November 15, 2018 – Getting Out of the ICU

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Anchor lead: Using several strategies helps people reduce the likelihood they will develop delirium while in the ICU, Elizabeth Tracey reports

Pain must be managed in those who are critically ill, a bundle of strategies called A-F for patient care in the ICU acknowledges. Dale Needham, a critical care expert and pioneer in early mobilization of patients at Johns Hopkins, says when a constellation of methods is employed, pain can be held at bay without sedation.

Needham: Where now we’ve got a patient that’s not in pain, that’s not sedated, is not delirious, and we can begin to have them engage in meaningful activity. And I always say the head bone is connected to the body bone.  When we manage sedation and delirium and have more clear thinking for our patients, then they’re able to engage in rehabilitation much more easily. There are also randomized controlled trials showing us that when patients get physical rehabilitation their duration of delirium decreases.  :32

Needham says avoidance of long term compromise because of an ICU stay is the desired outcome. At Johns Hopkins, I’m Elizabeth Tracey.