JUDY WOODRUFF: More than six million Americans are admitted into hospital intensive care units, or ICUs, each year. Undoubtedly, they are a crucial component of the health care system for treating seriously ill patients and preventing deaths.But some patients also eventually leave the ICU with new complications and problems.Special correspondent Jackie Judd looks at those concerns and an effort to make sure patients are getting the right interventions.
The Science, Why, and What of ICU Liberation and the ABCDEF Bundle for Patients and FamiliesDr. Wes Ely Hawaii SCCM 2017 PlenaryHAWAII PLENARY on ICU LIBERATION ABCDEF and PICS before over 2,000 people January 2017: Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called post-intensive care syndrome (PICS). PICS patients are suffering from impairments in these domains of life: cognitive (impaired executive functioning), emotional (depression, anxiety, post-traumatic stress disorder), and physical (weakness, myopathy, and neuropathy). They cannot resume their previous life including ADLs and IADLs. The ICU Liberation Collaborative was a real-world quality improvement initiative implemented across 76 ICUs designed to engage strategically the ABCDEF bundle from 2015-17 ( A – Assess, Prevent and Manage Pain, B – Both spontaneous awakening trials and spontaneous breathing trials, C – Choice of Sedation, D – Delirium: Assess, Prevent and Manage, E – Early Mobility and Exercise, and F – Family Engagement and Empowerment) through team and evidence-based care.
I ALLOW NOW DISCOURAGERS IN MY LIFE.
I ONLY ALLOW ENCOURAGERS.
And not that foolish inane encouragement either.
Well, I went to the new Doc. He is a man maybe in his 50s and I was impressed. Early days of course but I was able to talk to him and I knew that he understood the things I have been thinking. Maybe age is important for some of these complex illnesses. He has sent away for all my records .
He understands that I do not wish to take Harvoni without more certainty of a good outcome than I have at this time.
He also thinks that the pain in my right side could be postural. I surely have moved strangely ever since the Coma.
The biggest thing I came out of that visit with was a feeling of being respected and validated. I also did not come away afraid despite the seriousness of the illnesses that I have. The path in front of me needs assistance from People who do not make me feel afraid.
The Receptionist turned out to be the partner of a muso and she invited me to a performance of REQUIEM in Urunga in a couple of weeks. Amanda was also there and Jo – all Musos. It turned into a very happy visit and opened a door onto some hopes I had lost.
My Girl joined the Guides today and loved it.
I have paid the rent despite my worries about this. Tomorrow I shall pay Internet despite the same concerns.
I also booked a haircut for Saturday. I simply must get some pleasure back and some optimism.
When Lygia Dunsworth was sedated, intubated and strapped down in the intensive care unit at a Fort Worth hospital, she was racked by paranoid hallucinations:Outside her window, she saw helicopters evacuating patients from an impending tornado, leaving her behind. Nurses plotted to toss her into rough lake waters. She hallucinated an escape from the I.C.U. — she ducked into a food freezer, only to find herself surrounded by body parts.Mrs. Dunsworth, who had been gravely ill from abdominal infections and surgeries, eventually recovered physically. But for several years, her stay in intensive care tormented her. She had short-term memory loss and difficulty sleeping. She would not go into the ocean or a lake. She was terrified to fly or even travel alone.Nor would she talk about it. “Either people think you’re crazy or you scare them,” said Mrs. Dunsworth, 54, a registered nurse in the Dallas-Fort Worth area. In fact, she was having symptoms associated with post-traumatic stress disorder.