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Walking Home From The ICU

Walking Home From The ICU

By Kali
Kali Dayton, DNP, ACNP-BC, is an ICU nurse practitioner and ICU consultant. She hands the microphone to ICU survivors and bedside caregivers to reveal the realities of ICU experience and patients' journeys after discharge. The big picture of sedation and immobility is discussed and we explore how to improve short and long-term patient outcomes. We shift the vision from transferring out of the ICU to walking straight home after the ICU. www.DaytonICUconsulting.com
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Episode 43: Trapped In My Body As An ARDS Survivor

Walking Home From The ICU

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Episode 103: Communication Is a Basic Human Right- Even in the ICU
What impact does it have on patients to be lost in solitude while in medically-induced comas?  How does the inability to communicate impact patients' agitation, anxiety, and trauma?  How can providing communication tools ease the stress and burden of critical illness on clinicians, patients and families?  When patients are unable to verbalize, what tools are available to facilitate communication?  This episode explores the value of communication in the ICU and the impact of our sedation and immobility practices on the basic human right of communication.  www.daytonicuconsulting.com 
01:03:24
May 17, 2022
Episode 102: Waking Up in the ED
102: Waking Up in the ED When post-intubation wait times increased during the COVID19 crisis, Julie, an ED nurse, took "saving lives in the ED" to a whole new level. She shares with us what communication and patient autonomy mean to her and how she is applying that to how she cares for patients in the ED. One nurse can make a ripple effect throughout an entire hospital system. www.daytonicuconsulting.com 
50:57
May 01, 2022
Episode 101: The ABCDEF Bundle in the Neuro ICU
What does the ABCDEF bundle look like in neurocritical care? When patients suffer conditions such as intracranial hypertension that necessitate sedation and immobility, how does the ABCDEF bundle apply? Neurointensivist, Dr. Neha Dangayach, shares with us her team's strong ABCDEF culture and practices in the neuro ICU. @Drdangayach    www.daytonicuconsulting.com 
48:07
April 15, 2022
Episode 100: Moving the Mission Forward
After 100 episodes of compelling stories, research, and testimonials, we know what can and should be for intensive care medicine. What is the next step? How do we lead our ICU teams into the future and standardize "Awake and Walking ICUs"? What resources are available to educate and support our teams in this transition? www.DaytonICUConsulting.com 
20:28
April 05, 2022
Episode 99: How Physical Therapists Save Lives in the ICU
Episode 99: When physical therapists are allowed to work at the top of their licenses, how do they save lives? What barriers prevent them from fully contributing their expertise during critical illness? How is mobility a life-saving intervention? ICU Physical Therapist experts, Kenny Venere, PT, DPT, and Kyle Ridgeway, PT, DPT, CCS share with us their experiences and insights.  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
01:02:51
March 16, 2022
Episode 98: Occupational Therapists Change Outcomes in the ICU
Occupational Therapists Change Outcomes in the ICU How can occupational therapists help decrease time on the ventilator and time in the hospital? How can they preserve function and quality of life? What skills do they bring to preventing and treating delirium? Why should they be promptly utilized in a patient's journey? Corinne, Mallory, and Rachel share give us insight into the value occupational therapists bring into the ICU.  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
37:09
March 05, 2022
Episode 97: How To Truly Prevent Ventilator-associated Pneumonias
How does ventilator-associated pneumonia occur?  How does the failure to practice the ABCDEF bundle increase the risks of prolonged time on the ventilator and mortality? What do we know about the impact of early mobility on VAPs?  Let's dive deep into what we know about VAPs and how to drive down the rates in our ICUs.  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
43:52
February 23, 2022
Episode 96: The Backstory of Ventilator-associated Pneumonia
Ventilator-Associated Pneumonia has significant lethal and financial repercussions for patients and our healthcare system. So why aren’t we panicking about it? Are hospitals really liable for the costs incurred from this ventilator-associated condition? Dr. Benjamin Wang, MD joins us to share the backstory behind VAPs in our US healthcare system and government.  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
33:05
February 22, 2022
Episode 95: The Financial Cost of Sedation and Immobility
When healthcare systems say they don't have the resources to support proper practices, is that true? How much do deep sedation and immobility cost our ICU teams, hospitals, and healthcare systems? How can we use the research to support our plight for safe staffing ratios and evidence-based practices? Let's dive deep into the money talk.  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
31:04
February 11, 2022
Episode 94: The ICU Deathtrap
