Walking Home From The ICU: Recent Episodes
Kali
Kali Dayton, DNP, ACNP-BC, is an ICU nurse practitioner and ICU consultant. She hands the microphone to ICU survivors and bedside caregivers to reveal the realities of ICU experience and patients' journeys after discharge. The big picture of sedation and immobility is discussed and we explore how to improve short and long-term patient outcomes. We shift the vision from transferring out of the ICU to walking straight home after the ICU. www.DaytonICUconsulting.com Support this podcast: https://anchor.fm/restoringlife/support
While walking the halls full of critical nurses at AACN’s NTI conference, I had get their insights and perspectives. This episode is full of interviews with anonymous ICU nurses from all over the USA. Www.DaytonICUConsulting.com--- Support this podcast: https://podcasters.spotify.com/pod/show/walkinghomefromtheicu/support
Check out this episode with @Christinecasiano as she shares the contrast between being sedated vs. being awake while on ECMO. Register for the monthly ICU Revolutionists zoom meetings here: https://us02web.zoom.us/meeting/register/tZ0oc-6gqzsrGNYdgMGXvVAbcjewZpNpc6PC--- Support this podcast: https://podcasters.spotify.com/pod/show/walkinghomefromtheicu/support
It has been claimed that ICU early mobility is a "new and temporary fad". Is walking intubated patients really that new?
Let's start in 1970 and work our way through decades of research that continues to reaffirm that true mastery of the ABCDEF bundle gives patients the best chance to survive and thrive in and after the ICU.
Episode citations and transcript at www.daytonicuconsulting.com
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What is like to be intubated in your own ICU? Even when the environment and team are well known, what does an intensivist turned patient experience? Dr. Meta van der Woude shares with us her personal journey through the ICU. Www.daytonicuconsulting.com--- Support this podcast: https://podcasters.spotify.com/pod/show/walkinghomefromtheicu/support
What happened when I was reported to the board of nursing for advocating for early mobility in the ICU?
What are the roots of these concerns and this report?
How does social media impact culture and practices in the ICU?
Jess Hren, BSN, RN, Jenna Hightower, DPT, CCS, Phillip Gonzalez, MOT, OTR/L, BCPR discuss why I was reported to the board of nursing.
Episode transcript and citations: www.daytonicuconsulting.com
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Is it save to mobilize patients with trans-formal devices such as balloon pumps, impellas, and ECMO?
Who was the first person to dare to ask, "Why can't we mobilize patients with trans-femoral balloon pumps?"
Stephen Ramsey, PT, DPT, CCS shares with us his journey to developing the Ramsey protocol and revolutionizing mobility in the CVICU.
Episode transcript and citations at:
www.daytonicuconsulting.com
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What is it like for one lone ICU clinician to truly understand the risks of sedation and immobility? What it is like for them to try to implement interventions like awakening trials that have been supported by decades of research? How does lack of support and success increase moral injury, burnout, and the loss of expert and compassionate clinicians?"Kara" joins us to share her journey as an ICU pharmacist and revolutionist. Podcast episode transcripts and citations:www.daytonicuconsulting.com --- Support this podcast: https://podcasters.spotify.com/pod/show/walkinghomefromtheicu/support
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 that found himself intubated with COVID19. Drew and Maria Brophy share their astounding journey through critical illness and post-ICU syndrome.
Early Mobility Conference April 14-16th in Orlando, FL
https://www.earlymobility.com/2024conference
Podcast episode transcripts and citations at:
www.daytonicuconsulting.com
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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
Podcast episode transcripts and citations at:
www.daytonicuconsulting.com
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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
Episode citations and transcriptions found at www.daytonicuconsulting.com
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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
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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, FLhttps://www.earlymobility.com/2024conference
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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, FLhttps://www.earlymobility.com/2024conference
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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 exemplary work happening at Trivent Healthcare. Episode transcriptions and citations found at: www.daytonicuconsulting.comEarly Mobility Conference April 14-16th in Orlando, FLhttps://www.earlymobility.com/2024conference--- Support this podcast: https://podcasters.spotify.com/pod/show/walkinghomefromtheicu/support
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 deep into the science and beauty of verticalization therapy.
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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? If patients are not in sweet oblivion and restful slumber, what is their reality? Chuck Evans joins us to share his startling story of being sedated and sleepless for weeks in the ICU. www.daytonicuconsulting.comEarly Mobility Conference April 14-16th in Orlando, FLhttps://www.earlymobility.com/2024conference--- Support this podcast: https://podcasters.spotify.com/pod/show/walkinghomefromtheicu/support
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 sedation and mobility practices at the bedside?
Are nurses safe to question long-held habits and beliefs?
