SCCM Resources

The Society of Critical Care Medicine offers numerous resources related to pain, agitation and delirium.

For additional resources organized by topic, include Critical Care Medicine and Pediatric Critical Care Medicine articles, additional presentations, podcasts and more, visit LearnICU.org.​​​​​​​​

 

 Webcast Series

 

Interprofessional Team Coaching in the ICU: Results
This webcast is part two of a two-part series from the Society of Critical Care Medicine's ICU Liberation series. The webcasts were conducted for interprofessional teams (IPTs) working together to implement the ABCDEF Bundle. To be successful, all members of the IPT responsible for bundle implementation, including nurses, pharmacists, physical therapists, physicians, respiratory therapists and administrative leads or RN managers, were encouraged to attend both sessions.

This second session provided an opportunity for teams to share the results of their test of change. In addition, the session focused on how to address the influence and conflict challenges that frequently arise when working toward full ABCDEF Bundle implementation. At the end of the session, team members had a preliminary list of activities to continue working collaboratively toward bundle implementation.

Interprofessional Team Coaching in the ICU
This webcast is part one of a two-part series from the Society of Critical Care Medicine's ICU Liberation series. The webcasts were conducted for interprofessional teams (IPTs) working together to implement the ABCDEF Bundle. To be successful, all members of the IPT responsible for bundle implementation, including nurses, pharmacists, physical therapists, physicians, respiratory therapists and administrative leads or RN managers, were encouraged to attend both sessions.

The first session addresses the role of the IPT and the key abilities of partnership, cooperation, and coordination that make the team successful. Teams who attended also committed to implementing a test of change to implement as a team.

Early Progressive Mobility in the ICU – AACN Clinical Scene Investigator Academy Project
Early Progressive Mobility in the ICU – AACN Clinical Scene Investigator Academy Project, is the latest webcast from the Society of Critical Care Medicine’s (SCCM) ICU Liberation series, held in collaboration with the American Association of Critical-Care Nurses (AACN) and Project Dispatch, funded by the Agency for Healthcare Research and Quality.

Under the guidance of the AACN Clinical Scene Investigator (CSI) Academy, Duke Raleigh Hospital’s medical-surgical intensive care unit (ICU) implemented an early progressive mobility protocol. The goal was to decrease ICU lengths of stay and ventilator days, while increasing mobility and positive patient outcomes through reduced incidence of hospital-acquired infections (HAI) and complications. Since implementation, they have experienced a large number of successful outcomes and a strengthened ICU team, and have created a collaborative interprofessional culture in their unit. In this session, Cheryl L. Esbrook, OTR/L,BCPR, Katherine Geyer, BSN, RN, CCRN, CNIV, and Kristin Merritt, MSN, MBA/HCM, RN, NE-BC, CCRN, discuss the team’s approach to implementation, project planning, and protocol structure. They also highlight challenges, qualitative and quantitative outcomes, and meaningful patient stories.

Nurse-Driven Protocol for the Management of Alcohol and Polysubstance Abuse – AACN Clinical Scene Investigator Academy Project
Nurse-Driven Protocol for the Management of Alcohol and Polysubstance Abuse – AACN Clinical Scene Investigator Academy Project, is the latest webcast from the Society of Critical Care Medicine’s (SCCM) ICU Liberation series, held in collaboration with the American Association of Critical-Care Nurses (AACN). In September 2013, the Maimonides Medical Center’s medical intensive care unit (ICU) implemented a nurse-driven protocol for the management of patients with severe alcohol and/or substance withdrawal. The project goals included alleviating nursing staff anxiety when caring for these patients, decreasing ICU lengths of stay, reducing the number of ventilator days, and decreasing falls.

In this session, Laurie Wilson, RN, MSN, and Christina Ycaza-Gutierrez, RN, BSN, CCRN, explore the team’s journey throughout the execution of the project and review how project implementation goals were achieved. Faculty also discuss other positive outcomes such as decreased overall hospital length of stay, decreased incidence of patient tracheostomies, the positive impact on the hospital’s financial budget, and the project’s ability to continue to surpass expected goals six months after its completion.

