Category: Articles

Raging Tigers and Merciful Angels- The Fight to Humanize Critical Care

Raging Tigers and Merciful Angels: The Fight to Humanize Critical Care

Medicine is a field of evolution with a continuous trajectory of exploration, discovery, change, and progress. And this perpetual pattern has been just as reliable as the predictable resistance that comes with change.   Past Revolutionists Who Fought to Humanize Critical Care This was demonstrated in the journey of Ignaz Semmelweis (pictured above), a Hungarian

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Why Gradual ABCDEF Bundle Implementation Often Results in a Failure to Launch

Why Gradual ABCDEF Bundle Implementation Often Results in a Failure to Launch

“Let’s introduce the bundle gradually. We don’t want to overwhelm anyone. Let’s see what the team is willing to do. We can start with awakening and breathing trials, then tackle the rest once we have those down.” This kind of conversation has echoed through medical organizations and clinical leadership teams for years. It’s a logical

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Reviving Core Nursing Values in Critical Care Through the ABCDEF Bundle

Reviving Core Nursing Values in Critical Care Through the ABCDEF Bundle

Critical care is an extraordinary and complex specialty that’s continually evolving, with a growing capacity to save and extend life in the face of the most extreme perils. Research, knowledge, and technological developments have transformed nursing skills and our ability to care for patients who are critically ill. Unfortunately, the nursing values and ethics, which

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How Failing to Practice the ABCDEF Bundle Creates Legal Liabilities in the ICU

How Failing to Practice the ABCDEF Bundle Creates Legal Liabilities in the ICU

As a nurse and a nurse advocate, I am passionate about protecting nurses and all ICU clinicians from falling victim to legal liabilities in the ICU. The alarming reality is that when hospitals fail to train and support their teams in keeping patients as awake and mobile as possible, everyone from hospital administrators to bedside

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Sedation by Race- How Outdated ICU Practices Are Exacerbating Health Care Inequality for Hispanic Patients

Sedation by Race: How Outdated ICU Practices Are Exacerbating Health Care Inequality for Hispanic Patients

Health care inequality in critical care medicine is multifactorial and negatively impacts patient outcomes [18]. During COVID-19, for instance, it was noted that Hispanic patients were more at risk of having severe COVID-19 infections, and despite their younger age, they had a higher mortality rate. Socioeconomic disparities, lack of access to health care, timing, and

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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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