Category: PT/OT/SLP

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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Episode 137: Physical and Occupational Therapists in the ICU: Working Together But Not Together

Walking Home From The ICU Episode 137: Physical and Occupational Therapists in the ICU: Working Together But Not Together

Occupational and Physical Therapists save lives in the ICU with their unique and complementary expertise. Bryan Lohse, DPT, CCS and Paul Arnold, OTR/L, CLT share with us how their Awake and Walking CVICU has developed their therapy teams. They address the question of PT & OT cotreatments in the ICU. Episode Transcription Kali Dayton 0:02

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Walking Home From The ICU Episode 131 Occupational Therapists as Leaders In the ICU

Walking Home From The ICU Episode 131: Occupational Therapists as Leaders In the ICU

When Brenna’s ICU set out to become an “Awake and Walking ICU”, Brenna, OTR/L, accepted the challenge. She shares with us her journey to leading her team to have the skills and culture to optimize mobility during critical illness. Episode Transcription Kali Dayton 0:13 A few years ago, I spoke at a conference and I

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Walking From ICU Episode 107- Awake and Moving in the CVICU

Walking Home From The ICU Episode 107: Awake and Moving in the CVICU

Critically ill cardiovascular patients can be very high-risk and high-acuity patients with numerous devices and multiorgan failure. How and when can we safely initiate early mobility? What role should physical and occupational therapy play in the CVICU? Jenna Hightower, PT, DPT, CCS shares her incredible expertise and ground-breaking work in early mobility in the CVICU.

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Walking From ICU 104- ICU Rehabilitation

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 From ICU Episode 103- Communication Is a Basic Human Right- Especially in the ICU

Walking Home From The ICU Episode 103: Communication Is a Basic Human Right- Especially in the ICU

This episode explores the value of communication in the ICU and the impact of our sedation and immobility practices on the basic human right of communication. Episode Transcription Kali Dayton 0:38 This episode is dedicated to communication and the ICU. This has taken me a long time to publish in part because it is so

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Walking From ICU Episode 99- How Physical Therapists Save Lives in the ICU

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

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Walking From ICU Episode 98- Occupational Therapists Change Outcomes in the ICU

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

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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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