Family Engagement – AACN Clinical Scene Investigation Project
This webcast was held in collaboration with the American Association of Critical-Care Nurses (AACN). The AACN Clinical Scene Investigation (CSI) team at Massachusetts General Hospital (MGH) is composed of four nurses from the cardiac intensive care unit (ICU). This team administered an educational program on the ABCDEF bundle to an audience of ICU nurses at MGH. The final bundle element, family engagement and empowerment, was added to represent the value of family involvement in the overall patient plan. In this webcast, Erica Edwards, RN, MSN, CCRN, CMC, CHFN, and Alicia Sheehan, RN, BSN, provide the evidence for this addition, as well as illustrate how family engagement is implemented in the cardiac ICU.

Learning Objectives

  • Identify factors described in the literature about the importance of family engagement
  • Describe the background of family inclusion in the cardiac ICU
  • Discuss the implementation of family engagement and empowerment in the ABCDEF bundle

 

An Integrated Approach to ICU Delirium Assessment, Prevention and Management
Delirium is frequently found in critically ill adults, affecting patient outcomes both during and after the intensive care unit (ICU) stay. This webcast will address an important component of the ABCDEF Bundle, Delirium: Assess Prevent and Manage, for clinicians seeking to liberate their patients from the ICU and improve their outcomes. During this session, Michele Balas, PhD, RN, APRN-NP, CCRN, and John Devlin, PharmD, FCCM, FCCP, will discuss the importance of routine delirium screening in the critically ill and integrated strategies to boost the routine use of a validated instrument such as the confusion assessment method for the ICU (CAM-ICU) or the intensive care delirium checklist (ICDSC). The speakers will also address frequently asked questions about delirium management, and the presentation will conclude with a question-and-answer segment.   

Learning Objectives

  • Recognize the importance of routine delirium screening in the ICU using the CAM-ICU or the ICDSC
  • Identify modifiable risk factors for delirium in the critically ill
  • Apply non-pharmacologic strategies to reduce the burden of delirium in the critically ill
  • Understand the limited role that medication-focused interventions currently have in treating delirium in the ICU

Successfully Overcoming Assessment and Treatment Challenges for ICU Pain
Pain management in the intensive care unit (ICU) may be difficult because of a patient’s severity of injury and unstable health status. In the webcast, Successfully Overcoming Assessment and Treatment Challenges for ICU Pain, Celine Gelinas, PhD, RN, Aaron Joffe, DO, and Kathleen Puntillo, RN, PhD, FAAN, provide an overview of the landscape of pain assessment and management in ICU patients within the context of the ABCDEF bundle, and offer suggestions for interventions. The speakers address frequently asked questions of ICU clinicians regarding pain assessment and management, and the presentation concludes with a question-and-answer segment.

Learning Objectives

  • Describe the importance of pain assessment and its analgesic management within the framework of the ABCDEF bundle
  • Discuss the assessment of pain in non-communicative patients through use of the Critical-Care Pain Assessment Tool (CPOT)
  • Evaluate pharmacological options for treating pain in critically ill patients
  • Provide answers to frequently asked questions about pain assessment and management challenges that occur in critical care practice

Road Map for Implementing the New ABCDEF Bundle in Your ICU (PDF)
Mary Ann Barnes-Daly, RN, BSN, CCRN, DC, clinical performance improvement consultant at Sutter Health, and Juliana Barr, MD, FCCM, associate professor of anesthesiology, perioperative and pain medicine at Stanford University and staff anesthesiologist and intensivist at VA Palo Alto Health Care System, will provide a strategy for intensive care unit (ICU) teams striving to implement the new ABCDEF bundle. Faculty will examine the new element of the bundle: family engagement and empowerment. The bundle includes:
A = Assess, Prevent and Manage Pain
B = Both Spontaneous Awakening Trials and Spontaneous Breathing Trials
C = Choice of Sedation
D = Delirium: Assess, Prevent and Manage
E = Early Mobility and Exercise
F = Family Engagement and Empowerment

Spontaneous Awakening and Breathing Trials: Strategies to Optimize Patient Outcomes
Michael J. Cawley, PharmD, RRT, CPFT, FCCM, and Kenneth D. Hargett, MHA, RRT, FAARC, FCCM, focus on the use of spontaneous awakening trials (SAT) and spontaneous breathing trials (SBT) to reduce the intensive care unit (ICU) length of stay (LOS) and to help improve ICU outcomes. Through a case study, polling questions and audience interaction, this webcast examines team communications and offer both pharmacological perspectives and ventilator liberation strategies.

