November 14, 2018 – Avoiding ICU Delirium

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Anchor lead: Can delirium be avoided when someone has an ICU stay? Elizabeth Tracey reports

Can a bundle of strategies known as A to F help people in the ICU avoid developing delirium as well as other treatment related problems, as reported recently? Yes, says Dale Needham, an early mobilization pioneer in critical care medicine at Johns Hopkins.

Needham: What this talks to use about is the need to think carefully about patient’s pain, and often when we think about pain management we don’t actually need to give our patients sedation. Sedation is associated with delirium and if we can manage pain without adding sedating medications then our patients may have less delirium. And then the E part in the A to F bundle is early mobilization, early exercise, early rehabilitation.  :29

Needham says adequate pain relief can often be achieved with things like cold or heat, use of non-opioid pain relievers and other methods, allowing people to avoid using opioids, which are much more likely to produce delirium. He notes that physical activity is possible, even when someone is on a ventilator. At Johns Hopkins, I’m Elizabeth Tracey.