Walking Home From The ICU Episode 91: The Awake and Walking ICU in Denmark
Are there any other “Awake and Walking ICUs” outside of Salt Lake City, Utah? Dr. Thomas Strom shares with us his team’s success and research in Denmark. He provides powerful insight into the gaps and future of critical care medicine. Episode Transcription Kali Dayton 0:37 Okay, I am so excited about this really powerful episode.
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Walking Home From The ICU Episode 86: Ventilator Management in the Awake and Walking COVID19 Unit
How is the “Awake and Walking ICU” keeping their COVID19 patients mentally and physically functional during severe COVID19? Do they face constant ventilator asynchrony and how do they deal with it? Geoff shares with us his vast experience as a respiratory therapist in walking patients on mechanical ventilation during critical illness and now COVID19. Episode
Walking Home From The ICU Episode 85: RT Magic
Does sedation always improve ventilator dyssynchrony, or can it cause it? How does a lack of unity between disciplines impact patient care and outcomes? How can we better support and utilize the expertise of respiratory therapists to optimize care for patients on ventilators? Brady Scott, PhD, RRT shares his 20 years of experience and insights.
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Walking Home From The ICU Episode 84: Zentensive Care
How can we manage ventilators to decrease alarms, avoid misdiagnosing/mistreating asynchrony, and improve patient comfort and outcomes? Dr. Matt Siuba, MD, the “Zenintensivist”, shares with us his tools to decrease sedation and neuromuscular blockade use. Episode Transcription Kali Dayton 0:00 Hello, and welcome back. Before we start as the episode you have all been waiting
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Walking Home From The ICU Episode 79: Step Up and Step Forward
What can happen when a clinician wakes up to the reality of sedation and immobility? ICU revolutionists around the world are stepping up and stepping forward to elevate sedation and mobility practices for their patients. It can take 1 person to make 1 decision and change a patient’s entire life. Hear their success stories! Episode
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Walking Home From The ICU Episode 77: Start Where You Are
Are lung-protective strategies only implemented when patients are sedated? Is walking on the ventilator safe for the lungs? How do we transition from “sedating to keep patients safe” to “walking to keep patients safe”? Dr. Ali Fazili from the “Awake and Walking ICU” shares with us his expertise. Episode Transcription Kali Dayton 0:28 Hello, and
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Walking Home From The ICU Episode 76: Less Sedation = Less Work
Is it *really* easier to sedate patients? Ultimately, does giving patient delirium and ICU acquired weakness actually decrease staff workload? Travel nurse, Alex, gives us the real deal. Episode Transcription Kali Dayton 0:28 Alex, thanks so much for coming back onto the podcast are sure you are with us in Episode 32. But can you
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Walking Home From The ICU Episode 74: Walk Them To Sleep
What are the main “treatments” or “tools” to prevent and treat delirium? How can we facilitate “quiet nights” without harming patients with sedation? Peter Nydahl, RN, MScN, PhD, teaches us how to walk them to sleep. Episode Transcription Kali Dayton 0:27 Hello, and welcome back on one of the videos or pictures posted an Instagram
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Walking Home From The ICU Episode 70: Rallying The Troops In The PICU
What specific approaches help rally the troops to bring change to the ICU? How have other PICU teams cultivated a rich culture of mobility? When an interdisciplinary approach becomes the culture of the PICU, what happens to patient outcomes? Erin Gates, DPT and Sara Eilerman, DPT share with us the PICU UP! culture and practices
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Walking Home From The ICU Episode 69: Awake and Playing In The PICU
What does it take to inspire a PICU team to keep children on mechanical ventilation awake and playing? Who can bring the change? Hannah Child, a pediatric physiotherapist in the UK, shares with us her team’s evolution and successes. Episode Transcription Kali Dayton 0:00 Hello, and welcome back. Last episode, we were enlightened by Dr.
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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.
Implementation has been challenged by pushback at the bedside, but knowing how most patients can be off sedation and comfortable allowed me to advocate for the patients. So far, four patients were successfully kept off of sedation after getting intubated, and two of them immediately smiled at me as they woke up from induction meds. Kali and the members of the Awake and Walking ICU have decades of experience in this approach.
Mikita Fuchita, MD
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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