Critical Care Time 4. ICU Delirium with Dr. Wes Ely, MD.
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Jul 31, 2023 Dr. Wes Ely, MD, expert in ICU brain dysfunction, discusses important topics like prevention, diagnosis, and treatment of delirium in critical care. The conversation also touches on the impact of overuse of sedatives in COVID patients and the importance of family involvement. Implementing the ATF bundle for ICU patients and the use of medications and non-pharmacologic interventions in managing delirium are highlighted. The significance of patient's voice, compassion in critical care, and the speaker's focus on designing medical trials for long COVID immunomodulation are also covered.
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Delirium Prevalence and Impact
- Delirium is prevalent in ICU patients, affecting 70% of ventilated patients and 40% of non-intubated patients.
- It's an independent predictor of death, prolonged hospital stays, increased costs, and dementia.
Managing Delirium: Dr. Dre
- Treat the underlying disease, remove unnecessary drugs, and optimize the environment.
- Address sepsis, COPD, and other conditions while minimizing sedatives and promoting early mobility.
The A2F Bundle
- Implement the A2F bundle (analgesia, both SATs/SPTs, choice of drug, delirium monitoring, early mobility, family engagement).
- This bundle improves survival, shortens hospital stays, and reduces delirium.