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Mobility has a real impact on Delirium

Imagine not knowing where you are or who is poking and prodding at you! Imagine having no control over who does what to your body or when! Or hallucinating and not knowing what is real and what is not! Patients describe awful experiences related to Delirium. Effects can be long-lasting and impact ability to live independently, and many patients suffer from PTSD for many years after they have experienced Delirium. We cannot ignore the life-altering impact that Delirium has on our patients. Increasingly, evidence shows us that mobility is an important medicine to reduce delirium. This is a very interesting article highlighting the impact of mobility and the story of one hospital’s experience. Well worth the time to read / listen. Thank you for sharing your stories! https://www.marketplace.org/2017/05/02/health-care/stopping-icu-delirium-getting-patients-moving

Mobility has a real impact on Delirium

Imagine not knowing where you are or who is poking and prodding at you! Imagine having no control over who does what to your body or when! Or hallucinating and not knowing what is real and what is not! Patients describe awful experiences related to Delirium. Effects can be long-lasting and impact ability to live independently, and many patients suffer from PTSD for many years after they have experienced Delirium. We cannot ignore the life-altering impact that Delirium has on our patients. Increasingly, evidence shows us that mobility is an important medicine to reduce delirium. This is a very interesting article highlighting the impact of mobility and the story of one hospital’s experience. Well worth the time to read / listen. Thank you for sharing your stories! https://www.marketplace.org/2017/05/02/health-care/stopping-icu-delirium-getting-patients-moving

PTSD is real. Knowledge is power to help our patients

At the Johns Hopkins ICU Rehab conference in November, 2 brave prior patients were interviewed. Their stories and the one posted below are very powerful reminders of the critical role we have as critical care providers to understand the real issue of PTSD, and our responsibility to do everything we can to promote the ABCDEF bundle of care, and to ask patients if they have experienced any strange thoughts or dreams that seemed real. The truth is that 80-100% of ventilated patients experience some delirium. The majority of them think they are the only ones and think they are literally going crazy. They feel silly sharing their experiences and often (as the patients interviewed at JH shared), they were told that their thoughts were nonsense when they did try to share them. We can change this by recognizing that delirium and confused thinkiing are HIGHLY LIKELY in our ventilated patients. They ask us the following: 1. PLEASE talk to us and know that even though we cannot respond…. we hear EVERYTHING 2. PLEASE ask us if we have had any strange dreams, and do not belittle us for sharing them 3. PLEASE do not think that we are stupid or less than you just because we are very sick Read the article below written by a nurse who went through this experience. The goal of EarlyMobility.com for 2017 is to create a sense of urgency in EVERY ICU care provider to do more to get their patients up and moving.. Let’s together change the outcomes for our patients. It could just as easily be one of us or one of our family members. What would we want the care team to do for us, knowing what we know about immobility, as well as the benefits of the ABCDE bundle? Let’s get moving… getting people moving!! http://www.bostonglobe.com/lifestyle/health-wellness/2013/04/07/delirium-induced-flashbacks-plague-many-former-icu-patients/a7547VfsYc8rWDjG1NDkIJ/story.html

Attention Austrian Visitors!

Please mark your calendars for the Austrian Society of Anesthesiology and Intensive Care conference: “Anesthesiology and Intensive Care at the intervace between humanity and economics”. This conference will be on September 29 through October 1 2016 CCB Centrum Fur Chemie und Biomedizin, Innrain 80-82, 6020 Innsbruck. Lectures include: Ethical Issues in Clinical Practice; Limits in the Cardiothoracic Vascular Anesthesia; Perioperative Medicine; Medicine vs Economy; Perioperative Pain Management; Prognosis in Severe Brain Disorder, Positive Suggestions Live: Win-Win for patients and anesthetists; and organ-protective ventilation in ARDS. Please visit the Austrian Society of Anesthesia and ICU Medicine at https://www.oegari.at/

>40% of Elderly patients are Incontintent after just 1 day of hospitalization!

“Spontaneous physical activity decreases by as much as 50% in patients following hospital admission, remains low during hospitalization, and is significantly less than age- and gender-matched community-dwelling older adults (Browning, Denehy, & Scholes, 2007).” A quote from an article written by Colleen M. Casey, PhD, ANP-BC, CNS. Full reference is a great read.  “Casey C. The Study of Activity. An Integrative Review. Journal of Gerontological Nursing. Vol 39(8), 2013.”

In this article, Casey highlights that 40% of elderly patients become incontinent after just ONE day of Hospitalization. This seems remarkable until we consider typical clinical practice. Elderly people tend to go to the bathroom frequently, due to decreased elasticity of the bladder, yet when they are admitted to hospitals or nursing homes, they are often instructed to stay in bed until somebody answers the call bell. If they need to go.. They are faced with a very difficult decision… To risk getting up and falling, or “not doing as they are told” or to simply urinate in their bed, which is not only very undignified and in many cases, mortifying for the patient, but also then renders them the title of “Incontinent”.  They also then have increased risks of wound breakdown and psychological breakdown. Perhaps asking a simple question such as “How often do you typically go to the bathroom?” and then providing this schedule for patients could help avoid a lot of unnecessary “Incontinence” and it’s sequelae in our healthcare facilities.

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