Category: Walking Home From The ICU Podcast

Episode 151: Breathing Trials with Karsten Roberts

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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Episode 150: Awakening Trials- "Rehumanization of the Patient"- With Dr. Wes Ely

Walking Home From The ICU Episode 150: Awakening Trials- “Rehumanization of the Patient”- With Dr. Wes Ely

What is the purpose of awakening “trials”? When should awakening “trials” be done? How can we have successful awakening “trials”? Dr. Wes Ely joins us in this episode to crack the code on sedation cessation.   Episode Transcription Kali Dayton: Last week, I did a little survey on social media. I recognize that my followers

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Episode 149: A- Assess, Prevent, and Treat Pain with Joanna Stollings, PharmD

Walking Home From The ICU Episode 149: A- Assess, Prevent, and Treat Pain with Joanna Stollings, PharmD

The A of the ABCDEF Bundle is for “Assess, Prevent, and Treat Pain”. How do we truly master this tool and how does this impact patient outcomes? Can we assess, prevent, and treat pain while simultaneously striving to have all possible patients awake, autonomous, and even mobile? Joanna Stollings, PharmD, shares what the A of

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Walking Home From The ICU Episode 147: The Big Picture of Hospital-Aquired Pressure Injuries with Wound Care Karen

Walking Home From The ICU Episode 147: The Big Picture of Hospital-Acquired Pressure Injuries with Wound Care Karen

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

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Episode 146: Success Stories from ICU Revolutionists

Walking Home From The ICU Episode 146: Success Stories from ICU Revolutionists

Individuals and teams are transforming patient outcomes through the adaptation of the ABCDEF bundle. Hear a compilation of their inspiring successes in this episode! Episode Transcription The past few episodes have been heavy. Obviously we have to address the challenges we face and the damage being done to patients. Yet, we also need to focus

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Walking Home From The ICU Episode 145: The Trauma of Sedation and Immobility in Families in the ICU

Walking Home From The ICU Episode 145: The Trauma of Sedation and Immobility in Families in the ICU

Sedation and immobility impact more than patient outcomes in the ICU. Family members also suffer the isolation, burden, trauma, and loss from sedation and immobility in and after the ICU. Families are also at risk of developing post-ICU syndrome themselves. Nonetheless, they are left unprepared to care for their loved ones who are suffering the

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Episode 144: Living With a "Sedation-Induced Brain Injury" and PICS

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

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Episode 143- The Impact of Delirium on Stroke Survivors

Walking Home From The ICU Episode 143: The Impact of Delirium on Stroke Survivors

We know that stroke patients are at high risk of poor cognitive, physical, and psychological outcomes. How does delirium impact their outcomes and how can we better protect patients from additional brain injury from delirium? Episode Transcription Kali Dayton 0:00 Green. Rosa, welcome to the podcast. Can you introduce yourself to us? Rosa Hart, BSN,

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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

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