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
Walking Home From The ICU Episode 61: “You Can’t Sedate Away Delirium”
What barriers do we have in our ICU culture that prevent us from appropriately addressing delirium? What can we do to foster a better approach to helping delirious patients that are difficult to care for? Dr. Swamy gets real as we discuss the reality of delirium from our side of the bed. Episode Transcription
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Walking Home From The ICU Episode 60: “Just Let Them Sleep”
For decades we have sedated patients with the belief that it is more humane to “sleep” through critical illness. Survivors have told us their experiences were not “sleep” to them. What do neurologists and researchers say about the quantity and quality of sleep during medically-induced comas? Dr. Williams Roberson shares with us her research and
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Walking Home From The ICU Episode 59: One Nurse Bringing Change to a Hospital System
How can one nurse make bring the change? What can happen when a team catches the vision? How can a team transition their culture from deep sedation and immobility to awake and walking? Nora tells us about igniting her team’s fire and the changes they are celebrating. Episode Transcription Kali Dayton 0:29 Hello, we’ve
Walking Home From The ICU Episode 58: Deadly Treatment for a Deadly Virus?
Louise, ACNP, has dedicated her career to preserving lives in the Awake and Walking ICU. So what was it like for her to have her own loved one die from sedation and immobility? She tells it like it is and gives us a sobering insight into both sides of the bedside during COVID19. Episode
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Walking Home From The ICU Episode 57: The Shock of Working in a “Normal ICU”
When all you’ve ever known is walking patients on ventilators, what is it like to enter a time machine and go back to sedation and immobility? What did Tara learn taking care of COVID19 patients outside of her “Awake and Walking ICU”? She shares with us her reaffirmed empowerment to change patients’ outcomes through evidence-based
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Walking Home From The ICU Episode 56: Minding Your Own Business
What does it mean to you to be able to toilet yourself? What happens to patient dignity when they are deprived of the capacity to “mind their own business”? Rachel shares with us what is happening to patients even when they are not on mechanical ventilation. Episode Transcription Kali Dayton 0:28 Hey, everybody, before we
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Walking Home From The ICU Episode 55: Walking in ICUs Around the World
Where in the world do patients walk on ventilators and ECMO? Providers from 22 countries share with us their experiences with helping patients walk home from the ICU. Episode Transcription Kali Dayton 0:28 Okay, let’s talk about walking patients on ventilators. Though one of my favorite topics, I recognize that it is a big
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Walking Home From The ICU Episode 54: Back To Harmful Practices From the ’90s
After decades of research revealing the price patients pay from benzodiazepines, where are we now in the ICU? Dr. Wes Ely and Brenda Pun share with us the latest COVID study and how COVID-19 patients are being cared for around the world. Episode Transcription Kali Dayton 0:29 Hello, it’s been a while. Thanks for hanging
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Walking Home From The ICU Episode 53: ICU Early Walking with Heidi Engel
How do we bring changes to the ICU? What barriers impede the progress of our culture? Heidi Engel, PT, DPT, shares with us her continuous journey to humanizing her ICU. Episode Transcription Kali Dayton 0:29 Welcome to the Awake and Walking ICU podcast, I can tell that we have a lot of new listeners.
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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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