Why are prolonged sedation and immobility lethal? How do our standard practices of automatically sedating every patient on a ventilator deprive them of the chance to survive and thrive? What systemic barriers stop us from implementing evidence-based practices that save lives and drastically change outcomes? Michelle, DNP, ACNP dives deep into powerful case studies that explore the "ICU deathtrap".  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
01:19:37
December 17, 2021
Episode 93: The Awake and Walking COVID ICU
Why is the mortality rate for COVID ICU patients in the Awake and Walking ICU less than half of the other COVID ICUs in the same hospital system in the same community? How have sedation and mobility practices impacted rates of central lines, vasopressor use, paralysis, tracheostomies, and LTACH admissions? How has this ICU continued to keep COVID patients awake and mobile during this pandemic? Dr. Joel Pittman shares with us valuable updates from the Awake and Walking ICU.  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
27:31
December 09, 2021
Episode 92: Sedated Because She's Intubated and Intubated Because She's Sedated
Susanne was admitted to the ICU for ludwig's angina. When she required intubation only for airway protection, she was placed on the conveyor belt of ICU care. How did deep sedation and immobility impact her physical and psychological outcomes? How much more unnecessary time did she spent suffering in delirium on the ventilator? She tells us all in this episode.  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
01:01:41
December 06, 2021
Episode 91: The Awake and Walking ICU in Denmark
Are there any other “Awake and Walking ICUs” outside of Salt Lake City, Utah? Dr. Thomas Strom shares with us his team’s success and research in Denmark. He provides powerful insight into the gaps and future of critical care medicine.  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
01:19:39
November 14, 2021
Episode 90: Registered Dietitian Consultation STAT
What role do registered dietitians play in patient outcomes in the ICU? Why is malnutrition such an emergency? How can we better utilize the expertise of registered dietitians? What does the latest research show about our performance with nutrition in the ICU? Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
43:10
November 13, 2021
Episode 89: Dropping the Grenade On the ICU
What role does the choice of sedation in the field or ED play in the delirium that unfolds in the ICU? How can inter-departmental collaboration improve sedation practices and patient outcomes? How can the ICU better understand delirium and respond appropriately to new admissions from the other facilities and the ED? Jeff Polland, BS, NRP, FP-C, shares with us his work to avoid benzodiazepine abuse to improve patient outcomes.  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
50:06
November 05, 2021
Episode 88: Bring In Speech Language Pathology
How do speech-language pathologists save lives? How can we more fully utilize them in the ICU? How can PT, OT, AND SLP help, halt, or reverse pulmonary disease processes during acute and critical illness? Let’s discuss how they prevent harm and restore humanity in the ICU. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
54:35
October 24, 2021
Episode 87: Is Their Silence Worth Their Suffering?
Mark Hudson, an ICU survivor podcast host, is all too well acquainted with delirium. He has dedicated himself to advocating for fellow patients and survivors to prevent the torture of delirium. He tells it to us straight and guides us towards improvements. Mark Hudson's podcast: https://anchor.fm/icu-life-and-recovery Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
01:03:07
October 18, 2021
Episode 86: Ventilator Management in the Awake and Walking COVID19 Unit
How is the “Awake and Walking ICU” keeping their COVID19 patients mentally and physically functional during severe COVID19? Do they face constant ventilator asynchrony and how do they deal with it? Geoff shares with us his vast experience as a respiratory therapist in walking patients on mechanical ventilation during critical illness and now COVID19.  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
37:33
October 03, 2021
Episode 85: RT Magic
Does sedation always improve ventilator dyssynchrony, or can it cause it? How does a lack of unity between disciplines impact patient care and outcomes? How can we better support and utilize the expertise of respiratory therapists to optimize care for patients on ventilators? Brady Scott, PhD, RRT shares his 20 years of experience and insights. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
56:20
September 20, 2021
Episode 84: Zentensive Care
How can we manage ventilators to decrease alarms, avoid misdiagnosing/mistreating asynchrony, and improve patient comfort and outcomes? Dr. Matt Siuba, MD, the “Zenintensivist”, shares with us his tools to decrease sedation and neuromuscular blockade use. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
51:31
September 12, 2021
Episode 83: Paralyze With Fear
As neuromuscular blockade agents have come back into vogue, let’s talk about the big picture. When we understand the repercussions of this intervention, we will paralyze with fear. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
25:37
September 09, 2021
Episode 82: Burnout