"April" joins us now to share her experiences entering the ICU and how the ABCDEF bundle is really being practiced.
www.daytonicuconsulting.com
Early Mobility Conference April 14-16th in Orlando, FL
https://www.earlymobility.com/2024conference
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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 and citations at:
www.daytonicuconsulting.com
Early Mobility Conference April 14-16th in Orlando, FL
https://www.earlymobility.com/2024conference
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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. Podcast citations and transcripts found at www.daytonicuconsulting.com
Early Mobility Conference April 14-16th in Orlando, FL
https://www.earlymobility.com/2024conference
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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. Adrian Austin shares with us the full picture of the "D" of the ABCDEF bundle. Citations and transcriptions for all episodes found at www.daytonicuconsulting.com Early Mobility Conference April 14-16th in Orlando, FLhttps://www.earlymobility.com/2024conference--- Support this podcast: https://podcasters.spotify.com/pod/show/walkinghomefromtheicu/support
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 practices in the ICU.
Episode citations and transcriptions found at: www.daytonicuconsulting.com
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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.comEarly Mobility Conference April 14-16th in Orlando, FLhttps://www.earlymobility.com/2024conference--- Support this podcast: https://podcasters.spotify.com/pod/show/walkinghomefromtheicu/support
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, FLhttps://www.earlymobility.com/2024conference
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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 patient.
www.DaytonICUConsulting.com
Financial Benefits of the ABCDEF Bundle Webinar
October 18th, 2022 at 12pm EST
Register here:
https://us02web.zoom.us/j/4173781755?pwd=RHFhYml0Vlc2ZTNJcEJiVURIS1hrQT09
Early Mobility Conference April 14-16th in Orlando, FL
https://www.earlymobility.com/2024conference
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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're going to be going back to the basics and diving deep into how to truly practice the ABCDEF bundle in our ICUs. www.DaytonICUConsulting.com --- Support this podcast: https://podcasters.spotify.com/pod/show/walkinghomefromtheicu/support
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! Episode transcript and citations found at www.daytonicuconsulting.com
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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
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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 weakness while struggling through their own personal trauma. Stefan Becker, a professional psychotherapist, shares intimate insight into the journey he and his wife have suffered in the ICU.
Episode transcription and citations at: www.daytonicuconsulting.com
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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 evidence-based sedation and mobility practices. Only true experts can help us understand.
The real experts on post-ICU syndrome (PICS) are those that live with it. Carol Billian joins us now to share her personal expertise.
www.daytonicuconsulting.com
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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 in the neuro ICU.
Check out the "Stronger After Stroke Podcast" here!
Episode transcription and citations found at: www.daytonicuconsulting.com
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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.
www.daytonicuconsulting.com
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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.
www.daytonicuconsulting.com
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Is early mobility safe and feasible in the burn ICU?
Considering the significant barriers such as pain, dressing changes, variable device securement, delicate position needs, etc., how can an ICU team continue to practice early mobility?
Physical therapist, Audrey O'neill, DPT, shares with us her recent publication and years of expertise.
Vapotherm webinar: https://vtherm.com/0803
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It goes without saying that nurses are the gatekeepers of patient outcomes in the ICU.
Do ICU nurses really aspire to care for unresponsive and atrophying bodies?
How does the ABCDEF Bundle impact the nursing role, skillset, and job fulfillment?
James Fletcher, BSN, RN seems to fit the mold of a nurse that would thrive solely with the flashy skills of an ICU RN. He shares with us the impact nurses can make by using "soft-skills" and human touch in the ICU. He is brining joy back to nursing with the ABCDEF bundle.
www.daytonicuconsulting.com
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We know that early mobility is a potent tool to prevent and treat ICU delirium. How does it impact cognitive function 1 year after discharge? What do "Early" and "Mobility" REALLY mean? How has drastic variation in methodology in the research led to the confusion and conflict we now see in early mobility practices? How can we optimize early mobility in the ICU? Is it safe and feasible to mobilize most patients within 48 hrs after intubation? Is there evidence to support restrictive mobility parameters by ventilator settings, vasopressors, etc.? How can intensivists lead and support their teams to master the full ABCDEF bundle? Dr. Bhakti Patel shares with us her recent research and invaluable insights. See transcript and citations for this episode at: www.daytonicuconsulting.com
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Occupational and Physical Therapists save lives in the ICU with their unique and complementary expertise. Bryan Lohse, DPT, CCS and Paul Arnold, OTR/L, CLT share with us how their Awake and Walking CVICU has developed their therapy teams. They address the question of PT & OT cotreatments in the ICU.
