How do hospital-acquired pressure injuries (HAPIs) occur in the ICU and why is the ABCDEF bundle such a powerful tool to prevent HAPIs? How do HAPIs impact healthcare costs, staff workload, patient quality of life, and overall survival? Wound Care Karen joins us in this episode to explore the crisis of hospital-acquired pressure injuries in
Walking Home From The ICU Episode 144: Living With a “Sedation-Induced Brain Injury” and PICS
Until post-ICU syndrome is widely known and the impact is deeply appreciated, we will continue to fall short of evidence-based sedation and mobility practices. The real experts on post-ICU syndrome (PICS) are those that live with it. Carol Billian joins us now to share her personal expertise. Episode Transcription Kali Dayton 0:47 It’s time to
Walking Home From The ICU Episode 132: The Power of ICU Diaries to Treat Post-ICU PTSD
Post-ICU PTSD is a life altering and life-threatening condition. ICU diaries have shown promising benefits to helping survivors navigate the trauma they carry with them from the ICU and especially delirium. David Richards shares with us his journey during and after the ICU and how his ICU diary has been a key part of his
Walking Home From The ICU Episode 120: Walk Like Your Life Depends On It
What does being awake and mobile mean to current ECMO patient, Denise Bazalda? From her ICU room with a tracheostomy and connected to ECMO, @88deniseb, gives us incredible insight into how she is fighting for her life. Episode Transcription Kali Dayton 0:35 One of the main motifs throughout this podcast is patient autonomy and giving
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Walking Home From The ICU Episode 104: ICU Rehabilitation
When ICU-acquired weakness is not preventable, or we encounter a patient that has not received the ABCDEF bundle, how can we start the rehabilitation process? What approach can one lone clinician use for initiating recovery or preventing ICU-acquired weakness? Physiotherapist, Lucy Sutton, shares with us incredible insight into ICU rehabilitation. Episode Transcription Kali Dayton 0:01
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Walking Home From The ICU Episode 99: How Physical Therapists Save Lives in the ICU
When physical therapists are allowed to work at the top of their licenses, how do they save lives? What barriers prevent them from fully contributing their expertise during critical illness? How is mobility a life-saving intervention? ICU Physical Therapist experts, Kenny Venere, PT, DPT, and Kyle Ridgeway, PT, DPT, CCS share with us their experiences
Walking Home From The ICU Episode 98: Occupational Therapists Change Outcomes in the ICU
How can occupational therapists help decrease time on the ventilator and time in the hospital? How can they preserve function and quality of life? What skills do they bring to preventing and treating delirium? Why should they be promptly utilized in a patient’s journey? Corinne, Mallory, and Rachel share give us insight into the value
Walking Home From The ICU Episode 94: The ICU Deathtrap
Why are prolonged sedation and immobility lethal? How do our standard practices of automatically sedating every patient on a ventilator deprive them of the chance to survive and thrive? What systemic barriers stop us from implementing evidence-based practices that save lives and drastically change outcomes? Michelle, DNP, ACNP dives deep into powerful case studies that
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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 88: Bring In Speech Language Pathology
How do speech-language pathologists save lives? How can we more fully utilize them in the ICU? How can PT, OT, AND SLP help, halt, or reverse pulmonary disease processes during acute and critical illness? Let’s discuss how they prevent harm and restore humanity in the ICU. Episode Transcription Kali Dayton 0:28 Okay, way back in
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Over the last few years I have become aware of the PICS (post-intensive care syndrome) condition and the very serious negative impact that it has on our ICU survivors. I have become much more aware of the potential negative impact of anxiety, depression, PTSD and cognitive dysfunction. Many patients whom we consider saves in the sense they leave the ICU alive have many issues that most people would consider far from a successful experience. Their lives are often dramatically changed in a very negative fashion.
I am a professor of medicine and have been an ICU director for over forty years. What I find very disturbing in my own experience and that of many other intensivists is that this outcome is generally considered acceptable; the patient survived and will get better with time. We have little access to these patients and almost zero information about their condition unless they are unfortunate enough to return to our ICUs. Very few of us have a PICS clinic where we would have a chance to better understand the challenges that some of our patients encounter, and there are very few systems in place to provide feedback to us as ICU clinicians. Therefore, we are blissfully ignorant of the many challenges that a substantial number of our survivors encounter. This is a major problem. The vast majority of ICU survivors and their families will experience cognitive, emotional and physical symptoms which often have devastating impacts on their lives. At this time, with PICS clinics being a rarity, there is no reasonable mechanism for intensivists to have a solid perspective on the frequency and severity of this condition.
How patients and their families are treated in the ICU often has a major impact on how the patient and families survive post discharge. It is generally agreed that most sedation infusions, particularly benzodiazepines, frequently have higher incidences of delirium and post-discharge dysfunction. There are a few hospitals in this country where sedative infusions are rarely used and the incidence of the complications described above are dramatically decreased. I have visited one of these hospitals and was amazed to see how effectively patients on maximum ventilator support can be managed, even walking without sedative infusions. In an effort to explore this treatment option in greater detail I have identified Kali Dayton. She is a nurse practitioner who has practiced in this Awake and Walking ICU for many years and is an amazing source of information on this topic. After extensive discussion with many colleagues, administration and many others, and reviewing the major potential benefits of the program for our patients, we have decided to introduce this program into our hospital.
Peter J. Murphy, MD, FCCP, MRCPI, BSc
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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