Learning Objectives

  • Explore the role of SAT/SBT as a quality strategy in reducing ICU LOS and ventilator use
  • Discover how team communications can be improved to facilitate implementation of standardized care plans
  • Discuss the role of pharmacological weaning in achieving care plan goals to move patients from mechanical ventilation
 

 Podcasts

 

iCritical Care offers a wide selection of in-depth interviews on adult and pediatric topics. Gain unique perspectives as hosts chat with authors of the latest Critical Care Medicine and Pediatric Critical Care Medicine articles, well-known speakers and prominent SCCM members. Rated among the top 20 medical podcasts on iTunes, iCritical Care Podcasts are a valuable resource listeners can take anywhere.

Learn more about the iCritical Care Podcasts at www.sccm.org/iCriticalCare or susbsribe via iTunes by searching "SCCM."

SCCM Pod-341 Reflections on the ICU Liberation ABCDEF Bundle Improvement Collaborative
Ludwig Lin, MD, speaks with Brenda Pun, DNP, RN, ACNP, about the ICU Liberation ABCDEF Bundle Improvement Collaborative. Dr. Pun reflects upon Collaborative work, including origins and logistics of the project, team training and resource-sharing, and the importance of the interprofessional care model, as well as successes, challenges, and barriers to bundle implementation. Dr. Pun is the Project Clinical Manager at Vanderbilt University Medical Center in Nashville, Tennessee. She was a member of the ICU Liberation Moore Foundation Steering Committee and played an instrumental role in the development of the REDCap database that was used for quality improvement for the ICU Liberation Campaign. Dr. Pun served as a mentor and coach to her own team as well as others in the Collaborative. Her disclosures note that she is also an AACN speaker. Released 5/18/17

SCCM Pod-303 Post-Intensive Care Syndrome: Truth About Consequences, Right Care Right Now … and Later
Ludwig Lin, MD, speaks with Maurene A. Harvey, MPH, RN, MCCM, about her upcoming plenary talk, “Post-Intensive Care Syndrome: Truth About Consequences, Right Care Right Now … and Later,” which she will present this February at the 45th Critical Care Congress in Orlando, Florida. Post-Intensive Care Syndrome (PICS) is made up of health problems that remain after critical illness, including post-traumatic stress disorder. Ms. Harvey discusses the latest research and practical interventions to help prevent and manage PICS, including implementing the ICU Liberation ABCDEF Bundle. Learn more about patient resources for PICS at MyICUCare.org and visit ICULiberation.org for information on the ABCDEF Bundle. Ms. Harvey works as a Critical Care Educator and Consultant from Lake Tahoe, Nevada, and is a former president of the Society of Critical Care Medicine. Released: 11/25/15

SCCM Pod-293 Why ICU Clinicians Need to Care about Post-Intensive Care Syndrome
Ludwig Lin, MD, speaks with Mark Mikkelsen, MD, MSCE, about the article, “Why ICU Clinicians Need to Care about Post-Intensive Care Syndrome,” published in Critical Connections. Dr. Mikkelsen works as an Assistant Professor of Medicine at the Hospital of the University of Pennsylvania in Philadelphia, Pennsylvania. He is the co-chair of the Society’s new THRIVE initiative, which aims to improve patient and family support after critical illness. In this article, Dr. Mikkelsen and coauthors discuss post-intensive care syndrome (PICS), THRIVE, and the need for a shift toward patient- and family-centered care that emphasizes long-term outcomes and survivorship. Crit Conn. 2015; 14(3):1. Released: 9/10/15