PESI Critical Care Rehab Summit:
https://catalog.pesi.com/sales/rh_s_001719_criticalcarerehab_organic-629440?cmp_id=312&utm_source=Kali+Dayton&utm_medium=affiliate&utm_campaign=SUM001719&_ef_transaction_id=5ed922945678429c8b90a496ebefd68d
www.daytonicuconsulting.com
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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.
www.daytonicuconsulting.com
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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.
www.daytonicuconsulting.com
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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? What are the risks to patients and nurses when RASS orders are not followed? We dive deep into this with Alexis Nowling, MSN. www.daytonicuconsulting.com
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When Dr. Mikita Fuchita heard about an Awake and Walking ICU, he had to see it with his own eyes. After visiting the Awake and Walking ICU, how did Dr. Fuchita embark on bringing his colleagues together to update their sedation and mobility practices? He shares his personal conversion and his team's journey with us in this episode.
www.daytonicuconsulting.com
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Post-ICU PTSD is a life altering and life-threatening condition. ICU diaries have shown promising benefits to helping survivors navigate the trauma they carry with them from the ICU and especially delirium. David Richards shares with us his journey during and after the ICU and how his ICU diary has been a key part of his post-ICU survival.
www.daytonicuconsulting.com
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When Brenna's ICU set out to become an "Awake and Walking ICU", Brenna, OTR/L, accepted the challenge. She shares with us her journey to leading her team to have the skills and culture to optimize mobility during critical illness.
www.daytonicuconsulting.com
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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.
www.daytonicuconsulting.com
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When patients suffer from delirium in the ICU, what resources are available to them to support their cognitive rehabilitation? Psychologist, Dr. Jim Jackson, from episode 51, returns to the podcast. He shares with us his journey to writing his new book, "Clearing the Fog" as a roadmap to recovery for survivors. www.daytonicuconsulting.com--- Support this podcast: https://podcasters.spotify.com/pod/show/walkinghomefromtheicu/support
Let's talk about delirium severity.
Does the severity of delirium vary by ICU specialties or by ICU treatment?
What role does sedation play in delirium severity?
What role does race play in delirium severity?
Dr. Damaris Ortiz shares with us key findings from her important research.
www.daytonicuconsulting.com
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When the ICU at St. Joseph's Hospital in Colorado invested less than $100,000 into becoming an Awake and Walking ICU, what was their return on investment? How has supporting the training, education, and support of their team impacted their team dynamics, morale, and patient outcomes? Nancy Mcgann, PT, shares with us her team's exciting success! www.daytonicuconsulting.com--- Support this podcast: https://podcasters.spotify.com/pod/show/walkinghomefromtheicu/support
This week leading nursing podcasts are teaming up to confront delirium head-on.
Podcasts including Up My Nursing Game, Rapid Response RN, Good Nurse Bad Nurse, Cup of Nurses, and How to Not Kill Your Patient will dive deep into the reality and impact of delirium throughout the hospital from the ED to the acute care floor.
This episode, Tina from Good Nurse Bad Nurse co-hosts with Kali to explore how gaps in delirium education and support can turn lethal by a "Bad Nurse" and how a "Good Nurse" can change and save innumerable lives for generations to come.
www.daytonicuconsulting.com
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As Dr. Swamy said in episode 61, "You can't sedate away delirium".
Yet, when patients are delirious and agitated, how can we keep patients and clinicians safe?
How do we avoid and even discontinue sedation while keeping lines and tubes intact?
What role do restraints play in agitation and trauma for patients?
Are soft wrist restraints our best and only options?
Dr. Marie Pavini, intensivist, and innovator of Exersides shares with us more tools and insights for approaching sedation and delirium management in the ICU through updated restraint technology.
www.daytonicuconsulting.com
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Alcohol withdrawal can send our patients into a spiral of delirium and downstream complications in the ICU. What are the risks of benzodiazepines for our patients even during alcohol withdrawal? How can we give our patients the best chance to walk away from ETOH withdrawal and critical illness? Dr. Obiajulu Anozie, MD joins us in this episode to explore the benefits of phenobarbital for alcohol withdrawal. www.daytonicuconsulting.com--- Support this podcast: https://podcasters.spotify.com/pod/show/restoringlife/support
Medicine is a field of evolution. Are we open to learning, changing, and progressing?
Dr. Peter Murphy has worked in critical care for nearly 50 years. As a seasoned expert in the field, he shares with us his own wake-up call to the reality of decades-old sedation practices. He provokes the question: "Am I leading or fighting evolution?"
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Caleigh has had it both ways in the ICU. She has been sedated and immobilized which led to battling delirium and ICU acquired weakness. She has also been awake and mobile while intubated and walked out the doors. Listen to Caleigh share her insights and what meant to her to be communicative, connected, and autonomous during her fights for her life. Www.daytonicuconsulting.com --- Support this podcast: https://anchor.fm/restoringlife/support
Episode 121:
Having patients awake during mechanical ventilation can require a new skillset and approach to patient care. Let's talk about some of the tips and tricks for improving patient comfort and care. We'll hear it from an RN/podcast listener/ICU survivor and Louise Bezdjian, APRN from the original Awake and Walking ICU.