Episode 82: Burnout  What role do constant poor patient outcomes play in the pandemic of ICU staff burnout? What if we had a system that supported staff to practice evidence-based medicine? Would a more humane environment and process of care improve our morale? Would improved patient outcomes support staff retention? Liz McQueen, BSN, RN, shares with us how her flame has been rekindled. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
41:24
August 30, 2021
Episode 81: Choose Wisely
How does the choice to automatically sedate every patient on a ventilator impact patients for the following weeks, months, and years? Let's dive deeper into how our favorite sedatives change the course of critical illness. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
41:31
August 16, 2021
Episode 80: Big Picture of Propofol
How does propofol affect muscles? The brain? Outcomes? ERRXpodcast host and critical care pharmacist, Adis Keric, BCPS, BCCP, shares with us the big picture of propofol. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
40:46
August 14, 2021
Episode 79: Step Up and Step Forward
Episode 79: Step Up and Step Forward What can happen when a clinician wakes up to the reality of sedation and immobility? ICU revolutionists around the world are stepping up and stepping forward to elevate sedation and mobility practices for their patients. It can take 1 person to make 1 decision and change a patient’s entire life. Hear their success stories! Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
32:41
August 06, 2021
Episode 78: “Never Really Over”
What is it really like to be in a medically-induced coma? As an experienced ICU physiotherapist and war veteran, Aron Welsh provides soul-shaking insight into the graphic trauma of ICU delirium during and after deep sedation. Warning: Mature Audiences Only. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
54:44
July 17, 2021
Episode 77: Start Where You Are
Are lung-protective strategies only implemented when patients are sedated? Is walking on the ventilator safe for the lungs? How do we transition from “sedating to keep patients safe” to “walking to keep patients safe”? Dr. Ali Fazili from the “Awake and Walking ICU” shares with us his expertise.  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
40:57
July 08, 2021
Episode 76: Less Sedation = Less Work
Is it *really* easier to sedate patients? Ultimately, does giving patient delirium and ICU acquired weakness actually decrease staff workload? Travel nurse, Alex, gives us the real deal. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
38:52
June 26, 2021
Episode 75: Communicate. Don't Sedate.
When Jeff Sweat was about to be intubated, what was he told about what was to come? What information did his wife, Sunny Cannon, receive about the risks and reality of deep sedation? Was is it really like to "wake up" 3 weeks later? How have sedation, immobility, and tracheostomy impacted their family? Had they been allowed transparency and autonomy in Jeff's course, what would they have chosen? Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
01:28:27
June 19, 2021
Episode 74: Walk Them To Sleep
What are the main “treatments” or “tools” to prevent and treat delirium? How can we facilitate “quiet nights” without harming patients with sedation? Peter Nydahl, RN, MScN, PhD, teaches us how to walk them to sleep. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
35:08
June 16, 2021
Episode 73: Say It Again: Sedation is NOT Sleep
We habitually lie to ourselves and our patients' families when the word “sleep” leaves our tongues in reference to sedated patients. Why is sleep so vital to survival in the ICU? What prevents our patients from preserving their sanity and cognitive function? What has COVID taught us about the role of sleep in the ICU? Dr. Margaret Pisani, intensivist and sleep researcher, ties it all together for us. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
36:40
June 11, 2021
Episode 72: Military Veterans and Delirium
Why is baseline PTSD a risk factor for post-ICU PTSD? What does delirium look and feel like for war veterans? Why should the ICU community understand what veterans have experienced before and during the ICU? Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
43:41
June 11, 2021
Episode 71: What “Fight To Survive” Truly Means
When an ICU team started discussing end-of-life with 31-year-old Megan Wakley’s family, they fought to have her transferred to the “Awake and Walking ICU”. When research shows that the less sedation used and the more mobility performed the less likely patients are to die, what did that mean for Megan Wakely? She shares her story of surviving and thriving in the ICU. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
50:53
May 27, 2021
Episode 70: Rallying The Troops In The PICU
What specific approaches help rally the troops to bring change to the ICU?  How have other PICU teams cultivated a rich culture of mobility? When an interdisciplinary approach becomes the culture of the PICU, what happens to patient outcomes? Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
22:58
May 19, 2021
Episode 69: Awake and Playing In The PICU
What does it take to inspire a PICU team to keep children on mechanical ventilation awake and playing? Who can bring the change? Hannah Child, a pediatric physiotherapist in the UK, shares with us her team’s evolution and successes. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
35:14
May 15, 2021
Episode 68: PICU UP!
