Critical Matters 2018 PADIS Guidelines
Jun 12, 2019
John Devlin, a Professor at Northeastern University and lead author of the 2018 SCCM guidelines, dives into critical topics affecting ICU patients. He discusses the updated guidelines for pain, agitation, sedation, and sleep disruption, emphasizing individualized care. The conversation highlights innovative pain management strategies and the importance of early mobilization and sleep hygiene for recovery. Devlin also underscores the collaborative nature of care and how empowering patients can revolutionize ICU practices.
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Maintaining Light Sedation Goals
- Light sedation is defined roughly as a RASS of -2 to +1 and should be maintained continuously.
- Sedation goals require frequent assessment and active dose adjustment by the ICU team, especially nurses, to avoid deep sedation.
Prioritize Delirium Prevention
- Preventing delirium is paramount since effective pharmacologic treatments are lacking.
- Managing modifiable risk factors, family involvement, reorientation, and mobilization are key non-pharmacologic strategies.
Symptom-Targeted Delirium Treatment
- Treat delirium symptoms only when necessary, not delirium itself, using antipsychotics cautiously and short-term.
- Regularly reassess and discontinue antipsychotics to avoid prolonged use and potential harm post-ICU.