Citations and transcription: www.daytonicuconsulting.com
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What does being awake and mobile mean to current ECMO patient, Denise Bazalda? From her ICU room with a tracheostomy and connected to ECMO, @88deniseb, gives us incredible insight into how she is fighting for her life. Www.daytonicuconsulting.com --- Support this podcast: https://anchor.fm/restoringlife/support
Episode 119: How can delirium contribute to the trauma of a traumatic birthing experience? Midwife and ICU survivor, Amber, shares with us her personal journey through and after the ICU. Www.daytonicuconsulting.com --- Support this podcast: https://anchor.fm/restoringlife/support
During the worst of the COVID pandemic, how did this Baylor Scott and White The Heart Hospital- Plano CVICU decrease their COVID mortality rates by 30%? Jenelle Sheasby, MSN, RN, tells us about the transformation in their mobility practices. Www.Daytonicuconsulting.com--- Support this podcast: https://anchor.fm/restoringlife/support
The ICU community is buzzing with talk about the recent NEJM "TEAMS Study". What do the methods and findings of the study tell us? The author of the study, Dr. Carol Hodgson as well as Dr. Wes Ely and Heidi Engel, DPT join us to dissect and discuss this study.
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How does a personal fight for life in the ICU impact a survivor-intensivist’s approach to patient care? Dr. Rana Awdish, author of “In Shock”, shares intimate experiences in and after her ICU stay. Episode transcripts and citations at www.daytonicuconsulting.com--- Support this podcast: https://anchor.fm/restoringlife/support
We know that prolonged sedation and immobility are lethal. We also know that there are significant racial disparities in outcomes in the ICU. How does race impact sedation practices? What role does sedation management play in racial inequality in critical care medicine? Dr. Thomas Valley shares with us his invaluable research into sedation by race. Video viewing for this episode is now on Spotify!www.daytonicuconsulting.com --- Support this podcast: https://anchor.fm/restoringlife/support
We know that deep sedation and immobility are lethal. We also know that outcomes in the ICU vary between races. How does race impact sedation practices? What role does sedation management play in the racial disparities seen in the ICU? Dr. Tom Valley shares with us his invaluable research into sedation by race. www.daytonicuconsulting.com
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What was it like as a travel COVID ICU nurse to jump into an “Awake and Walking COVID ICU”? How does true mastery of the ABCDEF bundle impact RN workload, burnout, safety, and career fulfillment? Travel RN, Laurelai, shares with us her experiences and insights. Www.DaytonICUConsulting.com--- Support this podcast: https://anchor.fm/restoringlife/support
Introduction to an “Awake and Walking ICU” - An Episode in Spanish. Que experimentan a los pacientes durante sus comas inducidas? Porque y como debemos evitar a la sedation continua durante a la enfermedad crítica? Que es una “UCI Despierta y Caminante”? Este episodio cambiará a la perspectiva de nuestras prácticas en la UCI. Www.DaytonICUConsulting.con--- Support this podcast: https://anchor.fm/restoringlife/support
What does research reveal about how and why do unplanned extubations occur? How dangerous are unplanned extubations? Does sedation really keep patients safer from unplanned extubations? We dive into it deep in this episode. Transcriptions and citations found at www.DaytonICUConsulting.com
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What is like to be an ICU delirium survivor and intensivist? How did Dr. Wischmeyer’s own nutrition research transform his outcomes during his most critical ICU stay? He shares his journey with us in this episode. Www.DaytonICUConsulting.com
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The trauma ICU has unique risks to agitation, delirium, and long-term impairments. How does occupational therapy help the trauma ICU team avoid sedation, maximize mobility, and radically transform patient outcomes? Phillip Gonzalez, OTR, MOT, shares with us his expertise and success as an occupational therapist in the trauma ICU and traumatic brain injuries. www.daytonicuconsulting.com
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Traumatic brain injuries can have distinct exceptions that necessitate deep sedation and immobility. How then can we apply the ABCDEF bundle to protect injured brains and restore lives? Charlotte Davis, BSN, RN, CCRN and Richard Rivera, BSN, RN-BC share their expertise and their team's incredible success with the ABCDEF bundle in the settings of TBI.
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The trauma ICU has a variety of high-acuity and difficult conditions that can cause obstacles and hesitation to change sedation and mobility practices. How does the ABCDEF bundle apply to the trauma ICU? Dr. Gregory Schaefer joins us now to discuss his expertise and team’s success in practicing the ABCDEF bundle in the trauma ICU.
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Critically ill cardiovascular patients can be very high-risk and high-acuity patients with numerous devices and multiorgan failure. How and when can we safely initiate early mobility? What role should physical and occupational therapy play in the CVICU? Jenna Hightower, PT, DPT, CCS shares her incredible expertise and ground-breaking work in early mobility in the CVICU.
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As ECMO programs have grown in demand and popularity during COVID19, what have we learned about the safety, feasibility, and benefit of early mobility? Why is there such a significant disparity in mobility practices between ECMO teams? Dr. Julian Macedo shares with us his expertise and insights into early mobilization during ECMO.
