Are patients sleeping during medically-induced comas? Are they more comfortable and free of trauma while sedated? Can patients hear, feel, and understand their surroundings while in a medically-induced coma? Do patients know when sedation is turn up higher? Do they know which providers will let them wake up and which ones will try to “turn
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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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 135: The Contrast Between Awake and Sedated
The cultural assumption that everyone would rather be sedated is based on the myth that sedation is “sleep”. Very few survivors can give us a comparison of being sedated vs. being awake while intubated. Lara, like Susan East in episode 3, has had it both ways and shares with us the contrast. Episode Transcription Kali
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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 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 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
Walking Home From The ICU Episode 116: “In Shock” with Dr. Rana Awdish
How does a personal fight for life in the ICU impact a survivor-intensivist’s approach to patient care? Dr. Rana Awdish, author of “In Shock”, shares intimate experiences in and after her ICU stay. Episode Transcription Kali Dayton 00:38 Hello, and happy new year! Ending 2022, I am filled with gratitude for such an incredible year
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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
I stumbled upon Kali’s podcast midway through my anesthesia critical care fellowship in February 2021. At our institution, I got the impression that patients in the ICU either got better on their own or had a prolonged and complicated course to LTAC or death. In her podcast, Kali explained that LTAC was rarely the outcome for patients in the Awake and Walking ICU in Salt Lake City.
Their ICU survivors hardly ever got trached, PEGed, or sent to LTAC, and literally walked out of the hospital in condition as close to their previous health as they could be. Although the concept of using no sedation on ventilated patients was completely foreign to me, it made sense based on what I had read in the literature. I devoured all of the episodes from the beginning, many of them bringing tears and regret for my ignorance, followed by inspiration and hope in later episodes. Listening to her podcast has been one of the most profound experiences in my short, eight-year career in medicine.
After discovering the no sedation, early mobility practice at the Awake and Walking ICU, my focus shifted to bringing it to my own institution. I visited Salt Lake City in March to witness it with my own eyes. Since then, I’ve been in touch closely with Kali and Louise to learn the practical approaches to sedation wean and sedation avoidance for newly intubated patients in the ICU.
Mikita Fuchita, MD
Colorado, USA
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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