Walking Home From The ICU

Are there any other “Awake and Walking ICUs” outside of Salt Lake City, Utah? Dr. Thomas Strom shares with us his team’s success and research in Denmark. He provides powerful insight into the gaps and future of critical care medicine.  Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your CE credit for this episode and all learning you do ⁠⁠⁠⁠here⁠⁠⁠⁠...

What role do registered dietitians play in patient outcomes in the ICU? Why is malnutrition such an emergency? How can we better utilize the expertise of registered dietitians? What does the latest research show about our performance with nutrition in the ICU? Megan Dockweiler, MS, RD, CNSC, and Amand Bakko, MS, RD CNSC share with us their expertise as ICU Registered Dietitians. Photos, transcript...

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, FP-C, shares with us his work to avoid benzodiazepine abuse...

How do speech-language pathologists save lives? How can we more fully utilize them in the ICU? How can PT, OT, AND SLP help, halt, or reverse pulmonary disease processes during acute and critical illness? Let’s discuss how they prevent harm and restore humanity in the ICU. Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your CE credit for this episod...

Mark Hudson, an ICU survivor podcast host, is all too well acquainted with delirium. He has dedicated himself to advocating for fellow patients and survivors to prevent the torture of delirium. He tells it to us straight and guides us towards improvements. Mark Hudson's podcast: https://anchor.fm/icu-life-and-recovery Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @Dayt...

How is the “Awake and Walking ICU” keeping their COVID19 patients mentally and physically functional during severe COVID19? Do they face constant ventilator asynchrony and how do they deal with it? Geoff shares with us his vast experience as a respiratory therapist in walking patients on mechanical ventilation during critical illness and now COVID19.  Photos, transcriptions, and citations at: www....

Does sedation always improve ventilator dyssynchrony, or can it cause it? How does a lack of unity between disciplines impact patient care and outcomes? How can we better support and utilize the expertise of respiratory therapists to optimize care for patients on ventilators? Brady Scott, PhD, RRT shares his 20 years of experience and insights. Photos, transcriptions, and citations at: www. Dayton...

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. Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your CE credit for this episode and all learning...

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. Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your CE credit for this episode and all learning you do ⁠⁠⁠⁠here⁠⁠⁠⁠ ! Want to bring the revolution to your ICU? Check out...

Episode 82: Burnout  What role do constant poor patient outcomes play in the pandemic of ICU staff burnout? What if we had a system that supported staff to practice evidence-based medicine? Would a more humane environment and process of care improve our morale? Would improved patient outcomes support staff retention? Liz McQueen, BSN, RN, shares with us how her flame has been rekindled. Photos, tr...

How does the choice to automatically sedate every patient on a ventilator impact patients for the following weeks, months, and years? Let's dive deeper into how our favorite sedatives change the course of critical illness. Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your CE credit for this episode and all learning you do ⁠⁠⁠⁠here⁠⁠⁠⁠ ! Want t...

How does propofol affect muscles? The brain? Outcomes? ERRXpodcast host and critical care pharmacist, Adis Keric, BCPS, BCCP, shares with us the big picture of propofol. Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your CE credit for this episode and all learning you do ⁠⁠⁠⁠here⁠⁠⁠⁠ ! Want to bring the revolution to your ICU? Check out ⁠⁠⁠⁠www. Da...

Episode 79: Step Up and Step Forward What can happen when a clinician wakes up to the reality of sedation and immobility? ICU revolutionists around the world are stepping up and stepping forward to elevate sedation and mobility practices for their patients. It can take 1 person to make 1 decision and change a patient’s entire life. Hear their success stories! Photos, transcriptions, and citations...

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. Warning: Mature Audiences Only. Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your CE credit for this episode and all learni...

Are lung-protective strategies only implemented when patients are sedated? Is walking on the ventilator safe for the lungs? How do we transition from “sedating to keep patients safe” to “walking to keep patients safe”? Dr. Ali Fazili from the “Awake and Walking ICU” shares with us his expertise.  Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your C...

Is it *really* easier to sedate patients? Ultimately, does giving patient delirium and ICU acquired weakness actually decrease staff workload? Travel nurse, Alex, gives us the real deal. Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your CE credit for this episode and all learning you do ⁠⁠⁠⁠here⁠⁠⁠⁠ ! Want to bring the revolution to your ICU? Chec...

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 been allowed transparency and autonomy in Jeff's course, what would they...

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. Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your CE credit for this episode and all learning you do ⁠⁠⁠⁠here⁠⁠⁠⁠ ! Want to bring th...

We habitually lie to ourselves and our patients' families when the word “sleep” leaves our tongues in reference to sedated patients. Why is sleep so vital to survival in the ICU? What prevents our patients from preserving their sanity and cognitive function? What has COVID taught us about the role of sleep in the ICU? Dr. Margaret Pisani, intensivist and sleep researcher, ties it all together...

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? Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your CE credit for this episode and all learning you do ⁠⁠⁠⁠here⁠⁠⁠⁠ ! Want to bring the revolut...

When an ICU team started discussing end-of-life with 31-year-old Megan Wakley’s family, they fought to have her transferred to the “Awake and Walking ICU”. When research shows that the less sedation used and the more mobility performed the less likely patients are to die, what did that mean for Megan Wakely? She shares her story of surviving and thriving in the ICU. Photos, transcriptions, and cit...

What specific approaches help rally the troops to bring change to the ICU?  How have other PICU teams cultivated a rich culture of mobility? When an interdisciplinary approach becomes the culture of the PICU, what happens to patient outcomes? Erin Gates, DPT and Sara Eilerman, DPT share with us the PICU UP! culture and practices they have led their team to develop.    Photos, transcriptions, and c...

What does it take to inspire a PICU team to keep children on mechanical ventilation awake and playing? Who can bring the change? Hannah Child, a pediatric physiotherapist in the UK, shares with us her team’s evolution and successes. Photos, transcriptions, and citations at: www. DaytonICUConsulting.com @DaytonICUConsulting Get your CE credit for this episode and all learning you do ⁠⁠⁠⁠here⁠⁠⁠⁠ !...

We know that sedation causes and worsens ICU delirium, post-ICU PTSD, post-ICU dementia, and ICU-acquired weakness in adults. The research is vast and compelling. What does this mean for children? What does research reveal about the harm children suffer from drug-induced comas? Is there a different way to treat our children? Can we preserve their futures by changing our practices in the ICU? What...

If you were to come out of a medically-induced coma after weeks of delirium and atrophy with a new tracheostomy, only to find yourself unable to hold your head up...would you want to be discharged to an LTACH? Do other countries have LTACHs? Are there other options to survival after the ICU for survivors? Patrik shares with us his experience and role in guiding family and survivors out of the ICU....