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Episode 105: The ABCDEF Bundle in the CVICU
How does the ABCDEF bundle apply to the CVICU with a variety of diagnoses, acuities, and devices? Anna Dalton, DNP, ACANP, in an "Awake and Walking CVICU" shares with us the evolution their team has experienced in improving their mastery of the ABCDEF bundle.
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Episode 104: ICU Rehabilitation
When ICU-acquired weakness is not preventable, or we encounter a patient that has not received the ABCDEF bundle, how can we start the rehabilitation process? What approach can one lone clinician use for initiating recovery or preventing ICU-acquired weakness? Physiotherapist, Lucy Sutton, shares with us incredible insight into ICU rehabilitation.
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What impact does it have on patients to be lost in solitude while in medically-induced comas?
How does the inability to communicate impact patients' agitation, anxiety, and trauma?
How can providing communication tools ease the stress and burden of critical illness on clinicians, patients and families?
When patients are unable to verbalize, what tools are available to facilitate communication?
This episode explores the value of communication in the ICU and the impact of our sedation and immobility practices on the basic human right of communication.
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102: Waking Up in the ED
When post-intubation wait times increased during the COVID19 crisis, Julie, an ED nurse, took "saving lives in the ED" to a whole new level. She shares with us what communication and patient autonomy mean to her and how she is applying that to how she cares for patients in the ED. One nurse can make a ripple effect throughout an entire hospital system.
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What does the ABCDEF bundle look like in neurocritical care? When patients suffer conditions such as intracranial hypertension that necessitate sedation and immobility, how does the ABCDEF bundle apply? Neurointensivist, Dr. Neha Dangayach, shares with us her team's strong ABCDEF culture and practices in the neuro ICU. @Drdangayach
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After 100 episodes of compelling stories, research, and testimonials, we know what can and should be for intensive care medicine. What is the next step? How do we lead our ICU teams into the future and standardize "Awake and Walking ICUs"? What resources are available to educate and support our teams in this transition? www.DaytonICUConsulting.com
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Episode 99: When physical therapists are allowed to work at the top of their licenses, how do they save lives? What barriers prevent them from fully contributing their expertise during critical illness? How is mobility a life-saving intervention? ICU Physical Therapist experts, Kenny Venere, PT, DPT, and Kyle Ridgeway, PT, DPT, CCS share with us their experiences and insights.
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Occupational Therapists Change Outcomes in the ICU
How can occupational therapists help decrease time on the ventilator and time in the hospital? How can they preserve function and quality of life? What skills do they bring to preventing and treating delirium? Why should they be promptly utilized in a patient's journey? Corinne, Mallory, and Rachel share give us insight into the value occupational therapists bring into the ICU.
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How does ventilator-associated pneumonia occur?
How does the failure to practice the ABCDEF bundle increase the risks of prolonged time on the ventilator and mortality?
What do we know about the impact of early mobility on VAPs?
Let's dive deep into what we know about VAPs and how to drive down the rates in our ICUs.
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Ventilator-Associated Pneumonia has significant lethal and financial repercussions for patients and our healthcare system. So why aren’t we panicking about it? Are hospitals really liable for the costs incurred from this ventilator-associated condition? Dr. Benjamin Wang, MD joins us to share the backstory behind VAPs in our US healthcare system and government.
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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.
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Why are prolonged sedation and immobility lethal? How do our standard practices of automatically sedating every patient on a ventilator deprive them of the chance to survive and thrive? What systemic barriers stop us from implementing evidence-based practices that save lives and drastically change outcomes? Michelle, DNP, ACNP dives deep into powerful case studies that explore the "ICU deathtrap".
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Why is the mortality rate for COVID ICU patients in the Awake and Walking ICU less than half of the other COVID ICUs in the same hospital system in the same community? How have sedation and mobility practices impacted rates of central lines, vasopressor use, paralysis, tracheostomies, and LTACH admissions? How has this ICU continued to keep COVID patients awake and mobile during this pandemic? Dr. Joel Pittman shares with us valuable updates from the Awake and Walking ICU.
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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 us all in this episode.
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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.
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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?
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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 to improve patient outcomes.
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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.
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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!
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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.
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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.
