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
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
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
The mission to create Awake and Walking ICUs is not a brand new endeavor. Dr. Juli Barr, an early PAD and ICU liberation founder, shares with us the tools needed to master the ABCDEF bundle. Episode Transcription Kali Dayton 0:02 Dr. Barr, welcome to the podcast I am ecstatic to have you on. Can you
Walking Home From The ICU Episode 135: The Contrast Between Awake and Sedated
The cultural assumption that everyone would rather be sedated is based on the myth that sedation is “sleep”. Very few survivors can give us a comparison of being sedated vs. being awake while intubated. Lara, like Susan East in episode 3, has had it both ways and shares with us the contrast. Episode Transcription Kali
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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.
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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