RESOURCES

Lawrence Bistrong, MD, FCCP

November 7, 2024

The service Dayton ICU Consulting provided was exceptional and above expectations. As an ICU medical director, I have had to unlearn what has been taught to us over the years and what we thought was right. When I started listening to the Walking Home From The ICU podcast, I felt profound sadness and guilt for what we did to other human beings thinking what we were doing was right.

I have changed my practice and we had Dayton ICU Consulting at our hospital in each of our intensive care units for multiple sessions. It was eye-opening for the staff, especially the bedside RNs. We have developed significant momentum, especially in our surgical and trauma ICUs where staff that were non-believers are now champions of this movement. We have done videos of patients’ experiences and plan to use them to educate new hires. I am very excited about where we have come from and expect great things.

I cannot thank Kali Dayton and our staff enough for helping us improve ICU care and experiences for our patients.

About the Author, Kali Dayton

Kali Dayton, DNP, AGACNP, is a critical care nurse practitioner, host of the Walking Home From The ICU and Walking You Through The ICU podcasts, and critical care outcomes consultant. She is dedicated to creating Awake and Walking ICUs by ensuring ICU sedation and mobility practices are aligned with current research. She works with ICU teams internationally to transform patient outcomes through early mobility and management of delirium in the ICU.

ICU testimonial 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

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