Walking Home From The ICU Episode 154: E- EARLY Mobility with Heidi Engel
What is EARLY mobility? Why is it so vital that the ICU community advance past passive range of motion for intubated patients? What are the main barriers that prevent us from mastering the E of the ABCDEF bundle? If we’re not doing highest level of mobility for most of our patients, are we truly practicing
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Walking Home From The ICU Episode 153: D- Assess, Prevent, and Treat Delirium with Dr. Adrian Austin
The normality of delirium in the ICU is often mistaken for benign. What does it really mean to “assess, prevent, and treat delirium”? Are we treating a positive CAM score with the same urgency as a positive tropinin? If we are automatically starting deliriogenic medications on every patient immediately upon intubation, are we truly practicing
Walking Home From The ICU Episode 152: C- Choice of Sedation and Analgesia with John Devlin, PharmD
Is the C of the ABCDEF bundle only for avoiding benzodiazepines? How do we fully practice the “C” of the bundle and how does this impact patient care and outcomes? If we are automatically starting sedation without evaluation, are we truly practicing the ABCDEF bundle? John W. Devlin, PharmD, BCCCP, MCCM, FCCP joins us in
Walking Home From The ICU Episode 151: Breathing Trials with Karsten Roberts
Are awakening trials just for breathing trials? How do we set patients up for successful breathing trials to minimize time on the ventilator? What role does sedation and mobility play into prompt liberation from mechanical ventilation? Karsten Roberts, MSc, RRT, FAARC joins us now to dive deep into spontaneous breathing trials in the ABCDEF Bundle.
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What is the purpose of awakening “trials”? When should awakening “trials” be done? How can we have successful awakening “trials”? Dr. Wes Ely joins us in this episode to crack the code on sedation cessation. Episode Transcription Kali Dayton: Last week, I did a little survey on social media. I recognize that my followers
The A of the ABCDEF Bundle is for “Assess, Prevent, and Treat Pain”. How do we truly master this tool and how does this impact patient outcomes? Can we assess, prevent, and treat pain while simultaneously striving to have all possible patients awake, autonomous, and even mobile? Joanna Stollings, PharmD, shares what the A of
Walking Home From The ICU Episode 148: The History and True Mission of the ABCDEF Bundle
How did the ABCDEF bundle come to be and what is its true objective? What barriers are causing the ICU community to fall short of full compliance with the bundle and what is the future of the ABCDEF bundle? Michele Balas, PhD, RN shares with us her insights as one of the founders of the
The Financial Benefits of the ABCDEF Bundle
The ABCDEF Bundle is easily the best tool we have to improve patient care and outcomes in the ICU. If you know anything about these evidence-based practices, you’re probably well aware that they can decrease length of stay and readmissions, and reduce patients’ chances of dying, while making it more likely that they’ll return to
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How do hospital-acquired pressure injuries (HAPIs) occur in the ICU and why is the ABCDEF bundle such a powerful tool to prevent HAPIs? How do HAPIs impact healthcare costs, staff workload, patient quality of life, and overall survival? Wound Care Karen joins us in this episode to explore the crisis of hospital-acquired pressure injuries in
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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My dad came down with COVID pneumonia at the end of September. We did our best to treat him at home but eventually we realized we needed to get him to a hospital. After about four days in the hospital on oxygen he crashed and needed to be put on a ventilator. We were devastated.
When they put a person on a ventilator, hospital protocol generally is to sedate and paralyze the patient. My dad was sedated and paralyzed for a total of about 17 days. He was completely immobilized. One doctor told us that my dad had one of the worst cases of COVID pneumonia he had seen in a long time. We were, of course, extremely worried. As time went on, his condition worsened. Through a series of miracles, my dad stabilized enough that they were able to give him a tracheostomy. This was the turning point where he was able to get transferred to a LTAC facility (which is a critical care facility for COVID patients).
Fortunately, through a friend, we were put in touch with Kali Dayton. We were told she has had amazing success helping people come down off sedation and the paralytic. One of the side effects of sedation is the patients experience extreme delusions and hallucinations. While we were at the LTAC, Kali was extremely helpful in helping us understand the importance of getting my dad off the paralytic and sedation quickly. She informed us that every day he was on the sedation added weeks onto his recovery. We began pressuring the staff at the LTAC to get him off the sedation. Kali has found that it is critical to get a ventilated patient up and moving and you can’t unless they are off sedation. The staff at the LTAC were very hesitant to take my dad off sedation, at times even telling us he was off it, when in fact, he was still on sedation.
Heidi Lanthen
Utah, USA
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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