We know that sedation causes and worsens ICU delirium, post-ICU PTSD, post-ICU dementia, and ICU-acquired weakness in adults. The research is vast and compelling. What does this mean for children? What does research reveal about the harm children suffer from drug-induced comas? Is there a different way to treat our children? Can we preserve their futures by changing our practices in the ICU? What will it take to protect our children? Dr. Kudchadkar shares her life-preserving research and practices. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
48:54
May 09, 2021
Episode 67: On to LTACH?
If you were to come out of a medically-induced coma after weeks of delirium and atrophy with a new tracheostomy, only to find yourself unable to hold your head up...would you want to be discharged to an LTACH? Do other countries have LTACHs? Are there other options to survival after the ICU for survivors? Patrik shares with us his experience and role in guiding family and survivors out of the ICU. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
34:08
May 06, 2021
Episode 66: Trach and Peg
Why do tracheostomy rates fluctuate so drastically between ICUs? What is the true reason for so many tracheostomies? What are the long-term effects of tracheostomies? Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
25:20
May 04, 2021
Episode 65: "Create Survivors, Not Victims"
Jeroen Molinger, MSc brings the research to the bedside. He ties together the importance of muscle maintenance, nutrition, and how to create survivors not victims. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
32:57
April 20, 2021
Episode 64: Nutrition During Critical Illness
What role does nutrition play in improving outcomes in the ICU? How can we help preserve muscle through appropriate nutrition during critical illness? Jeroen Molinger, MSc continues to upgrade our approach to critical care through exercise physiology. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
35:29
April 16, 2021
Episode 63: Muscles Matter
Why is ICU-acquired weakness an independent predictor of mortality? What role does muscular atrophy play in multi-organ failure? When we unnecessarily sacrifice muscles for other organs, how badly do we damage patients’ chances to survive and thrive? Jereon Molinger, MSc, brings eye-opening information to the discussion. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
39:49
April 12, 2021
Episode 62: Patient and Families Have the Right to Know the Risks
We say we respect patient autonomy. We provide patients or families informed consent prior to intubation. Should patients and families be warned of the risks and repercussions of sedation and immobility? When sedation is nonessential, should patients be given the choice to be comatose or awake and moving? Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
09:32
April 09, 2021
Episode 61: "You Can't Sedate Away Delirium"
What barriers do we have in our ICU culture that prevent us from appropriately addressing delirium? What can we do to foster a better approach to helping delirious patients that are difficult to care for? Dr. Swamy gets real as we discuss the reality of delirium from our side of the bed. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
46:22
April 07, 2021
Episode 60: "Just Let Them Sleep"
For decades we have sedated patients with the belief that it is more humane to “sleep” through critical illness. Survivors have told us their experiences were not “sleep” to them. What do neurologists and researchers say about the quantity and quality of sleep during medically-induced comas? Dr. Williams Roberson shares with us her research and invaluable insights into sedation and sleep. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
36:40
April 01, 2021
Episode 59: One Nurse Bringing Change to a Hospital System
How can 1 nurse make bring the change? What can happen when a team catches the vision? How can a team transition their culture from deep sedation and immobility to awake and walking? Nora tells us about igniting her team's fire and the changes they are celebrating. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
34:24
March 26, 2021
Episode 58: Deadly Treatment for a Deadly Virus?
