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
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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,
Walking Home From The ICU Episode 157: Sedation is Sleep-Deprivation
For decades, we have culturally passed on the myth that patients are sleeping while sedated into medically induced comas. We have assured ourselves and each other that sedation “prevents PTSD”. Research has proven that sedation makes true restorative sleep impossible and real recall of the reality of the ICU is protective against post-ICU PTSD. So
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After decades of research and effort, why is there a persistent struggle to truly practice the ABCDEF bundle? Are antiquated sedation practices because nurses are unwilling to change, or is it because they are unsupported and untrained in the risks and realities of sedation? Even when training is provided in the classroom, what do nurses
Walking Home From The ICU Episode 155: F- Family Engagement and Empowerment with Lito Rama
How do families impact patient outcomes in the ICU? What does it really mean to engage and empower families in the ICU? Have our teams truly recovered from the strict visitation restrictions from COVID? How does an ABCDEF Bundle culture influence our visitation policies? Lito Rama, RN, MBA joins us now to share with us
Walking Home From The ICU Episode 154: E- EARLY Mobility with Heidi Engel
What is EARLY mobility? Why is it so vital that the ICU community advance past passive range of motion for intubated patients? What are the main barriers that prevent us from mastering the E of the ABCDEF bundle? If we’re not doing highest level of mobility for most of our patients, are we truly practicing
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Walking Home From The ICU Episode 153: D- Assess, Prevent, and Treat Delirium with Dr. Adrian Austin
The normality of delirium in the ICU is often mistaken for benign. What does it really mean to “assess, prevent, and treat delirium”? Are we treating a positive CAM score with the same urgency as a positive tropinin? If we are automatically starting deliriogenic medications on every patient immediately upon intubation, are we truly practicing
Walking Home From The ICU Episode 152: C- Choice of Sedation and Analgesia with John Devlin, PharmD
Is the C of the ABCDEF bundle only for avoiding benzodiazepines? How do we fully practice the “C” of the bundle and how does this impact patient care and outcomes? If we are automatically starting sedation without evaluation, are we truly practicing the ABCDEF bundle? John W. Devlin, PharmD, BCCCP, MCCM, FCCP joins us in
Walking Home From The ICU Episode 151: Breathing Trials with Karsten Roberts
Are awakening trials just for breathing trials? How do we set patients up for successful breathing trials to minimize time on the ventilator? What role does sedation and mobility play into prompt liberation from mechanical ventilation? Karsten Roberts, MSc, RRT, FAARC joins us now to dive deep into spontaneous breathing trials in the ABCDEF Bundle.
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My dad came down with COVID pneumonia at the end of September. We did our best to treat him at home but eventually we realized we needed to get him to a hospital. After about four days in the hospital on oxygen he crashed and needed to be put on a ventilator. We were devastated.
When they put a person on a ventilator, hospital protocol generally is to sedate and paralyze the patient. My dad was sedated and paralyzed for a total of about 17 days. He was completely immobilized. One doctor told us that my dad had one of the worst cases of COVID pneumonia he had seen in a long time. We were, of course, extremely worried. As time went on, his condition worsened. Through a series of miracles, my dad stabilized enough that they were able to give him a tracheostomy. This was the turning point where he was able to get transferred to a LTAC facility (which is a critical care facility for COVID patients).
Fortunately, through a friend, we were put in touch with Kali Dayton. We were told she has had amazing success helping people come down off sedation and the paralytic. One of the side effects of sedation is the patients experience extreme delusions and hallucinations. While we were at the LTAC, Kali was extremely helpful in helping us understand the importance of getting my dad off the paralytic and sedation quickly. She informed us that every day he was on the sedation added weeks onto his recovery. We began pressuring the staff at the LTAC to get him off the sedation. Kali has found that it is critical to get a ventilated patient up and moving and you can’t unless they are off sedation. The staff at the LTAC were very hesitant to take my dad off sedation, at times even telling us he was off it, when in fact, he was still on sedation.
Heidi Lanthen
Utah, USA
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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