Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support

Among ICU patients receiving acute ventilatory support for respiratory failure, patient-directed music (PDM) resulted in greater reduction in anxiety compared with usual care, but not compared with NCH. Concurrently, PDM... read more

Finding Out What Matters to Our Patients

Do you spend time finding out what the "why" is for your patient? Have you considered it’s not what is the matter with the patient but what matters to the patient? What the patient thinks their purpose is? Or at the very... read more

SOS Asynchronies: Do We Need Help?

Synchrony between the patient and the ventilator is defined as the appropriate interaction between the two, where the ventilator recognizes patient’s effort and provides support for breathing at the right time—that is,... read more

How You Can Protect Your Parent From Delirium

Unlike dementia, which is constant and gets progressively worse, delirium tends to come and go, fluctuating even in the course of a day. The symptoms are transitory, yet for people who develop delirium, it can be the start... read more

Controversial US Ketamine Trial Sparks Ethics Complaint

Advocacy group alleges that emergency medical workers in Minnesota gave patients ketamine injections without consent, despite known risks. A consumer-advocacy group is filing a complaint with the US government about two clinical... read more

Thai cave rescue: The drug that allowed boys to survive rescue mission

Thai schoolboys were rescued from the cave using dissociative ketamine plus positive-pressure facemask ventilation (to prevent water from leaking into their masks), so they basically used delayed sequence intubation strategy.... read more

Methodologic Innovation in Creating Clinical Practice Guidelines

Our multifaceted, interdisciplinary approach and novel methodologic strategies can help inform the development of future critical care clinical practice guidelines. Critical illness survivors contributed to prioritizing topics,... read more

Patient Remains Awake for 90 Minutes of CPR

A man undergoing CPR, exhibited signs of conscious awareness for 90 minutes before the medical team stopped the life-sustaining procedure, according to a new case report. The 69-year-old man was admitted to a hospital in... read more

Getting Creative with Ketamine

Versatile and safe, Ketamine can help with sedation, induction, asthma and pain. Can a shot of it even treat suicidality? New indications for Ketamine seem to be popping up every day. Its primary ED use is for procedural... read more

Limiting Sedation for Patients with ARDS

Current evidence supports the use of protocol-based, light-sedation strategies in critically ill patients with ARDS. Further research into sedation management specifically in ARDS populations is needed. Deep sedation strategies... read more

The A1 Sedation Package: Better Care for Intubated Patients

You are called to the scene of a 56-year-old male found unresponsive in his garage workshop. Upon examining him you find him minimally responsive to painful stimulus, moaning and groaning. His family tells you he has high... read more

Early Mobilization of Patients in ICU

Currently there is a divide between ICU clinicians who wish to implement early mobilization based on current evidence and clinicians who believe that early mobilization is an intervention that should be tested in a large... read more

Updated Version of the Confusion Assessment Method for the ICU

The 2014 updated version of the CAM-ICU is valid according to DSM-5 criteria and reliable regarding inter-observer agreement in a research setting. Delirium remains under-recognized by bedside clinicians. Delirium was diagnosed... read more

Simplifying Mechanical Ventilation

Mechanical Ventilation is a modality commonly used in the critically ill, but many providers, may not have a strong understanding of the basics. Emergency Medicine and Critical Care Physicians need to have a firm grasp of... read more

Comparison of Self-Reported and Behavioral Pain Assessment Tools in Critically Ill Patients

Self-reported and behavioral pain assessment scales are often used interchangeably in critically ill patients due to fluctuations in mental status. The correlation between scales is not well elucidated. The purpose of this... read more

Pressure Injuries and Sedation: Are they related?

Critically ill patients inherently have most of the risk factors for the development of pressure injuries. One of the key factors is immobility, which is very frequent in ICUs. This lack of mobility is enhanced by the administration... read more

Persistence of Delirium after Cessation of Sedatives and Analgesics and Impact on Clinical Outcomes in Critically Ill Patients

As delirium is a common manifestation in critically ill patients and is associated with worse clinical outcomes, we sought to characterize the reversibility of delirium after discontinuation of sedation and to determine whether... read more

Music as Therapy in the ICU

Music has been shown to reduce respiratory, cardiac and blood pressure frequencies in response to the reduction of stress hormones. In a randomized clinical trial, it was shown to reduce anxiety and sedation doses/intervals... read more

Early Mobility in Critically Ill Patients

Kyle Enfield, MD, speaks with Wes Ely, MD, MPH, about his talk presented at the Multiprofessional Critical Care Review: Adult course in Rosemont, Illinois entitled, "Early Mobility in Critically Ill Patients: More to Come."... read more

Recovery After Critical Illness: Putting the Puzzle Together

In this review, we seek to highlight how critical illness and critical care affect longer-term outcomes, to underline the contribution of ICU delirium to cognitive dysfunction several months after ICU discharge, to give new... read more

General Anesthesia a Viable Sedation Strategy for Thrombectomy in Stroke

An analysis of a New York registry with 1174 patients who underwent thrombectomy showed a correlation between general anesthesia and death. Several other studies that only compared embolectomies done with and without general... read more

The Overlooked Danger of Delirium in Hospitals

The condition, once known as "ICU psychosis," disproportionately affects seniors and those who have been heavily sedated—and the delusions can last long after they're discharged. Patients treated in intensive-care units... read more