Louise, ACNP, has dedicated her career to preserving lives in the Awake and Walking ICU. So what was it like for her to have her own loved one die from sedation and immobility? She tells it like it is and gives us a sobering insight into both sides of the bedside during COVID19. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
01:05:29
March 19, 2021
Episode 57: The Shock of Working in a "Normal ICU"
When all you’ve ever known is walking patients on ventilators, what is it like to enter a time machine and go back to sedation and immobility? What did Tara learn taking care of COVID19 patients outside of her “Awake and Walking ICU”? She shares with us her reaffirmed empowerment to change patients’ outcomes through evidence-based practice. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
28:38
March 14, 2021
Episode 56: Minding Your Own Business
What does it mean to you to be able to toilet yourself? What happens to patient dignity when they are deprived of the capacity to “mind their own business”? Rachel shares with us what is happening to patients even when they are not on mechanical ventilation. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
29:15
March 09, 2021
Episode 55: Walking in ICUs Around the World
Where in the world do patients walk on ventilators and ECMO? Providers from 22 countries share with us their experiences with helping patients walk home from the ICU. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
39:33
February 25, 2021
Episode 54: Back To Harmful Practices From the 90's
After decades of research revealing the price patients pay from benzodiazepines, where are we now in the ICU? Dr. Wes Ely and Brenda Pun share with us the latest COVIDD study and how COVID19 patients are being cared for around the world. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
32:17
February 05, 2021
Episode 53: ICU Early Walking with Heidi Engel
How do we bring changes to the ICU? What barriers impede the progress of our culture? Heidi Engel, PT, DPT, shares with us her continuous journey to humanizing her ICU. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
01:04:06
November 30, 2020
Episode 52: Haunted Beyond the ICU
What truly happens during delirium? When do the hallucinations and terror stop? Survivors give us a sobering reality check of what caused the deep psychological trauma during their ICU stays and how their lives are forever impacted. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
16:42
October 25, 2020
Episode 51: Post-ICU PTSD: Fact vs. Fallacy
What does research reveal about the most common contributing factors of post-ICU PTSD? Does sedation prevent or inflict trauma? Dr. Jackson shares with us his decades of research and experience with post-ICU PTSD. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
36:13
September 19, 2020
Episode 50: The Reality of Post-ICU PTSD
What causes Post-ICU PTSD? What is it like to live with this trauma? How does it impact life after the ICU? Spencer Freeman shares with us intimate insight into living with Post-ICU PTSD. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
01:07:41
August 31, 2020
Episode 49: The Cost of Rot
How do Hospital Acquired Pressure Injuries (HAPI) impact patient outcomes and quality of life? How can they be better prevented? Cami, our wound care specialist, shares with us penetrating insight into the reality of rotting in the ICU. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
20:13
July 12, 2020
Episode 48: What is An "Awake and Walking ICU" Q&A
What do you want to know about the Awake and Walking ICU? Join the facebook group, "Walking Home From the ICU Discussion Group".  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
01:00:32
July 10, 2020
Episode 47: Change Practices to Change Lives
What does an awake and walking ICU patient look like walking back into the pulmonology clinic? Dr. Shilling shares what this process has meant for his practice in the clinic. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
18:40
June 28, 2020
Episode 46: Waking Up After Decades of Sedation
What was it like for a seasoned ICU nurse with decades of valuable experience to completely change their sedation practices? What was it like to then re-enter a “normal” environment and strive to continue the best practice? Paula shares with us her personal shock and conversion. Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
34:34
June 19, 2020
Episode 45: Physical Therapy In the ICU During COVID19
What roles do physical and occupational play in helping COVID19 patients survive and thrive? How have they changed their approaches during the challenges of COVID19? Why should we never remove their therapies from ICU care?  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
23:22
June 11, 2020
Episode 44: Walking Home From the ICU after COVID19
When 69-year-old Dr. Ken Hurwitz was intubated for COVID19, how was his life saved and even preserved? After 3 weeks on the ventilator, why was he able to walk away and go straight home?  Photos, transcriptions, and citations at: www.DaytonICUConsulting.com @DaytonICUConsulting
47:39
June 06, 2020
Episode 43: Trapped In My Body As An ARDS Survivor
Now that we know what happens to patients after sedation and immobility, do we know what it is really like? Do we understand what happens to patient dignity, autonomy, and identity when they lose control of their bodies? Eileen Rubin shares with us what it was like as a 33-year-old trial attorney to wake up and not be able to lift a finger. www.DaytonICUConsulting.com @DaytonICUConsulting
48:54
June 05, 2020
Episode 42: The Power of Nursing Care Against COVID19
When good nursing care is not possible during a pandemic, what happens to patient outcomes? Makenzie tells her tales as an ICU nurse in NY as we explore the role nursing care plays in saving and restoring lives. www.DaytonICUConsulting.com @DaytonICUConsulting
15:24
June 03, 2020
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02:46
May 19, 2020
Episode 41: Crisis Culture During COVID19
What happens to our culture and practice when patient volumes and needs exceed our ICU capacity? How does this impact short and long-term outcomes? Dr. Dixie Harris shares with us the reality of ICU care in NY during the COVID19 pandemic.  www.DaytonICUConsulting.com @DaytonICUConsulting
35:09
May 17, 2020
Episode 40: Cultural Revolution
What was it like in the early phases of the “Awake and Walking ICU?” How was the new practice introduced? How was the culture revolutionized in spite of opposition? Who rejected the change? How did nurse Patty go from incredulous to emphatic? www.DaytonICUConsulting.com @DaytonICUConsulting
15:37
May 16, 2020
Episode 39: Ethical Turmoil
What is it like to be “born” into an awake and walking ICU and then be immersed in a different culture? Jim shares with us his culture shock and ethical turmoil as he strives to maintain his best practice in a new environment. www.DaytonICUConsulting.com @DaytonICUConsulting
40:37
May 13, 2020
Episode 38: “THEY’RE AWAKE?!?”