SCCM Pod-292 It Takes a Team: Contributions of Each Team Member in a Post-Intensive Syndrome Clinic Model
Ludwig Lin, MD, speaks with James C. Jackson, Psy.D, and Carla Sevin, MD, about the article, “It Takes a Team: Contributions of Each Team Member in a Post-Intensive Syndrome Clinic Model,” published in Critical Connections. Dr. Jackson works as an Assistant Professor of Medicine in the Division of Allergy, Pulmonary, and Critical Care Medicine and the Center for Health Services Research at the Vanderbilt University School of Medicine in Nashville, Tennessee. Dr. Sevin also works in the Division of Allergy, Pulmonary, and Critical Care Medicine as an Assistant Professor of Medicine and serves as Director of the Pulmonary Patient Care Center at the Vanderbilt University School of Medicine. Drs. Jackson and Sevin are part of a team at Vanderbilt running The ICU Recovery Center, a facility dedicated to addressing the multifaceted recovery needs of individuals who have survived a critical illness. In this article, they discuss the recovery center, lessons learned and some best practices for those seeking to improve care for patients leaving the ICU. Crit Conn. 2015; 14(3):6. Released: 9/3/15

SCCM-Pod 287 Posttraumatic Stress Disorder in Critical Illness Survivors: A Metaanalysis
Ludwig Lin, MD, speaks with Ann M. Parker, MD, about the article, "Posttraumatic Stress Disorder in Critical Illness Survivors: A Metaanalysis*," published in Critical Care Medicine. Dr. Parker is a Fellow in the Division of Pulmonary and Critical Care Medicine and is part of the Outcomes After Critical Illness and Surgery (OACIS) Group at Johns Hopkins University in Baltimore, Maryland. In this article, Dr. Parker and coauthors conduct a systemic review and metaanalysis of the prevalence, risk factors, and prevention/treatment strategies for posttraumatic stress disorder symptoms in critical illness survivors. Crit Care Med. 2015; 43(5):1121-1129.  Released: 7/30/15  UPDATE: Parker notes that literature is available on the economic impact of PTSD. Reference – Davydow DS, Hough CL, Zatzick D, et al. Psychiatric symptoms and acute care service utilization over the course of the year following medical-surgical ICU admission: a longitudinal investigation*. Crit Care Med. 2014;42(12):2473-2481. Released: 7/30/15

SCCM Pod-254 44th Critical Care Congress: The ABCDEF Bundle Evolution
Michael Weinstein, MD, FACS, FCCP, speaks with E. Wesley Ely, MD, FCCM, at the 44th Critical Care Congress in Phoenix, Arizona. Dr. Ely, Professor of Medicine and Critical Care at Vanderbilt University Medical Center in Nashville, Tennessee, discusses the "Evolution of the ABCDEF Bundle" and the Society’s ICU Liberation initiative, which aims to help practitioners become more familiar with the Pain, Agitation and Delirium guidelines and assessment tools. Released: 1/27/15

SCCM Pod-245 Neonatal-Specific Consensus Definition for Sepsis
Margaret Parker, MD, MCCM, speaks with James L. Wynn, MD, about the article, “Time for a Neonatal-Specific Consensus Definition for Sepsis,” published in Pediatric Critical Care Medicine. Dr. Wynn is an Assistant Professor of Pediatrics in the Department of Pediatrics, the Division of Neonatal-Perinatal Medicine, at Vanderbilt University in Nashville, Tennessee. In this article, Dr. Wynn and coauthors review the accuracy of the pediatric consensus definition of sepsis, specifically relating to term neonates and preterm neonates. Pediatr Crit Care Med. 2014; 15(6):523-528. Released: 10/23/14

SCCM Pod-244 Early Mobility Implementation Strategies
Michael Weinstein, MD, FACS, FCCP, speaks with Heidi J. Engel, PT, DPT, of UCSF Medical Center regarding her lecture on “Early Mobility Implementation Strategies,” which she presented during the 43rd Critical Care Congress in San Francisco, California. Released: 10/10/14  

