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Managing Pain, Anxiety and Delirium in the ICU

Nick Mark MD @nickmmark

#Pain #Anxiety #Delirium #CriticalCare #Comparison #Management
Pain, Anxiety and Delirium ... in the ICU Nick ... #CriticalCare # ... Comparison #Management ... #Diagnosis #ICU
Post-Intensive Care Syndrome (PICS)
Symptoms of PICS:
 - Physical Domain: Generalized weakness, Fatigue, Difficulty walking
 - Cognitive
analgesics - Delirium ... treatments - Delirium ... Sedation titration (RASS ... 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 ... Non-pharmacologic management ... management of delirium ... theABofPharmaC #ICU ... #management #criticalcare
Pain, Agitation, and Delirium (PAD) in the ICU
Addressing the ICU Triad (PAD) can be accomplished through
Agitation, and Delirium ... below) D - Delirium ... Sedation Scale (RASS ... #PAD #ICU #CriticalCare ... #diagnosis #management
Checklist for Treatment of Delirium in the ICU 

Remove causative factors 
 - 
Exclude hypoglycemia if
for Treatment of Delirium ... in the ICU Remove ... #Delirium #Checklist ... #Management #Treatment ... #MICU #CriticalCare
Nasal Oxygen Delivery Devices
Nasal cannula can be used to deliver supplemental O2. Conventional nasal cannula are
deliver low flow rates ... intubation & lower ICU ... • Higher flow washes ... Delivery #Devices #management ... #pulmonary #criticalcare
Vasopressors and Inotropes
 • Norepinephrine - Levophed - "Levo" - Generally thought of as the first
common in OR; in MICU ... Vasopressors #Inotropes #management ... #criticalcare # ... summary #comparison
ICU Pre-Rounding Bundle Checklist
VITALS: trends!
 • Important to know if the pt is getting better or
ICU Pre-Rounding ... Sedation: know RASS ... goal (+/- CAM-ICU ... Bundle #Checklist #CriticalCare ... #Management
It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a
diagnosis but rather ... more specific rather ... differential #algorithm #management ... heartfailure #chf #criticalcare ... #icu #clinical
Oxygen Delivery Devices
1. Flow is a variable describing the movement of a volume of gas over
delivering high flow rates ... Devices #Flow #Comparison ... #management #criticalcare