Walking Home From The ICU Episode 81: Choose Wisely
How does the choice to automatically sedate every patient on a ventilator impact patients for the following weeks, months, and years? Let’s dive deeper into how our favorite sedatives change the course of critical illness. Episode Transcription Kali Dayton 0:00 This episode is really important, but maybe a lot. So I hope to make this
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Walking Home From The ICU Episode 80: Big Picture of Propofol
How does propofol affect muscles? The brain? Outcomes? ERRXpodcast host and critical care pharmacist, Adis Keric, BCPS, BCCP, shares with us the big picture of propofol. Episode Transcription Kali Dayton 0:28 Hello, it has been so exciting to meet with your teams around the country for webinars and presentations. Sharing the research through case studies
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Walking Home From The ICU Episode 78: “Never Really Over”
What is it really like to be in a medically-induced coma? As an experienced ICU physiotherapist and war veteran, Aron Welsh provides soul-shaking insight into the graphic trauma of ICU delirium during and after deep sedation. Episode Transcription Kali Dayton 0:00 Okay, welcome back, I need to apologize to those that have tried to
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Walking Home From The ICU Episode 75: Communicate. Don’t Sedate.
When Jeff Sweat was about to be intubated, what was he told about what was to come? What information did his wife, Sunny Cannon, receive about the risks and reality of deep sedation? Was is it really like to “wake up” 3 weeks later? How have sedation, immobility, and tracheostomy impacted their family? Had they
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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 73: Say It Again: Sedation is NOT Sleep
We habitually lie to ourselves and our patients’ families when the word “sleep” leaves our tongues in reference to sedated patients. Why is sleep so vital to survival in the ICU? What prevents our patients from preserving their sanity and cognitive function? What has COVID taught us about the role of sleep in the ICU?
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Walking Home From The ICU Episode Episode 72: Military Veterans and Delirium
Why is baseline PTSD a risk factor for post-ICU PTSD? What does delirium look and feel like for war veterans? Why should the ICU community understand what veterans have experienced before and during the ICU? Episode Transcription Kali Dayton 0:27 Let’s talk about this. We know that a huge risk factor for post ICU PTSD
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Walking Home From The ICU Episode 71: What “Fight To Survive” Truly Means
When an ICU team started discussing end-of-life with 31-year-old Megan Wakley’s family, they fought to have her transferred to the “Awake and Walking ICU”. When research shows that the less sedation used and the more mobility performed the less likely patients are to die, what did that mean for Megan Wakely? Episode Transcription Kali
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Walking Home From The ICU Episode 68: PICU UP!
We know that sedation causes and worsens ICU delirium, post-ICU PTSD, post-ICU dementia, and ICU-acquired weakness in adults. The research is vast and compelling. What does this mean for children? What does research reveal about the harm children suffer from drug-induced comas? Is there a different way to treat our children? Can we preserve their
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Walking Home From The ICU Episode 62: Patient and Families Have the Right to Know the Risks
We say we respect patient autonomy. We provide patients or families informed consent prior to intubation. Should patients and families be warned of the risks and repercussions of sedation and immobility? When sedation is nonessential, should patients be given the choice to be comatose or awake and moving? Episode Transcription Kali Dayton 0:19 If
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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