Walking Home From The ICU

Are patients sleeping during medically-induced comas? Are they more comfortable and free of trauma while sedated? Can patients hear, feel, and understand their surroundings while in a medically-induced coma? Do patients know when sedation is turn up higher? Do they know which providers will let them wake up and which ones will try to "turn you off"? Drew Brophy is a world-renown artist t...

Antipsychotics have been a hot topic in the ICU. Do they treat delirium? Can they be used to replace continuous sedation? When and how can we utilize antipsychotics to optimize care and outcomes? Dr. Marie Rueve from episode 160 joins us again to clear the air on antipsychotics in the ICU. ***Early Mobility Conference April 14-16th in Orlando, FL*** https://www.earlymobility.com/2024conference Pod...

Sabrina Eggmann is a PhD physiotherapist with 17 years of experience. She shares with us how her team utilized their years of expertise in early mobility to preserve their practices for COVID19 patients in Switzerland. https://pubmed.ncbi.nlm.nih.gov/33492400/ Check out Sabrina's latest article in the Lancet Journal: https://www.thelancet.com/pdfs/journals/eclinm/PIIS2589-5370(24)00018-X.pdf E...

In episode 132, David Richards shared with us the life-saving impact of his ICU diary. In this episode, Seth van der Meer from Post-ICU shares with us exciting technological advancements that can help make ICU diaries standardized and accessible for all patients. https://post-icu.com Episode transcriptions and citations at: www.daytonicuconsulting.com Get your CE credit for this episode and all le...

As a nurse of 22 years, Lynn had been taught that patients were comfortably sleeping while sedated in medically-induced comas. She shares the horrific realities she suffered while intubated and sedated and the months of playing "Truth or Propofol?" after discharge. Episode transcript and citations found at www.daytonicuconsulting.com ***Early Mobility Conference April 14-16th in Orlando,...

How can inpatient psychiatrists help ICU teams prevent and treat delirium? How can their expertise help ICU teams minimize sedation, prevent trauma, and treat the psychiatric needs of ICU patients? Dr. Marie Rueve shares with us the role psychiatrists can play in transforming patient care and outcomes in the ICU. www.daytonicuconsulting.com ***Early Mobility Conference April 14-16th in Orlando, FL...

What happens when resources and staffing are dedicated to providing high touch and high compliance with the ABCDEF bundle? How does adequate staffing, interdisciplinary team dynamics, and quality protocols impact patient outcomes and financial benefits? What is the "secret sauce" of successfully weaning patients from the ventilator? Sam Nimah and Phillip Morris share with us the exemplar...

What happens to the body at the cellular, neurological, pulmonary, musculoskeletal, and cardiovascular levels when it remains supine for days to weeks? What is verticalization therapy and what does current research reveal about its benefits during critical illness? Verticalization experts, Phillip Gonzalez, MOT, OTR/L, BCPR, Nikki Stephens, DNP, APRN, FNP-C, and Jenna Hightower, PT, DPT, CCS dive...

For decades, we have culturally passed on the myth that patients are sleeping while sedated into medically induced comas. We have assured ourselves and each other that sedation "prevents PTSD". Research has proven that sedation makes true restorative sleep impossible and real recall of the reality of the ICU is protective against post-ICU PTSD. So what is really happening under sedation?...

After decades of research and effort, why is there a persistent struggle to truly practice the ABCDEF bundle? Are antiquated sedation practices because nurses are unwilling to change, or is it because they are unsupported and untrained in the risks and realities of sedation? Even when training is provided in the classroom, what do nurses learn at the bedside? How does poor leadership impact sedati...

How do families impact patient outcomes in the ICU? What does it really mean to engage and empower families in the ICU? Have our teams truly recovered from the strict visitation restrictions from COVID? How does an ABCDEF Bundle culture influence our visitation policies? Lito Rama, RN, MBA joins us now to share with us the vast evidence supporting families in the ICU. Podcast episode transcript an...

What is EARLY mobility? Why is it so vital that the ICU community advance past passive range of motion for intubated patients? What are the main barriers that prevent us from mastering the E of the ABCDEF bundle? If we're not doing highest level of mobility for most of our patients, are we truly practicing the ABCDEF bundle? Heidi Engel, DPT, joins us now to clear the air about early mobility....

The normality of delirium in the ICU is often mistaken for benign. What does it really mean to "assess, prevent, and treat delirium"? Are we treating a positive CAM score with the same urgency as a positive tropinin? If we are automatically starting deliriogenic medications on every patient immediately upon intubation, are we truly practicing the "D" of the ABCDEF Bundle? Dr. A...

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 this episode to share his expertise on best sedation and analgesia...

Are awakening trials just for breathing trials? How do we set patients up for successful breathing trials to minimize time on the ventilator? What role do sedation and mobility play in prompt liberation from mechanical ventilation? Karsten Roberts, MSc, RRT, FAARC joins us now to dive deep into spontaneous breathing trials in the ABCDEF Bundle. www.daytonicuconsulting.com***Early Mobility Conferen...

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. Transcriptions and citations at: www.daytonicuconsulting.com ***Early Mobility Conference April 14-16th in Orlando, FL***https://www.earlymobility.com/2024conference Get your CE credit for thi...

The A of the ABCDEF Bundle is for "Assess, Prevent, and Treat Pain". How do we truly master this tool and how does this impact patient outcomes? Can we assess, prevent, and treat pain while simultaneously striving to have all possible patients awake, autonomous, and even mobile? Joanna Stollings, PharmD, shares what the A of the ABCDEF Bundle really means and how to master it for each pa...

How did the ABCDEF bundle come to be and what is its true objective? What barriers are causing the ICU community to fall short of full compliance with the bundle and what is the future of the ABCDEF bundle? Michele Balas, PhD, RN shares with us her insights as one of the founders of the ABCDEF bundle. This episode kicks of our 8-episode series dedicated to each element of the ABCDEF bundle. We&#39...

How do hospital-acquired pressure injuries (HAPIs) occur in the ICU and why is the ABCDEF bundle such a powerful tool to prevent HAPIs? How do HAPIs impact healthcare costs, staff workload, patient quality of life, and overall survival? Wound Care Karen joins us in this episode to explore the crisis of hospital-acquired pressure injuries in the ICU. Check out the Wound Care Karen Podcast here! Epi...

Individuals and teams are transforming patient outcomes through the adaptation of the ABCDEF bundle. Hear a compilation of their inspiring successes in this episode! www.daytonicuconsulting.com ***Don't miss the upcoming free webinar, "Financial Benefits of the ABCDEF Bundle", on October 18th at 12pm EST. Register here: https://us02web.zoom.us/meeting/register/tZIufuGsrTwjE9Lg_pK5i_F...

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 damage of sedation, delirium, and ICU-acquired weakne...

What if we were as worried about "brain-protective strategies" as "lung-protective strategies" in the ICU? Such an approach will never be standardized until the ICU community truly recognizes the brain injuries survivors are left with after sedation and immobility. Until post-ICU syndrome is widely known and the impact is deeply appreciated, we will continue to fall short of ev...

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? Rosa Hart, BSN, RN, SCRN from the "Stronger After Stroke" joins us now to explore the struggles, barriers, and importance of the ABCDEF bundle for stroke patients i...

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. Contact information for Dr. Brian Peach found with the transcription for this podcast episode at: www.daytonicuconsulting.com Get your CE c...

Critical illness in the ICU is a battle. It is a fight for life. 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. Get your CE credit for this episode and all learni...