SCCM Pod 205 CCM: New Pain, Agitation and Delirium Guidelines
Jeffrey Guy, MD, MSc, MMHC, speaks with Juliana Barr, MD, FCCM, lead author on the Society of Critical Care Medicine's American College of Critical Care Medicine, “Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit,” published in the January Critical Care Medicine. The guidelines provide a roadmap for developing integrated, evidence-based, and patient-centered protocols for preventing and treating pain, agitation and delirium (PAD) in critically ill patients. Bundles included in the guideline link management strategies with other intensive care unit (ICU) interventions, such as spontaneous awakening trials and early mobility protocols. Barr is an Associate ICU Medical Director at the Veterans Affairs Palo Alto Health Care System in Palo Alto, California, and Associate Professor in Anesthesia at Stanford University. (Crit Care Med. 2013; 41[1]:263-306)

SCCM Pod-157 Sedation Strategies in the ICU
Troy E. Batterton, PharmD, a pharmacist at Lakeland Regional Medical Central, and Dean Sandifer, MD, an internist, both practicing at Lakeland Regional Medical Center in Lakeland, Florida, discuss sedation strategies in critical care, including designing, building and maintaining protocols in intensive care units. For additional resources on sedation, including additional podcasts, visit LearnICU.org.

SCCM Pod-156 Delirium in the Critically Ill Patient
Pratik Pandharipande, MD, FCCM, is an assistant professor of anesthesiology at Vanderbilt University Medical Center in Nashville, Tennessee. Pandharipande discusses the definition and scope of delirium and how to identify and manage the condition in children.

SCCM Pod-151 Symptoms Experienced by ICU Patients at Risk of Dying
Kathleen A. Puntillo, RN, DNSc, is the lead author of an article published in the November 2010 Critical Care Medicine titled, “Symptoms Experienced by Intensive Care Unit Patients at High Risk of Dying.” The study provides a detailed assessment of the symptom experiences of intensive care unit patients at risk of dying and evaluates the relationship between delirium and patients’ symptom reports. Puntillo is a professor of nursing at the University of California, San Francisco School of Nursing. (Crit Care Med. 2010 38 [11]:2155-2160)

SCCM Pod-139 CCM: Duration of Delirium as an ICU Predictor of Cognitive Impairment
Timothy D. Girard, MD, MSCI, discusses his article published in the July 2010 Critical Care Medicine, titled “Delirium as a Predictor of Long-Term Cognitive Impairment in Survivors of Critical Illness.” His study tests the idea that duration of delirium in the ICU is an independent predictor of long-term cognitive impairment after critical illness. Girard is an assistant professor of medicine at Vanderbilt University School of Medicine in Nashville, Tennessee. (Crit Care Med. 2010;38[7]:1513-1520)​​​

 

 Literature

 

ICU Liberation: The Power of Pain Control, Minimal Sedation, and Early Mobility
Format: Print Book
Publication Year: 2015

ICU Liberation: The Power of Pain Control, Minimal Sedation, and Early Mobility offers practical information
to help frontline staff implement sedation liberation and promote ICU patient mobility. The chapters provide
evidence based on expert opinion, principles derived from other disciplines, and practical experience.
Topics include how to perform a gap analysis, delirium in the ICU, the need for sleep, and ventilator strategies.

ICU Liberation in the News

The HAC No One Wants to Talk About - HealthLeaders Media

Critical Connections 
SCCM's Newsmagazine
February 2013 - Pain Management in the ICU

August 2010

 

 Presentations

 

ABCDE and F Bundle: The Science Behind Liberating ICU Patients and Families
In this plenary session from the 46th Critical Care Congress, E. Wesley Ely, MD, MPH, FCCM, delivers a talk entitled ABCDE and F Bundle: The Science Behind Liberating ICU Patients and Families. He describe the Society of Critical Care Medicine’s pain, agitation, and delirium (PAD) guidelines, review the epidemiology and risk factors for critical illness brain injury, introduce the evidence-based ABCDEF bundle and successful quality improvement methodology and discusses optimizing culture change to improve patient outcomes.

Implementing the ABCDEF Bundle Implementation Slides 
The ABCDEF Bundle Implementation Slides are part of the educational content developed for the ICU Liberation ABCDEF Bundle Collaborative.

