Walking Home From The ICU (Kali )

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

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

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 @DaytonICUConsulting

www.DaytonICUConsulting.com @DaytonICUConsulting

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. 

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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

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 

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

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

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

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

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

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

The ICU is an overwhelming and daunting environment to start a new career. While learning so many new skills from experienced mentors, how did Michael Glade, RN, BSN also see past “what is done” to “what should be done” in his ICU?

Michael shares with us what led him to help lead the revolution in his ICU.

Www.DaytonICUConsulting.com

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? 

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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

What is the ethical and moral responsibility of a medical director to personally practice, lead, and support their ICU to keep patients as awake and mobile as possible? Dr. Parimal Bharucha shares with us the incredible revolution that has happened in his ICU.

Www.DaytonICUConsulting.com

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

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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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

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, FL*** https://www.earlymobility.com/2024conference

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

How does the Awake and Walking ICU approach apply to the trauma ICU?

How did education, training, leadership support, and deep compassion empower these experience trauma nurses to transform their ICU culture and practices?

What successes have they had and how has keeping patients awake and mobile impacted their career fulfillment and team dynamics?

Jessica Williams, BSN, RN, Adrienne Craig, BSN, RN, and Amber Brandt, BSN, RN share their team’s journey in this episode!

Want to revolutionize your ICU? Check out www.daytonicuconsulting.com.

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. 

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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

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

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

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

What do you want to know about the Awake and Walking ICU? Join the facebook group, "Walking Home From the ICU Discussion Group". 

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

Survivors tell us what "cognitive deficits" really look like and the impact they have on their function and lives. www.DaytonICUConsulting.com @DaytonICUConsulting

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. 

www.daytonicuconsulting.com 

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

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.

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, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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.

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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.

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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. 

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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

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

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

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

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. 

www.daytonICUConsulting.com 

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.

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

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

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

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

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

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

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 

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

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, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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

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.

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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

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

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

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

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. 

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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.

www.daytonicuconsulting.com

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

What happens when a visionary physician in a low-resource hospital in Bangledash leads his team to practice the ABCDEF bundle?

How did this passionate team of ICU clinicians transform their care from automatic sedation and immobility to standardized mobility three times a day?

How did they come to treat mobility as important and optional as an antibiotic?

Dr. Mohammad Jhahidul Alam shares their story in this episode!

Standardized sedation and immobility are rooted in a gap in education. What is the power of a nurse educator in transforming knowledge, culture, and practice in the ICU?

Jeana Flakes, MSN, RN shares how she helped lead the ICU Revolution as a nurse educator at Mercy San Juan Medical Center.

Www.DaytonICUConsulting.com

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

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. 

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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

What role do respiratory therapists play in creating Awake and Walking ICUs? How did Candace Wistrich, RRT, BSRT and Nelya Kapitula, RRT, BSRT lead their respiratory therapy department to move the revolution forward? They join us now to share their team’s journey!

Vote for “Awake and Walking ICUs” as “best nurse innovation” and Kali Dayton as “best nurse leader” before 12/31 here!

Www.nurse.org/nominate

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

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

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

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

Ilija Klipa MS, ACSM-CEP,ACSM-EP,ACSM EIM III, AACVPR-CCRP is a cardiac/pulmonary physiologist a high-acuity cardiac ICU. He shares his journey in pioneering physiology in the ICU as well as leading the revolution to create an Awake and Walking ICU.

Check out Ilija's upcoming 30-credit ECMO mobility courses here:

https://cme.ahn.org/content/extracorporeal-membrane-oxygenation-ecmo-education-and-simulation-0#group-tabs-node-course-default1

www.DaytonICUConsulting.com

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

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

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.DaytonICUConsulting.com @DaytonICUConsulting

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

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

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

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

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.

www.daytonicuconsulting.com

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

What happens when a medical director really sees the reality of “normal practices” and becomes a revolutionist? Dr. Bistrong shares his personal conversion and the key role he has playing in his team’s transformation.

Www.DaytonICUConsulting.com

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

What is the role of the critical care director in leading ICU teams to become Awake and Walking ICUs? How can directors use the evidence to win executive leadership support for their teams to have what they need to succeed?

Ginger Manss, DNP shares with us her key role as senior director of critical care in the revolution at MSJMC.

Check out their ICU Liberation video at: https://www.youtube.com/watch?v=LFJPlZazah8

Www.DaytonICUConsulting.com

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_Fslap7KYHuw63o

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

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.

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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

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

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

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.

Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting

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

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