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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
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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 have chosen? Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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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
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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 for us. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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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
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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 citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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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? Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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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
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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 will it take to protect our children? Dr. Kudchadkar shares her life-preserving research and practices. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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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. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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Why do tracheostomy rates fluctuate so drastically between ICUs? What is the true reason for so many tracheostomies? What are the long-term effects of tracheostomies? Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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Jeroen Molinger, MSc brings the research to the bedside. He ties together the importance of muscle maintenance, nutrition, and how to create survivors not victims. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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What role does nutrition play in improving outcomes in the ICU? How can we help preserve muscle through appropriate nutrition during critical illness? Jeroen Molinger, MSc continues to upgrade our approach to critical care through exercise physiology. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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Why is ICU-acquired weakness an independent predictor of mortality? What role does muscular atrophy play in multi-organ failure? When we unnecessarily sacrifice muscles for other organs, how badly do we damage patients’ chances to survive and thrive? Jereon Molinger, MSc, brings eye-opening information to the discussion. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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We say we respect patient autonomy. We provide patients or families informed consent prior to intubation. Should patients and families be warned of the risks and repercussions of sedation and immobility? When sedation is nonessential, should patients be given the choice to be comatose or awake and moving? Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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What barriers do we have in our ICU culture that prevent us from appropriately addressing delirium? What can we do to foster a better approach to helping delirious patients that are difficult to care for? Dr. Swamy gets real as we discuss the reality of delirium from our side of the bed. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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For decades we have sedated patients with the belief that it is more humane to “sleep” through critical illness. Survivors have told us their experiences were not “sleep” to them. What do neurologists and researchers say about the quantity and quality of sleep during medically-induced comas? Dr. Williams Roberson shares with us her research and invaluable insights into sedation and sleep. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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How can 1 nurse make bring the change? What can happen when a team catches the vision? How can a team transition their culture from deep sedation and immobility to awake and walking? Nora tells us about igniting her team's fire and the changes they are celebrating. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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Louise, ACNP, has dedicated her career to preserving lives in the Awake and Walking ICU. So what was it like for her to have her own loved one die from sedation and immobility? She tells it like it is and gives us a sobering insight into both sides of the bedside during COVID19. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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When all you’ve ever known is walking patients on ventilators, what is it like to enter a time machine and go back to sedation and immobility? What did Tara learn taking care of COVID19 patients outside of her “Awake and Walking ICU”? She shares with us her reaffirmed empowerment to change patients’ outcomes through evidence-based practice.
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What does it mean to you to be able to toilet yourself? What happens to patient dignity when they are deprived of the capacity to “mind their own business”? Rachel shares with us what is happening to patients even when they are not on mechanical ventilation. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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Where in the world do patients walk on ventilators and ECMO? Providers from 22 countries share with us their experiences with helping patients walk home from the ICU. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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After decades of research revealing the price patients pay from benzodiazepines, where are we now in the ICU? Dr. Wes Ely and Brenda Pun share with us the latest COVIDD study and how COVID19 patients are being cared for around the world. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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How do we bring changes to the ICU? What barriers impede the progress of our culture? Heidi Engel, PT, DPT, shares with us her continuous journey to humanizing her ICU. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
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What truly happens during delirium? When do the hallucinations and terror stop? Survivors give us a sobering reality check of what caused the deep psychological trauma during their ICU stays and how their lives are forever impacted.
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What does research reveal about the most common contributing factors of post-ICU PTSD? Does sedation prevent or inflict trauma? Dr. Jackson shares with us his decades of research and experience with post-ICU PTSD.
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What causes Post-ICU PTSD? What is it like to live with this trauma? How does it impact life after the ICU? Spencer Freeman shares with us intimate insight into living with Post-ICU PTSD.
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How do Hospital Acquired Pressure Injuries (HAPI) impact patient outcomes and quality of life? How can they be better prevented? Cami, our wound care specialist, shares with us penetrating insight into the reality of rotting in the ICU.
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What do you want to know about the Awake and Walking ICU? Join the facebook group, "Walking Home From the ICU Discussion Group".
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What does an awake and walking ICU patient look like walking back into the pulmonology clinic? Dr. Shilling shares what this process has meant for his practice in the clinic.
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What was it like for a seasoned ICU nurse with decades of valuable experience to completely change their sedation practices? What was it like to then re-enter a “normal” environment and strive to continue the best practice? Paula shares with us her personal shock and conversion.
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What roles do physical and occupational play in helping COVID19 patients survive and thrive? How have they changed their approaches during the challenges of COVID19? Why should we never remove their therapies from ICU care?
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When 69-year-old Dr. Ken Hurwitz was intubated for COVID19, how was his life saved and even preserved? After 3 weeks on the ventilator, why was he able to walk away and go straight home?
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Now that we know what happens to patients after sedation and immobility, do we know what it is really like? Do we understand what happens to patient dignity, autonomy, and identity when they lose control of their bodies? Eileen Rubin shares with us what it was like as a 33-year-old trial attorney to wake up and not be able to lift a finger.
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When good nursing care is not possible during a pandemic, what happens to patient outcomes? Makenzie tells her tales as an ICU nurse in NY as we explore the role nursing care plays in saving and restoring lives. www.DaytonICUConsulting.com @DaytonICUConsulting
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www.DaytonICUConsulting.com @DaytonICUConsulting
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What happens to our culture and practice when patient volumes and needs exceed our ICU capacity? How does this impact short and long-term outcomes? Dr. Dixie Harris shares with us the reality of ICU care in NY during the COVID19 pandemic.