Patient-Centered Rounds Using the ABCDEF Bundle: Video Series
Each video in this series, Patient-Centered Rounds Using the ABCDEF Bundle, shows examples of patient care rounds.

Patient-Centered Rounds Using the ABCDEF Bundle: Facilitator Guide for the Video Series
Patient Centered Rounds Using the ABCDEF Bundle: Video 1
Patient-Centered Rounds Using the ABCDEF Bundle: Video 2 
Patient-Centered Rounds Using the ABCDEF Bundle: Video 3

ABCDEF Bundle Improvement Collaborative: Is the Whole Greater Than the Sum of the Parts?
This session was presented during the 45th Critical Care Congress as part of the Society of Critical Care Medicine's ICU Liberation Initiative.

ICU Liberation: Post Intensive Care Syndrome (PICS)
James C. Jackson, Psy.D, assistant professor at Vanderbilt University, discusses Post-Intensive Care Syndrome (PICS), a condition that affects survivors of critical care illness. He defines PICS, examines how PICS affects patients and families, and identifies common ICU practices that lead to the development of PICS.

Rounding the ICU with the ABCDE Bundle
These informative videos, courtesy of Sutter Health and the Gordon and Betty Moore Foundation, examine incorporation of the ABCDE bundle during multiprofessional rounds in the intensive care unit.
Rounding in the ICU with the ABCDE Bundle – Part 1
Rounding in the ICU with the ABCDE Bundle – Part 2

ICU Delirium: The Patient and Family Experience
In this illuminating video, ICU survivor Anthony Russo provides an emotional and frank account of his ICU experience at Sutter Health following his contraction of H1N1. He paints a vivid and heart wrenching picture of his struggle with delirium and its long-term impact on his life. He also expresses immense gratitude to the medical team at Sutter Health who saved his life.

Implementing the Pain, Agitation, Delirium, Immobility Guidelines in the ICU
In these excerpts from the Society of Critical Care Medicine's 43rd Critical Care Congress, leaders from the ICU Liberation initiative discuss strategies for improving outcomes and identify strategies and barriers to guideline implementation. The session also includes a presentation from a patient, who shares his ICU survivor experience.

ICU Liberation: My Experience in the ICU
ICU Liberation: CDC Multi-Site Wake Up and Breathe Program
ICU Liberation: Physical Medicine and Mobility Strategies in the ICU
ICU Liberation: Changing Practice at the Bedside
ICU Liberation: Implementation of the PAD Guidelines using an Inter-Professional Team Model

Recovering from the ICU: A Survivor's Story
Alison Clay, MD, shares her experience as an ICU survivor.

Clinical Management of Pain, Agitation and Delirium

Use It or Lose It: Neuromuscular Weakness

Nursing Considerations Toward Promoting Early Mobility

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 Reference List

 
 

 Pediatric Resources

 

Assess, Prevent, and Manage Pain
Implementing the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle into everyday care: opportunities, challenges, and lessons learned for implementing the ICU Pain, Agitation, and Delirium Guidelines.
Balas MC, Burke WJ, Gannon D, et al. Implementing the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle into everyday care: opportunities, challenges, and lessons learned for implementing the ICU Pain, Agitation, and Delirium Guidelines. Crit Care Med. 2013 Sep;41(9 Suppl 1):S116-S127.

Clinical recommendations for pain, sedation, withdrawal and delirium assessment in critically ill infants and children: an ESPNIC position statement for healthcare professionals.
Harris J, Ramelet A, van Dijk M, et al. Clinical recommendations for pain, sedation, withdrawal and delirium assessment in critically ill infants and children: an ESPNIC position statement for healthcare professionals. Intensive Care Med. 2016 Jun;42(6):972-986.

Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle.
Balas MC, Vasilevskis EE, Olsen KM, et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med. 2014 May;42(5):1024-1036.

Both SAT and SBT

Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial.
Curley MA, Wypij D, Watson RS, et al; RESTORE Study Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators Network. Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial. JAMA. 2015 Jan 27;313(4):379-389.