What is it like to jump into an awake and walking ICU as a travel nurse? Alex shares with us her first shock and impressions upon entering a different culture. She teaches us the changes and wisdom her practice has gained. www.DaytonICUConsulting.com @DaytonICUConsulting
10:05
May 11, 2020
Episode 37: Culture Shock
How much of our practice is driven by culture vs. evidence? What role does ICU culture play in our perspective, knowledge, and patient outcomes? How often do we dare to ask “Why?”, “What if?” or, “Why not?”       www.DaytonICUConsulting.com @DaytonICUConsulting
09:43
May 11, 2020
Episode 36: We Need To Talk
What if we expected to be able to communicate with all patients on mechanical ventilation? How would that impact our practices? What role does communication play in patient survival and outcomes? www.DaytonICUConsulting.com @DaytonICUConsulting 
33:41
May 09, 2020
Episode 35: Mobility is EVERYONE’S job
What happens after patients are sedated and immobilized for weeks? What will the rehabilitation process for COVID19 survivors be like? How long will it take for them to be able to sit, stand, and walk again? Christiane Perme, the post-ICU rehabilitation specialist, shares with us how to prevent such outcomes and help patients thrive in their lives again. www.DaytonICUConsulting.com @DaytonICUConsulting
38:40
May 05, 2020
Episode 34:Recommendations From a 4-Time Ventilator Survivor
Ann Bannon was intubated four times and awake on the endotracheal tube and ventilator for months. She gives us valuable insight into how to help the new flood of ventilated patients. www.DaytonICUConsulting.com @DaytonICUConsulting
19:08
April 02, 2020
Episode 33: COVID19- The Domino Effect
What can we do to improve mortality in the midst of a pandemic? As times have changed, our practices must change as well. www.DaytonICUConsulting.com @DaytonICUConsulting
08:10
March 24, 2020
Episode 32: Delirium Day
In commemoration of Delirium Day, it is most appropriate to hear from one of the leading delirium experts, Dr. Sharon Inouye! She shares with us her professional and personal experiences with delirium in all aspects of hospitalization.  www.DaytonICUConsulting.com @DaytonICUConsulting
38:12
March 11, 2020
Episode 31: Nurse Manager
Nancy tells us about her transition to the awake and walking ICU as a nurse manager. She explains the nurse manager’s role in preserving a culture of humanity in the ICU. She shares with us how sedation cessation saved her own mother’s life.  www.DaytonICUConsulting.com @DaytonICUConsulting 
23:28
March 11, 2020
Episode 30: Speech Language Pathologists
Lydia, CCC-SLP, shares with us the vital role speech therapy plays in helping patients get back to their lives. She explains how awake and walking enables patients to resume eating sooner and preserves cognition. The utilization of speech therapy is explained and applied in ways that the ICU world has never understood before.  www.DaytonICUConsulting.com @DaytonICUConsulting
27:55
March 11, 2020
Episode 29: Occupational Therapists
How does occupational therapy get to be utilized when patients are awake and walking on the ventilator? What role does occupational therapy play in preserving physical and cognitive function during critical illness? How has this enhanced role impacted the fulfillment Merrill, MOT, finds in his career? www.DaytonICUConsulting.com @DaytonICUConsulting
13:26
March 11, 2020
Episode 28: Pharmacists
Kathryn, BCCCP, tell us of her culture shock coming to the awake and walking ICU after years in units around the country. She tells about the role pharmacists play in delirium prevention and preservation of function in the ICU. She shares how this shift in focus has enhanced her job satisfaction.  www.DaytonICUConsulting.com @DaytonICUConsulting
30:56
March 10, 2020
Episode 27: Physicians
Dr. Badke, MD, shares what it was like to shift perspective and culture as a new intensivist in the awake and walking ICU. He explains what role the physician plays in helping patients walking home after the ICU.  www.DaytonICUConsulting.com @DaytonICUConsulting
12:46
March 10, 2020
