Category: Survivors of an Awake and Walking ICU

Episode 141: Fighting For Your Life With Your Eyes Open

Walking Home From The ICU Episode 141: Fighting For Your Life With Your Eyes Open

Sedation is often given with the hopes of sparing patients the discomfort and awareness of the struggles of the ICU. Yet, does that ultimately prevent harm and suffering? Antonette Montalvo, APRN shares with us what it meant to her to be able to fight for her life with her eyes open. Episode Transcription Kali Dayton

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Walking Home From The ICU Episode 122 Caleigh’s Voice Through Critical Illness

Walking Home From The ICU Episode 122: Caleigh’s Voice Through Critical Illness

Caleigh has had it both ways in the ICU. She has been sedated and immobilized which led to battling delirium and ICU acquired weakness. She has also been awake and mobile while intubated and walked out the doors. Listen to Caleigh share her insights and what meant to her to be communicative, connected, and autonomous

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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 71 What “Fight To Survive” Truly Means

Walking Home From The ICU Episode 71: What “Fight To Survive” Truly Means

When an ICU team started discussing end-of-life with 31-year-old Megan Wakley’s family, they fought to have her transferred to the “Awake and Walking ICU”. When research shows that the less sedation used and the more mobility performed the less likely patients are to die, what did that mean for Megan Wakely?   Episode Transcription Kali

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Walking From ICU Episode 44 Walking Home From the ICU after COVID19

Walking Home From The ICU Episode 44: Walking Home From the ICU after COVID19

When 69-year-old Dr. Ken Hurwitz was intubated for COVID19, how was his life saved and even preserved? After 3 weeks on the ventilator, why was he able to walk away and go straight home? Episode Transcription Kali Dayton 0:28 In the past few episodes, we learned about the conditions, treatments and outcomes experienced during the

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Dayton Walking From ICU Episode 34 Recommendations From a 4-Time Ventilator Survivor

Walking Home from The ICU Episode 34: Recommendations From a 4 -Time Ventilator Survivor

Kali talks with Ann Bannon, who was intubated four times and awake on the endotracheal tube and ventilator for months. She gives us valuable insight into how to help the new flood of ventilated patients. Episode Transcription Kali Dayton Ann, thank you so much for joining us. Appreciate you coming on our show and helping

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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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