The preventability of ventilator-associated events. The CDC Prevention Epicenters Wake Up and Breathe Collaborative.
Klompas M, Anderson D, Trick W, et al; CDC Prevention Epicenters. The preventability of ventilator-associated events. The CDC Prevention Epicenters Wake Up and Breathe Collaborative. Am J Respir Crit Care Med. 2015 Feb 1;191(3):292-301.

Choice of Analgesia and Sedation

Is propofol a friend or a foe of the pediatric intensivist? Description of propofol use in a PICU.
Koriyama H, Duff JP, Guerra GG, Chan AW; Sedation Withdrawal and Analgesia Team. Is propofol a friend or a foe of the pediatric intensivist? Description of propofol use in a PICU. Pediatr Crit Care Med. 2014 Feb;15(2):e66-e71.

Delirium: Assess, Prevent and Manage

Implementing delirium screening in the ICU: secrets to success.
Brummel NE, Vasilevskis EE, Han JH, Boehm L, Pun BT, Ely EW. Implementing delirium screening in the ICU: secrets to success. Crit Care Med. 2013 Sep;41(9):2196-2208.

Pediatric delirium: monitoring and management in the pediatric intensive care unit.
Smith HA, Brink E, Fuchs DC, Ely EW, Pandharipande PP. Pediatric delirium: monitoring and management in the pediatric intensive care unit. Pediatr Clin North Am. 2013 Jun;60(3):741-760.

Pediatric delirium and associated risk factors: a single-center prospective observational study.
Silver G, Traube C, Gerber LM, et al. Pediatric delirium and associated risk factors: a single-center prospective observational study. Pediatr Crit Care Med. 2015 May;16(4):303-309.

Diagnosing delirium in critically ill children: validity and reliability of the Pediatric Confusion Assessment Method for the Intensive Care Unit.
Smith HA, Boyd J, Fuchs DC, et al. Diagnosing delirium in critically ill children: validity and reliability of the Pediatric Confusion Assessment Method for the Intensive Care Unit. Crit Care Med. 2011 Jan;39(1):150-157.

Cornell assessment of pediatric delirium: a valid, rapid, observational tool for screening delirium in the PICU.
Traube C, Silver G, Kearney J, et al. Cornell assessment of pediatric delirium: a valid, rapid, observational tool for screening delirium in the PICU. Crit Care Med. 2014 Mar;42(3):656-663.

Detecting pediatric delirium: development of a rapid observational assessment tool.
Silver G, Traube C, Kearney J, et al. Detecting pediatric delirium: development of a rapid observational assessment tool. Intensive Care Med. 2012 Jun;38(6):1025-1031.

Pediatric delirium: evaluating the gold standard.
Silver G, Kearney J, Traube C, Atkinson TM, Wyka KE, Walkup J. Pediatric delirium: evaluating the gold standard. Palliat Support Care. 2015 Jun;13(3):513-516.

Early Mobility and Exercise

Early mobilization in the pediatric intensive care unit: a systematic review.
Wieczorek B, Burke C, Al-Harbi A, Kudchadkar SR. Early mobilization in the pediatric intensive care unit: a systematic review. J Pediatr Intensive Care. 2015;2015:129-170.

PICU Up! Impact of a quality improvement intervention to promote early mobilization in critically ill children.
Wieczorek B, Ascenzi J, Kim Y, et al. PICU Up! Impact of a quality improvement intervention to promote early mobilization in critically ill children. Pediatric Crit Care Med. 2016 Oct 10 [Epub ahead of print].

Optimizing sedation management to promote early mobilization for critically ill children.
Saliski M, Kudchadkar SR. Optimizing sedation management to promote early mobilization for critically ill children. J Pediatr Intensive Care. 2015;4(4):188-193.

Transforming PICU culture to facilitate early rehabilitation.
Hopkins RO, Choong K, Zebuhr CA, Kudchadkar SR. Transforming PICU culture to facilitate early rehabilitation. J Pediatr Intensive Care. 2015 Dec;4(4):204-211.

 

 

 Videos