Walking Home From The ICU Episode 115: Sedation By Race
We know that prolonged sedation and immobility are lethal. We also know that there are significant racial disparities in outcomes in the ICU. How does race impact sedation practices? What role does sedation management play in racial inequality in critical care medicine? Dr. Thomas Valley shares with us his invaluable research into sedation by race.
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Tyler’s Story: How Evidence-Based Practices Helped Preserve an ARDS Survivor’s Quality of Life
Most patients who are admitted to the ICU in need of mechanical ventilation have to suffer through days or even weeks of deep sedation, immobility, and all the ill effects of these practices. But for patients with acute respiratory distress syndrome (ARDS), this lack of adherence to evidence-based practices can spell the death of their
Walking Home From The ICU Episode 114: From the Eyes of a Travel Nurse
What was it like as a travel COVID ICU nurse to jump into an “Awake and Walking COVID ICU”? How does true mastery of the ABCDEF bundle impact RN workload, burnout, safety, and career fulfillment? Travel RN, Laurelai, shares with us her experiences and insights. Episode Transcription Kali Dayton 0:00 In episode 76 Travel nurse
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Walking Home From The ICU Episode 113: Introducción a una “UCI Despierta y Caminante”
“Awake and Walking ICU” – Episodio en español. Que experimentan a los pacientes durante sus comas inducidas? Porque y como debemos evitar a la sedation continua durante a la enfermedad crítica? Que es una “UCI Despierta y Caminante”? Este episodio cambiará a la perspectiva de nuestras prácticas en la UCI. Episode Transcription Episodio en español
Walking Home From The ICU Episode 112: Unplanned Extubations
What does research reveal about how and why do unplanned extubations occur? How dangerous are unplanned extubations? We dive into it deep in this episode. Episode Transcription One of the common foundational reasons for giving sedation automatically after intubation is for an inherited sense of safety. Between being uneducated about the risks and repercussions of
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Walking Home From The ICU Episode 111: Both Sides of the ICU Bed With Dr. Wischmeyer
What is like to be an ICU delirium survivor and intensivist? How did Dr. Wischmeyer’s own nutrition research transform his outcomes during his most critical ICU stay? He shares his journey with us in this episode. Episode Transcription Kali Dayton 0:00 Being a patient in the ICU brings a breadth of wisdom and insight. I’m
Joan’s Story: Yet Another Example of the Benefits of the ABCDEF Bundle
Despite all the evidence to the contrary, most ICUs still operate as if the best thing you can do for patients on the ventilator is to ensure they remain sedated and immobile. But the truth is, there are mountains of evidence to show the harm that these practices can cause for ICU patients, and just
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Walking Home From The ICU Episode 110: Occupational Therapy in the Trauma ICU
The trauma ICU has unique risks to agitation, delirium, and long-term impairments. How does occupational therapy help the trauma ICU team avoid sedation, maximize mobility, and radically transform patient outcomes? Phillip Gonzalez, OTR, MOT, shares with us his expertise and success as an occupational therapist in the trauma ICU and traumatic brain injuries. Episode Transcription
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Walking Home From The ICU Episode 109: The ABCDEF Bundle for Traumatic Brain Injuries
Traumatic brain injuries can have distinct exceptions that necessitate deep sedation and immobility. How then can we apply the ABCDEF bundle to protect injured brains and restore lives? Charlotte Davis, BSN, RN, CCRN and Richard Rivera, BSN, RN-BC share their expertise and their team’s incredible success with the ABCDEF bundle in the settings of TBI.
Bryan Carter is a man with a history of type 1 diabetes who was admitted to the ICU for acute respiratory failure secondary to influenza A, which quickly developed into acute respiratory distress syndrome (ARDS). He remained awake and walking while intubated on mechanical ventilation, even with high ventilator settings, including a PEEP of 18
As an RN in the Medical-Surgical ICU at the hospital I work at, I began my interest in ICU Liberation through an Evidence-Based Practice project.
While I was initially grabbed by what the literature has to say about over-sedation and patient outcomes, it wasn’t until I discovered Kali’s Walking Home From The ICU podcast that a culture of sedationless ICU care sounded tangible. The group I worked with on the project was both inspired, devastated, and intrigued by the stories Kali illuminates on the podcast, and we were able to bring her to our hospital for a virtual Zoom Webinar, where she presented on the practices in the Awake and Walking ICU.
This webinar was an incredible way to draw attention toward this necessary culture shift as Kali shared stories of patients awake and mobile in the ICU despite the complexity of their illness. The webinar inspired our final draft for the new practice guideline on analgesia and sedation management in the ICU, and since then we have seen intubated COVID patients playing tic tac toe on the door with staff members on the other side, taking laps around the unit, performing their own oral care using a hand mirror, and most importantly, keeping their autonomy and integrity while fighting to leave the ICU to resume the life they had before coming in.
Nora Raher, BSN, RN, MSICU
Virginia, USA
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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