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
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 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,
Learn More > from Walking Home From The ICU Episode 143: The Impact of Delirium on Stroke Survivors
Walking Home From The ICU Episode 142: Treating Post-ICU PTSD
We know that critical illness, sedation, delirium, etc., can leave patients with deep psychological trauma. How can we help them recover? What resources are available to treat post-ICU PTSD? Dr. Brian Peach shares with us his exciting developments and research. Episode Transcription Kali Dayton 0:00 This week I flew out to meet with the executive
Learn More > from Walking Home From The ICU Episode 142: Treating Post-ICU PTSD
We know that early mobility is a potent tool to prevent and treat ICU delirium. How does it impact cognitive function 1 year after discharge? What do “Early” and “Mobility” REALLY mean? How has drastic variation in methodology in the research led to the confusion and conflict we now see in early mobility practices? How
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: 129: Cognitive Rehabilitation After ICU With Dr. Jim Jackson
When patients suffer from delirium in the ICU, what resources are available to them to support their cognitive rehabilitation Psychologist, Dr. Jim Jackson, from episode 51, returns to the podcast. He shares with us his journey to writing his new book, “Clearing the Fog” as a roadmap to recovery for survivors. Episode Transcription Kali Dayton
Walking Home From The ICU Episode 119: The Trauma of Delirium After a Traumatic Birth
How can delirium contribute to the trauma of a traumatic birthing experience? Midwife and ICU survivor, Amber, shares with us her personal journey through and after the ICU. Episode Transcription Kali Dayton 0:35 Okay, it’s time to bring it all back to the real reason for transitioning to an “Awake and Walking ICU”, which is
Susanne was admitted to the ICU for ludwig’s angina. When she required intubation only for airway protection, she was placed on the conveyor belt of ICU care. How did deep sedation and immobility impact her physical and psychological outcomes? How much more unnecessary time did she spent suffering in delirium on the ventilator? She tells
Walking Home From The ICU Episode 87: Is Their Silence Worth Their Suffering?
Mark Hudson, an ICU survivor podcast host, is all too well acquainted with delirium. He has dedicated himself to advocating for fellow patients and survivors to prevent the torture of delirium. He tells it to us straight and guides us towards improvements. Episode Transcription Kali Dayton 0:00 Okay, a huge objective of this podcast is
Learn More > from Walking Home From The ICU Episode 87: Is Their Silence Worth Their Suffering?
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
By clicking the Subscribe button, you agree to this site's Privacy Policy. Your information is always kept safe.