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What was it like in the early phases of the “Awake and Walking ICU?” How was the new practice introduced? How was the culture revolutionized in spite of opposition? Who rejected the change? How did nurse Patty go from incredulous to emphatic? www.DaytonICUConsulting.com @DaytonICUConsulting
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What is it like to be “born” into an awake and walking ICU and then be immersed in a different culture? Jim shares with us his culture shock and ethical turmoil as he strives to maintain his best practice in a new environment. www.DaytonICUConsulting.com @DaytonICUConsulting
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What is it like to jump into an awake and walking ICU as a travel nurse? Alex shares with us her first shock and impressions upon entering a different culture. She teaches us the changes and wisdom her practice has gained.
www.DaytonICUConsulting.com @DaytonICUConsulting
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How much of our practice is driven by culture vs. evidence? What role does ICU culture play in our perspective, knowledge, and patient outcomes? How often do we dare to ask “Why?”, “What if?” or, “Why not?” www.DaytonICUConsulting.com @DaytonICUConsulting
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What if we expected to be able to communicate with all patients on mechanical ventilation? How would that impact our practices? What role does communication play in patient survival and outcomes? www.DaytonICUConsulting.com @DaytonICUConsulting
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What happens after patients are sedated and immobilized for weeks? What will the rehabilitation process for COVID19 survivors be like? How long will it take for them to be able to sit, stand, and walk again? Christiane Perme, the post-ICU rehabilitation specialist, shares with us how to prevent such outcomes and help patients thrive in their lives again.
www.DaytonICUConsulting.com @DaytonICUConsulting
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Ann Bannon was intubated four times and awake on the endotracheal tube and ventilator for months. She gives us valuable insight into how to help the new flood of ventilated patients. www.DaytonICUConsulting.com @DaytonICUConsulting
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What can we do to improve mortality in the midst of a pandemic? As times have changed, our practices must change as well. www.DaytonICUConsulting.com @DaytonICUConsulting
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In commemoration of Delirium Day, it is most appropriate to hear from one of the leading delirium experts, Dr. Sharon Inouye! She shares with us her professional and personal experiences with delirium in all aspects of hospitalization.
www.DaytonICUConsulting.com @DaytonICUConsulting
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Nancy tells us about her transition to the awake and walking ICU as a nurse manager. She explains the nurse manager’s role in preserving a culture of humanity in the ICU. She shares with us how sedation cessation saved her own mother’s life.
www.DaytonICUConsulting.com @DaytonICUConsulting
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Lydia, CCC-SLP, shares with us the vital role speech therapy plays in helping patients get back to their lives. She explains how awake and walking enables patients to resume eating sooner and preserves cognition. The utilization of speech therapy is explained and applied in ways that the ICU world has never understood before.
www.DaytonICUConsulting.com @DaytonICUConsulting
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How does occupational therapy get to be utilized when patients are awake and walking on the ventilator? What role does occupational therapy play in preserving physical and cognitive function during critical illness? How has this enhanced role impacted the fulfillment Merrill, MOT, finds in his career?
www.DaytonICUConsulting.com @DaytonICUConsulting
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Kathryn, BCCCP, tell us of her culture shock coming to the awake and walking ICU after years in units around the country. She tells about the role pharmacists play in delirium prevention and preservation of function in the ICU. She shares how this shift in focus has enhanced her job satisfaction.
www.DaytonICUConsulting.com @DaytonICUConsulting
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Dr. Badke, MD, shares what it was like to shift perspective and culture as a new intensivist in the awake and walking ICU. He explains what role the physician plays in helping patients walking home after the ICU.
www.DaytonICUConsulting.com @DaytonICUConsulting
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What does it mean to be the steward of patient outcomes? Louise, ACNP, explains how nurse practitioners are guardians of delirium prevention and preservation of function for her patients in the ICU.
