Transformative ICU Consultant | Leading Expert in Awake and Walking ICU Models | Acute Care Nurse Practitioner
If Megan was in your ICU on a PEEP 16 and fi02 90%, would she be awake, mobile, communicative, and autonomous? Would your team be fighting to protect her brain and body from long-term damage while treating sick lungs? Listen to Megan share her experience with the full ABCDEF Bundle in an Awake and Walking ICU in episode 71 of the podcast, “Walking Home From the ICU”. Link in comments.
Sheldon Wulff
4mo
This is incredible. I have led similar scenarios on our unit (APRV, FiO2 90%, ETT) and it is so rewarding to the individual, their family/support network, and the clinicians involved. I do have a couple of general questions (echoed by a few others in this thread)… 1) Trache versus ETT. Why was this patient not tracheostomised? I note a lot of the mobility posts I see on your accounts show patients with ETTs. I can understand this within the first 7 days, but beyond that are the patients receiving a trache? 2) I note from this episode the patients (understandable) frustration with communication, even when desedated. Do you utilise in-line OWV to assist with this? Appreciating PEEP 16 may be a bit high and I’m not privy to her ability to protect airway to facilitate this safely.
Valerie Aston
4mo
Intermountain Health Care has championed low sedation and early mobilization for 25 years. Dr. Terry Clemmer and NP Polly Bailey have published our work in numerous journals. We started in one ICU at LDS Hospital and moved forward from there. It takes a team but I have walked a ventilated patient with 1 RN and 1 Physical Therapist in my career as a Respiratory Therapist.
We would not have enough staff to do this . It appears at least five employees were helping this patient walk. Would be curious to know if this unit is always this well staffed or if this was a special project ?
Fabio Velloso
4mo
Patología de base? siempre estuvo con intubacion orotraqueal?
This is so powerful. I keep asking myself “how do they do this?” What would have to change for your unit to be able to ambulate ventilated patients?
William Wiseman
4mo
Not every Unit is able but all are capable! Empowerment and incentivization from Hospital leadership would go a long way. Who gets reimbursed for the better outcomes? Healthcare staff utilizing novel ideas and research to execute on the units? Doubtful. It’s amazing to see these teams execute despite all that! These are REAL leaders! Unfortunately operating within a miserable system/environemtn.
Excellent post, we should all be striving for this in our ICU’s. So much harm from immobility but also so much push back at all levels to starting early mobility programs
Massive kudos for this work! I hope we see more embracing of this type of care!
Transformative ICU Consultant | Leading Expert in Awake and Walking ICU Models | Acute Care Nurse Practitioner
4mohttps://daytonicuconsulting.com/walking-home-from-the-icu-podcast/walking-home-from-the-icu-episode-71-what-fight-to-survive-truly-means/