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Managing Pain, Anxiety and Delirium in the ICU

Nick Mark MD @nickmmark

#Pain #Anxiety #Delirium #CriticalCare #Comparison #Management
Managing Pain, Anxiety ... and Delirium in ... #CriticalCare # ... Comparison #Management ... #Diagnosis #ICU
Valproic Acid in the ICU for Agitation and Delirium
Up to 70% of ICU patients experience agitation
Agitation and Delirium ... Opioids and benzodiazepines ... used for pain & ... guidelines for delirium ... #pharmacology #criticalcare
Pain, Agitation, and Delirium (PAD) in the ICU
Addressing the ICU Triad (PAD) can be accomplished through
Pain, Agitation, ... Opioids: • Fentanyl ... Generally first line opioid ... #PAD #ICU #CriticalCare ... #diagnosis #management
Post-Intensive Care Syndrome (PICS)
Symptoms of PICS:
 - Physical Domain: Generalized weakness, Fatigue, Difficulty walking
 - Cognitive
analgesics - Delirium ... treatments - Delirium ... ) - Pain assessment ... Syndrome #PICS #diagnosis ... #management #criticalcare
Delirium in the ICU

Defining delirium
Types of delirium
Consequences of delirium
Reversible causes of delirium
Drug-induced delirium
Non-pharmacologic management of delirium
Pharmacologic
ICU Defining ... management of delirium ... theABofPharmaC #ICU ... #management #criticalcare ... #diagnosis
Checklist for Treatment of Delirium in the ICU 

Remove causative factors 
 - 
Exclude hypoglycemia if
for Treatment of Delirium ... if uncontrolled pain ... #Delirium #Checklist ... #Management #Treatment ... #MICU #CriticalCare
Causes of COVIDー19 ICU delirium
Restricted Visitation
 • Family Disconnected
 • Sense of Isolation
 • Disorientation
 •
Causes of COVIDー19 ICU ... delirium Restricted ... Interventions • Fewer Pain ... #coronavirus #diagnosis ... #criticalcare
Pancreatitis management checklist 
Evaluation to guide etiology & management 
 - RUQ ultrasound 
 - Calcium
Pain control - ... - Opioids may ... limit them as able ... Pancreatitis #Checklist #Diagnosis ... #Management #CriticalCare
Acute Pancreatitis - Diagnosis and Management - GrepMed Handbook

Presentation: 
 • Epigastric abdominal pain (90%, characteristically
and Management ... Epigastric abdominal pain ... Scheduled APAP, IV Opioids ... ileus), consider pain-dose ... ketamine (ICU);
It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a
simply a clinical diagnosis ... #algorithm #management ... cardiology #treatment #table ... heartfailure #chf #criticalcare ... #icu #clinical