www.DaytonICUConsulting.com @DaytonICUConsulting
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Respiratory therapists are key to helping patients walk on the ventilator. Cash, RRT, shares his tips and secrets to walking and even showering patients on the ventilator. He reveals how having patients awake and walking has impacted his ICU career. www.DaytonICUConsulting.com @DaytonICUConsulting
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What is it like for physical therapists that get to do more than a passive range of motion with patients on ventilators? Physical therapists in the awake and walking ICU save lives and enable patients to have their lives back after discharge. Angela Hallstrom, DPT tells us how they do it. www.DaytonICUConsulting.com @DaytonICUConsulting
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What is it like as an RN to care for intubated patients on the ventilator that are AWAKE and WALKING? Brandy, RN shares with us why she is passionate about keeping brains and bodies strong during critical illness. She reveals how humanizing the ICU has impacted her career. www.DaytonICUConsulting.com @DaytonICUConsulting
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Patients cannot walk out of the ICU without the efforts and expertise of each discipline. What role does each discipline play in returning patients to their lives? www.DaytonICUConsulting.com @DaytonICUConsulting
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How did this ICU get so off the grid? Decades before the research and in a generation of paralytics and benzodiazepines, a nurse saw a problem and had a vision. Polly Bailey, ACNP, shares with us her journey to building an awake and walking ICU. www.DaytonICUConsulting.com @DaytonICUConsulting
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Though avoiding sedation and mobility decreases mortality, death is not always avoidable. How does being awake and mobile during critical illness impact your last mortal moments? What does it look like to have a chance to say goodbye? www.DaytonICUConsulting.com @DaytonICUConsulting
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Tyler Lintz was admitted for severe septic shock, pneumonia, and ARDS. He eventually needed ECMO but was still allowed to keep walking. Tyler and Amber tell us how he returned to being a firefighter 3 months after ECMO. www.DaytonICUConsulting.com @DaytonICUConsulting
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Tyler Lintz was admitted for severe septic shock, pneumonia, and ARDS. He eventually needed ECMO but was still allowed to keep walking. Tyler and Amber tell us how he returned to being a firefighter 3 months after ECMO. www.DaytonICUConsulting.com @DaytonICUConsulting
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Joan Johnston was admitted for ARDS and remained on the ventilator for 17 days. She shares with us what it was like to be awake, walking, and even showering while intubated. www.DaytonICUConsulting.com @DaytonICUConsulting
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James was admitted for severe mycoplasma pneumonia that turned into mild ARDS. His downs syndrome and autism inspired the ICU team to get creative to keep him awake and walking on the ventilator. His journey straight home moves us to reconsider our standard practices. www.DaytonICUConsulting.com @DaytonICUConsulting
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Bryan Carter was admitted for severe pneumonia that became severe ARDS. He was allowed to be awake and walk on the ventilator until he was proned. When he was able to be supine he was right back on his feet. He shares with us his story and how his treatment impacted his outcomes. www.DaytonICUConsulting.com @DaytonICUConsulting
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If we treated patients differently, would their outcomes be different? What if patients never stopped walking during critical illness? One ICU dared to ask. www.DaytonICUConsulting.com @DaytonICUConsulting
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Caregivers also leave ICU with high rates of PTSD and long-term life impacts. Mike Maranhas shares his side of his wife's ICU stay and recovery. www.DaytonICUConsulting.com @DaytonICUConsulting
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Caregivers also leave ICU with high rates of PTSD and long-term life impacts. Mike Maranhas shares his side of his wife's ICU stay and recovery. www.DaytonICUConsulting.com @DaytonICUConsulting
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When we send patients to LTAC or SNF to relearn how to walk, what is that like? Susi Rimkus, DNP, shares with us her experience with rehabilitating rehabilitation. www.DaytonICUConsulting.com @DaytonICUConsulting
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What is it like to wake up with less physical capacity than a newborn? What is it like to be sent to LTAC with no expectations of returning home? When patients have not moved for weeks+, what is the journey to recovery like? How long does it take? What are the psychological effects on survivors and loved ones? Jim and Cheryl Rettinger give us an inside look. www.DaytonICUConsulting.com @DaytonICUConsulting
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What happens down the road to patients that are on bedrest during their time on the ventilator? Is there another way? Let's put it into the big picture. www.DaytonICUConsulting.com @DaytonICUConsulting
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ICU Survivor, David Burrows, shares his experience of weeks of sedation and the delirium and ICU-acquired weakness that followed. He gives us insight into the reality of his new life with the post-ICU syndrome. www.DaytonICUConsulting.com @DaytonICUConsulting
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ICU Survivor, David Burrows, shares his experience of weeks of sedation and the delirium and ICU-acquired weakness that followed. He gives us insight into the reality of his new life with the post-ICU syndrome. www.DaytonICUConsulting.com @DaytonICUConsulting
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Survivors tell us what "cognitive deficits" really look like and the impact they have on their function and lives. www.DaytonICUConsulting.com @DaytonICUConsulting
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Dr. Wes Ely, the creator of the CAM scoring tool and the ACDEF Bundle, shares with us the realities and consequences of ICU delirium. www.DaytonICUConsulting.com @DaytonICUConsulting
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68% of nurses believe sedation is for patient comfort. Survivors of prolonged tell us the reality of how "sweet" their sedation dreams really were. www.DaytonICUConsulting.com @DaytonICUConsulting
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Susan East is a three times survivor of ARDS. She tells us why she sought legal protection against sedation after her first experience with ARDS. www.DaytonICUConsulting.com @DaytonICUConsulting
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Is sedation always a necessity or a habit with history? Dr. Terry Clemmer, one of the founders of critical care, shares the evolution of mechanical ventilation and sedation culture he witnessed during his 50 years of critical care medicine. www.DaytonICUConsulting.com @DaytonICUConsulting
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Kali shares the variation in sedation and mobility practices she witnesses in critical care throughout the USA. ICU survivors changed her perspective and belief in what is right and best for patients. www.DaytonICUConsulting.com @DaytonICUConsulting
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