Walking Home From The ICU Episode 134: Are We Sedating Them to Death?
We know that deep sedation is an independent predictor of mortality. This guides most sedation orders to require a RASS of 0- (-2). Is that what is really happening at the bedside? What percentage of patients are actually lightly sedated to the RASS goal vs. deeply sedated? What is driving oversedation throughout the ICU community?
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Walking Home From The ICU Episode 130: Becoming an Awake and Walking ICU With Dr. Bellucci
After visiting the original Awake and Walking ICU, how did Dr. Brian Bellucci help bring these changes to his ICU? What is the physician’s role in supporting a team’s sedation and mobility practices? How can we increase physician buy-in? Dr. Bellucci shares with us his team’s journey to becoming an Awake and Walking ICU. Episode
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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Susanne’s Story: How to Improve ICU Patient Outcomes with the ABCDEF Bundle
When we think about the intensive care unit, most of us would assume it’s a place that provides the best possible treatment for patients, and is always on the cutting edge of science, medicine and technology. But while this may be true in many aspects, when it comes to things like sedation, early mobility, and
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Walking Home From The ICU Episode 95: The Financial Cost of Sedation and Immobility
When healthcare systems say they don’t have the resources to support proper practices, is that true? How much do deep sedation and immobility cost our ICU teams, hospitals, and healthcare systems? How can we use the research to support our plight for safe staffing ratios and evidence-based practices? Let’s dive deep into the money talk.
Walking You Through The ICU Episode 8: Sedation and Medically-Induced Comas
Despite the high risks and harm of prolonged deep sedation, why do most ICUs place every patient on a ventilator into a medically-induced coma? Let’s talk straight about the history and big picture of our ICU sedation culture. Episode Transcription Now that you understand delirium, we have to address medically-induced comas. In all honesty, this
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Susanne was admitted to the ICU for ludwig’s angina. When she required intubation only for airway protection, she was placed on the conveyor belt of ICU care. How did deep sedation and immobility impact her physical and psychological outcomes? How much more unnecessary time did she spent suffering in delirium on the ventilator? She tells
Walking Home From The ICU Episode 89: Dropping the Grenade On the ICU
What role does the choice of sedation in the field or ED play in the delirium that unfolds in the ICU? How can inter-departmental collaboration improve sedation practices and patient outcomes? How can the ICU better understand delirium and respond appropriately to new admissions from the other facilities and the ED? Jeff Polland, BS, NRP,
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Walking Home From The ICU Episode 84: Zentensive Care
How can we manage ventilators to decrease alarms, avoid misdiagnosing/mistreating asynchrony, and improve patient comfort and outcomes? Dr. Matt Siuba, MD, the “Zenintensivist”, shares with us his tools to decrease sedation and neuromuscular blockade use. Episode Transcription Kali Dayton 0:00 Hello, and welcome back. Before we start as the episode you have all been waiting
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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
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Kali Dayton’s consultancy energized our ICU to adopt the very latest evidence-based therapies to identify, prevent, and treat delirium with the ultimate goal being to eliminate preventable delirium by leveraging lessons shared by Kali to get our ICU patients awake, mobile, and walking.
The advice and tier-one support by Dayton ICU Consulting is a critical component of any ICU leader who wants to do better and make the greatest impact possible for patients so that they survive the ICU and go home to continue their livelihoods free of post-intensive care syndrome or PTSD.
Kali offers a powerful vector to ensure ICU care is state of the art.
Brian Delmonaco, MD, FACEP, Medical Director, Pulmonology and Critical Care Medicine, Samaritan Health Services
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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