Episode 26: Nurse Practitioners
What does it mean to be the steward of patient outcomes? Louise, ACNP, explains how nurse practitioners are guardians of delirium prevention and preservation of function for her patients in the ICU.  www.DaytonICUConsulting.com @DaytonICUConsulting
24:58
March 10, 2020
Episode 25: Respiratory Therapists
Respiratory therapists are key to helping patients walk on the ventilator. Cash, RRT, shares his tips and secrets to walking and even showering patients on the ventilator. He reveals how having patients awake and walking has impacted his ICU career. www.DaytonICUConsulting.com @DaytonICUConsulting
17:31
March 10, 2020
Episode 24: Physical Therapists
What is it like for physical therapists that get to do more than a passive range of motion with patients on ventilators? Physical therapists in the awake and walking ICU save lives and enable patients to have their lives back after discharge. Angela Hallstrom, DPT tells us how they do it. www.DaytonICUConsulting.com @DaytonICUConsulting
18:22
March 10, 2020
Episode 23: Registered Nurses
What is it like as an RN to care for intubated patients on the ventilator that are AWAKE and WALKING? Brandy, RN shares with us why she is passionate about keeping brains and bodies strong during critical illness. She reveals how humanizing the ICU has impacted her career.  www.DaytonICUConsulting.com @DaytonICUConsulting
23:17
March 08, 2020
Episode 22: Interdisciplinary Teamwork
Patients cannot walk out of the ICU without the efforts and expertise of each discipline. What role does each discipline play in returning patients to their lives? www.DaytonICUConsulting.com @DaytonICUConsulting
04:06
March 08, 2020
Episode 21: What We've "Always Done" Isn't Always Right
How did this ICU get so off the grid? Decades before the research and in a generation of paralytics and benzodiazepines, a nurse saw a problem and had a vision. Polly Bailey, ACNP, shares with us her journey to building an awake and walking ICU. www.DaytonICUConsulting.com @DaytonICUConsulting
36:01
March 08, 2020
Episode 20: A Chance To Say Goodbye
Though avoiding sedation and mobility decreases mortality, death is not always avoidable. How does being awake and mobile during critical illness impact your last mortal moments? What does it look like to have a chance to say goodbye? www.DaytonICUConsulting.com @DaytonICUConsulting
06:47
March 08, 2020
Episode 19: Walking On ECMO Part 2
Tyler Lintz was admitted for severe septic shock, pneumonia, and ARDS. He eventually needed ECMO but was still allowed to keep walking. Tyler and Amber tell us how he returned to being a firefighter 3 months after ECMO. www.DaytonICUConsulting.com @DaytonICUConsulting
32:01
March 08, 2020
Episode 18: Walking On ECMO Part 1
Tyler Lintz was admitted for severe septic shock, pneumonia, and ARDS. He eventually needed ECMO but was still allowed to keep walking. Tyler and Amber tell us how he returned to being a firefighter 3 months after ECMO. www.DaytonICUConsulting.com @DaytonICUConsulting
24:21
March 08, 2020
Episode 17: Walking On The Ventilator For 17 Days
Joan Johnston was admitted for ARDS and remained on the ventilator for 17 days. She shares with us what it was like to be awake, walking, and even showering while intubated. www.DaytonICUConsulting.com @DaytonICUConsulting
18:31
March 06, 2020
Episode 16: Defending the Defenseless
James was admitted for severe mycoplasma pneumonia that turned into mild ARDS. His downs syndrome and autism inspired the ICU team to get creative to keep him awake and walking on the ventilator. His journey straight home moves us to reconsider our standard practices. www.DaytonICUConsulting.com @DaytonICUConsulting
06:18
March 05, 2020
Episode 15: Walking Through Severe ARDS
Bryan Carter was admitted for severe pneumonia that became severe ARDS. He was allowed to be awake and walk on the ventilator until he was proned. When he was able to be supine he was right back on his feet. He shares with us his story and how his treatment impacted his outcomes. www.DaytonICUConsulting.com @DaytonICUConsulting
34:40
