Is it save to mobilize patients with trans-formal devices such as balloon pumps, impellas, and ECMO? Who was the first person to dare to ask, “Why can’t we mobilize patients with trans-femoral balloon pumps?” Stephen Ramsey, PT, DPT, CCS shares with us his journey to developing the Ramsey protocol and revolutionizing mobility in the CVICU.
Walking Home From The ICU Episode 166: The Struggle of an ICU Revolutionist to Save Lives
What is it like for one lone ICU clinician to truly understand the risks of sedation and immobility? What it is like for them to try to implement interventions like awakening trials that have been supported by decades of research? How does lack of support and success increase moral injury, burnout, and the loss of
Are patients sleeping during medically-induced comas? Are they more comfortable and free of trauma while sedated? Can patients hear, feel, and understand their surroundings while in a medically-induced coma? Do patients know when sedation is turn up higher? Do they know which providers will let them wake up and which ones will try to “turn
Walking Home From The ICU Episode 164: Antipsychotics in the ICU with Dr. Marie Rueve
Antipsychotics have been a hot topic in the ICU. Do they treat delirium? Can they be used to replace continuous sedation? When and how can we utilize antipsychotics to optimize care and outcomes? Dr. Marie Rueve from episode 160 joins us again to clear the air on antipsychotics in the ICU. Episode Transcription Kali
Sabrina Eggmann is a PhD physiotherapist with 17 years of experience. She shares with us how her team utilized their years of expertise in early mobility to preserve their practices for COVID19 patients in Switzerland. Episode Transcription Kali Dayton 0:48 There’s been a lot of online discussion about whether or not early mobility during
Walking Home From The ICU Episode 162: Standardizing ICU Diaries
In episode 132, David Richards shared with us the life-saving impact of his ICU diary. In this episode, Seth van der Meer from Post-ICU shares with us exciting technological advancements that can help make ICU diaries standardized and accessible for all patients. Episode Transcription Kali Dayton 0:47 Hello, I know we’ve had a month
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As a nurse of 22 years, Lynn had been taught that patients were comfortably sleeping while sedated in medically-induced comas. She shares the horrific realities she suffered while intubated and sedated and the months of playing “Truth or Propofol?” after discharge. Episode Transcription Kali Dayton 0:05 I recently had fascinating interactions online with nurses
Walking Home From The ICU Episode 160: Psychiatrists in the ICU
How can inpatient psychiatrists help ICU teams prevent and treat delirium? How can their expertise help ICU teams minimize sedation, prevent trauma, and treat the psychiatric needs of ICU patients? Dr. Marie Rueve shares with us the role psychiatrists can play in transforming patient care and outcomes in the ICU. Episode Transcription Kali Dayton
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Walking Home From The ICU Episode 159: Building a Dream Team
What happens when resources and staffing are dedicated to providing high touch and high compliance with the ABCDEF bundle? How does adequate staffing, interdisciplinary team dynamics, and quality protocols impact patient outcomes and financial benefits? What is the “secret sauce” of successfully weaning patients from the ventilator? Sam Nimah and Phillip Norris share with us
Learn More > from Walking Home From The ICU Episode 159: Building a Dream Team
What happens to the body at the cellular, neurological, pulmonary, musculoskeletal, and cardiovascular levels when it remains supine for days to weeks? What is verticalization therapy and what does current research reveal about its benefits during critical illness? Verticalization experts, Phillip Gonzalez, MOT, OTR/L, BCPR, Nikki Stephens, DNP, APRN, FNP-C, and Jenna Hightower, PT, DPT,
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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