Walking Home From The ICU Episode 83: Paralyze With Fear
As neuromuscular blockade agents have come back into vogue, let’s talk about the big picture. When we understand the repercussions of this intervention, we will paralyze with fear. Episode Transcription Kali Dayton 0:00 Oh, neuromuscular blockade agents, such a hot topic right now. I approach it with trepidation, and passion. Let’s start with the
Learn More > from Walking Home From The ICU Episode 83: Paralyze With Fear
Walking Home From The ICU Episode 78: “Never Really Over”
What is it really like to be in a medically-induced coma? As an experienced ICU physiotherapist and war veteran, Aron Welsh provides soul-shaking insight into the graphic trauma of ICU delirium during and after deep sedation. Episode Transcription Kali Dayton 0:00 Okay, welcome back, I need to apologize to those that have tried to
Learn More > from Walking Home From The ICU Episode 78: “Never Really Over”
Walking Home From The ICU Episode 75: Communicate. Don’t Sedate.
When Jeff Sweat was about to be intubated, what was he told about what was to come? What information did his wife, Sunny Cannon, receive about the risks and reality of deep sedation? Was is it really like to “wake up” 3 weeks later? How have sedation, immobility, and tracheostomy impacted their family? Had they
Learn More > from Walking Home From The ICU Episode 75: Communicate. Don’t Sedate.
Walking Home From The ICU Episode 74: Walk Them To Sleep
What are the main “treatments” or “tools” to prevent and treat delirium? How can we facilitate “quiet nights” without harming patients with sedation? Peter Nydahl, RN, MScN, PhD, teaches us how to walk them to sleep. Episode Transcription Kali Dayton 0:27 Hello, and welcome back on one of the videos or pictures posted an Instagram
Learn More > from Walking Home From The ICU Episode 74: Walk Them To Sleep
Walking Home From The ICU Episode Episode 72: Military Veterans and Delirium
Why is baseline PTSD a risk factor for post-ICU PTSD? What does delirium look and feel like for war veterans? Why should the ICU community understand what veterans have experienced before and during the ICU? Episode Transcription Kali Dayton 0:27 Let’s talk about this. We know that a huge risk factor for post ICU PTSD
Learn More > from Walking Home From The ICU Episode Episode 72: Military Veterans and Delirium
Walking Home From The ICU Episode 61: “You Can’t Sedate Away Delirium”
What barriers do we have in our ICU culture that prevent us from appropriately addressing delirium? What can we do to foster a better approach to helping delirious patients that are difficult to care for? Dr. Swamy gets real as we discuss the reality of delirium from our side of the bed. Episode Transcription
Learn More > from Walking Home From The ICU Episode 61: “You Can’t Sedate Away Delirium”
Walking Home From The ICU Episode 56: Minding Your Own Business
What does it mean to you to be able to toilet yourself? What happens to patient dignity when they are deprived of the capacity to “mind their own business”? Rachel shares with us what is happening to patients even when they are not on mechanical ventilation. Episode Transcription Kali Dayton 0:28 Hey, everybody, before we
Learn More > from Walking Home From The ICU Episode 56: Minding Your Own Business
Walking Home From The ICU Episode 52: Haunted Beyond the ICU
What truly happens during delirium? When do the hallucinations and terror stop? Survivors give us a sobering reality check of what caused the deep psychological trauma during their ICU stays and how their lives are forever impacted Episode Transcription Kali Dayton 0:28 Throughout this podcast, we have explored the reality that prolonged deep sedation causes
Learn More > from Walking Home From The ICU Episode 52: Haunted Beyond the ICU
Walking Home From The ICU Episode 50: The Reality of Post-ICU PTSD
What causes Post-ICU PTSD? What is it like to live with this trauma? How does it impact life after the ICU? Spencer Freeman shares with us intimate insight into living with Post-ICU PTSD. Episode Transcription Kali Dayton 0:27 Throughout the podcast, we have talked a lot about delirium in the sense of what causes it,
Learn More > from Walking Home From The ICU Episode 50: The Reality of Post-ICU PTSD
Walking Home from The ICU Episode 32: Delirium Day
In commemoration of Delirium Day, it is most appropriate to hear from one of the leading delirium experts, Dr. Sharon Inouye! She shares with us her professional and personal experiences with delirium in all aspects of hospitalization. Episode Transcription Kali Dayton Hello! Today, March 11 is delirium day. So not in celebration, but in commemoration
Learn More > from Walking Home from The ICU Episode 32: Delirium Day
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
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
By clicking the Subscribe button, you agree to this site's Privacy Policy. Your information is always kept safe.