March 05, 2020
Episode 14: Different Treatment Different Outcomes
If we treated patients differently, would their outcomes be different? What if patients never stopped walking during critical illness? One ICU dared to ask. www.DaytonICUConsulting.com @DaytonICUConsulting
23:08
March 04, 2020
Episode 13: Loved Ones Are Survivors Too Part II
Caregivers also leave ICU with high rates of PTSD and long-term life impacts. Mike Maranhas shares his side of his wife's ICU stay and recovery. www.DaytonICUConsulting.com @DaytonICUConsulting
27:30
March 03, 2020
Episode 12: Loved Ones Are Survivors Too Part I
Caregivers also leave ICU with high rates of PTSD and long-term life impacts. Mike Maranhas shares his side of his wife's ICU stay and recovery. www.DaytonICUConsulting.com @DaytonICUConsulting
22:06
March 03, 2020
Episode 11: Rehabilitate Rehabilitation
When we send patients to LTAC or SNF to relearn how to walk, what is that like? Susi Rimkus, DNP, shares with us her experience with rehabilitating rehabilitation. www.DaytonICUConsulting.com @DaytonICUConsulting
31:58
March 01, 2020
Episode 10: I Can't Move
What is it like to wake up with less physical capacity than a newborn? What is it like to be sent to LTAC with no expectations of returning home? When patients have not moved for weeks+, what is the journey to recovery like? How long does it take? What are the psychological effects on survivors and loved ones? Jim and Cheryl Rettinger give us an inside look. www.DaytonICUConsulting.com @DaytonICUConsulting
29:02
February 29, 2020
Episode 9: The Big Picture of Immobility
What happens down the road to patients that are on bedrest during their time on the ventilator? Is there another way? Let's put it into the big picture. www.DaytonICUConsulting.com @DaytonICUConsulting
10:14
February 29, 2020
Episode 8: Living With Post-ICU Syndrome Part II
ICU Survivor, David Burrows, shares his experience of weeks of sedation and the delirium and ICU-acquired weakness that followed. He gives us insight into the reality of his new life with the post-ICU syndrome. www.DaytonICUConsulting.com @DaytonICUConsulting
35:50
February 28, 2020
Episode 7: Living With Post-ICU Syndrome Part I
ICU Survivor, David Burrows, shares his experience of weeks of sedation and the delirium and ICU-acquired weakness that followed. He gives us insight into the reality of his new life with the post-ICU syndrome. www.DaytonICUConsulting.com @DaytonICUConsulting
16:50
February 28, 2020
Episode 6: Broken Brains
Survivors tell us what "cognitive deficits" really look like and the impact they have on their function and lives. www.DaytonICUConsulting.com @DaytonICUConsulting
09:22
February 27, 2020
Episode 5: The Big Picture of ICU Delirium with Dr. Wes Ely
Dr. Wes Ely, the creator of the CAM scoring tool and the ACDEF Bundle, shares with us the realities and consequences of ICU delirium. www.DaytonICUConsulting.com @DaytonICUConsulting
29:16
February 25, 2020
Episode 4: Sedation is NOT Sleep
68% of nurses believe sedation is for patient comfort. Survivors of prolonged tell us the reality of how "sweet" their sedation dreams really were. www.DaytonICUConsulting.com @DaytonICUConsulting
20:27
February 23, 2020
Episode 3: DNS= Do NOT Sedate Me
Susan East is a three times survivor of ARDS. She tells us why she sought legal protection against sedation after her first experience with ARDS.  www.DaytonICUConsulting.com @DaytonICUConsulting 
30:57
February 19, 2020
Episode 2: How Did We Get Here??
Is sedation always a necessity or a habit with history? Dr. Terry Clemmer, one of the founders of critical care, shares the evolution of mechanical ventilation and sedation culture he witnessed during his 50 years of critical care medicine. www.DaytonICUConsulting.com @DaytonICUConsulting
34:40
February 16, 2020
Episode 1: Start Here
Kali shares the variation in sedation and mobility practices she witnesses in critical care throughout the USA. ICU survivors changed her perspective and belief in what is right and best for patients.  www.DaytonICUConsulting.com  @DaytonICUConsulting
09:16
February 01, 2020