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
Patients and Their Families Have the Right to Know the Risks of Sedation
Patient autonomy is a pillar of clinical ethics, and it’s vital to the integrity of any clinical practice. Observance of this principle works to uphold patients’ rights, fosters trust and collaboration, respects diversity, and empowers individuals to actively participate in decision-making regarding their healthcare. In our efforts to protect patient autonomy, one of the best
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Walking Home From The ICU Episode 143: The Impact of Delirium on Stroke Survivors
We know that stroke patients are at high risk of poor cognitive, physical, and psychological outcomes. How does delirium impact their outcomes and how can we better protect patients from additional brain injury from delirium? Episode Transcription Kali Dayton 0:00 Green. Rosa, welcome to the podcast. Can you introduce yourself to us? Rosa Hart, BSN,
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Walking Home From The ICU Episode 142: Treating Post-ICU PTSD
We know that critical illness, sedation, delirium, etc., can leave patients with deep psychological trauma. How can we help them recover? What resources are available to treat post-ICU PTSD? Dr. Brian Peach shares with us his exciting developments and research. Episode Transcription Kali Dayton 0:00 This week I flew out to meet with the executive
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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 140: Early Mobility in the Burn ICU
Is early mobility safe and feasible in the burn ICU? Considering the significant barriers such as pain, dressing changes, variable device securement, delicate position needs, etc., how can an ICU team continue to practice early mobility? Episode Transcription Kali Dayton 0:02 Audrey, welcome to the podcast. Thanks for joining us and all your great work
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Walking Home From The ICU Episode 139: The Power of RN “Soft-Skills” to Change Outcomes
It goes without saying that nurses are the gatekeepers of patient outcomes in the ICU. Do ICU nurses *really* aspire to care for unresponsive and atrophying bodies? How does the ABCDEF Bundle impact the nursing role, skillset, and job fulfillment? James Fletcher, BSN, RN seems to fit the mold of a nurse that would thrive
We know that early mobility is a potent tool to prevent and treat ICU delirium. How does it impact cognitive function 1 year after discharge? What do “Early” and “Mobility” REALLY mean? How has drastic variation in methodology in the research led to the confusion and conflict we now see in early mobility practices? How
ICU Rounding Culture: What Needs to Change and How We Can Help
One of the biggest barriers to improving ICU patient care is a lack of interdisciplinary collaboration, especially when it comes to ICU rounding. In theory, rounding should give clinicians the opportunity to review and discuss each patient’s care, and then come together to ensure that care is a reflection of best practices and the patient’s
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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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