle saves lives and helps to restore the quality of life for ICU survivors, many intensive care units continue to standardize deep sedation and immobility. But why is this? Why does one ICU use sedation on less than 20% of intubated patients, while another sedates 100% of these patients
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Walking Home From The ICU Episode 169: Intubated in Your Own ICU
What is like to be intubated in your own ICU? Even when the environment and team are well known, what does an intensivist turned patient experience? Dr. Meta van der Woude shares with us her personal journey through the ICU. Episode Transcription Kali: Dr. Van der Woude, thank you so much for coming to the
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Walking Home From The ICU Episode 168: I Was Reported to the Board of Nursing!
What happened when I was reported to the board of nursing for advocating for early mobility in the ICU? What are the roots of these concerns and this report? How does social media impact culture and practices in the ICU? Jess Hren, BSN, RN, Jenna Hightower, DPT, CCS, Phillip Gonzalez, MOT, OTR/L, BCPR discuss why
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I 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
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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