One of my colleagues, Rachel Williams (@rawbubbles9), and her team are working very hard to get the patients moving and then hopefully home sooner whilst on the wards. This involves a number of methods including reindeer!

My contacts at the American Association of Critical Care Nurses put me in touch with Jill Guttormson, the author of Nurses’ Attitudes and Practices Related to Sedation: A National Survey.  It seems we are still not great at doing the sedation hold and this is an attempt to find out why. Some interesting points raised I think.

Paul uses this A-Z checklist for every patient on the ward round. Here he takes us through it to add to our understanding of some of the issues we need to consider when assessing our patients.

In this episode Bryan discusses some of the issues with pain, agitation and delirium with the pharmacist Komal Pandya. 

We all try to understand how to help our patients and sometimes get it wrong, but lets continue to work hard to improve.

Jakob SM, Ruokonen E, Grounds RM, et al. Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. Jama. 2012;307(11):1151-60.

https://www.ncbi.nlm.nih.gov/pubmed/22436955

Mehta S, Burry L, Cook D, et al. Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: a randomized controlled trial. Jama. 2012;308(19):1985-92.

https://www.ncbi.nlm.nih.gov/pubmed/?term=mehta+2012+sedation+interuption

Pandharipande PP, Pun BT, Herr DL, et al. Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial. Jama. 2007;298(22):2644-53.

https://www.ncbi.nlm.nih.gov/pubmed/18073360

Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. Jama. 2009;301(5):489-99.

https://www.ncbi.nlm.nih.gov/pubmed/?term=sedcom+2009

Shehabi Y, Howe BD, Bellomo R, et al. Early Sedation with Dexmedetomidine in Critically Ill Patients. The New England journal of medicine. 2019;380(26):2506-17.

https://www.ncbi.nlm.nih.gov/pubmed/31112380

Sue Brierley Hobson is a dietitian in Wales and was part of a recent study looking into the efficacy of volume based feeding. We chat about this and the PERFect protocol.

Safety and efficacy of volume-based feeding in critically ill, mechanically ventilated adults using the 'Protein & Energy Requirements Fed for Every Critically ill patient every Time' (PERFECT) protocol: a before-and-after study.

Dr Paul Hughes Webb chats with me about how we define aneamia and what we can do about it for our patients.

The last podcast from the NTI2019 and this was with other practitioners who all use Social Media to help others learn. This was a great conversation and a great way to wrap up. Thanks NTI I had a great time.

Maureen A Seckel chatted about some of the studies she had noticed over the last year related to sepsis and I then went on to discuss proning with Danette Mitchell and how she had implemented an education program in her unit.

Michael H Ackerman and Dr. Tom S. Ahrens chat with me about some of the recent changes in sepsis management. (Spoiler alert- not many to talk about!)

Brandy Venable and I discuss how we can utilise QR codes to create just in time learning for the staff in critical care.

What are the heamodynamics we should be concerned with and should we be measuring them?

Jason developed life threatening sepsis after catching the H1N1 virus. He spent a lot of time in ITU, but then decided to become an ITU nurse. This gives him a unique perspective.

@onlyintheicu is the twitter handle of a nurse who has experienced some mental health issues including an attempted suicide. She and I  discuss the implications of this increasing problem for ICU staff

Sometimes handing over our patients problems to another health care provider can be done badly not getting us the response we need. How can we improve that?

I finally met Sean Dent who posts very regularly on Facebook and Instagram and is also someone I follow and interact with on Twitter. We also chat with Sarah Wells who is trying to help new and junior nurses by supporting them via social media.

Nicole Kupchik presented some of the key studies of the last year. Here she covers some of them for us with Anna Rodriguez

Ruth Kleinpell, Teresa Rincon and Denise Ward chat with Bryan Boling about the development of Telehealth in The USA. 

Nicole presented on the implications of genetics on medicine management with our patients. Anna Rodriguez chats to her about it. Oh, and we finish with a Game of Thrones chat (no spoilers)

Jon White chats with Nancy and Gayle about what makes staffing levels safe and how we can ensure that we keep our staff healthy,

Bryan Boling chats with Daniel and Brandi about some of the liver problems our patients can have at the #NTI2019

Megan (@nursenoodles) is president elect at the conference this year and in this episode she chats with Jon (@technursejon) about her upcoming work, social media and how she got that Twitter name!

One of the reasons our patients cannot sleep is because of all the noise we make at night. Is the answer just to make less noise? How can we do this? Will it make a difference? I chat with Julie Darbyshire (@JLDarbyshire) whose PhD is on this subject to find out more. 

There are now Advanced Practitioners appearing across the world of nursing, physiotherapy and paramedicine to mention just a few.

Here Bryan and I chat with Ruth Kelinpell who is the President of the Society of Critical Care Medicine about how these roles developed, what is happening today and what may happen in the future.

Lots of interesting points raised and some great food for thought.

I was lucky enough to be able to join Tanj and Dale Needham in this conversation at the ICS State of the Art conference 2018 in London. We discuss some of the ongoing issues with delirium in the critical care patient and how we might help them in prevention.

Palliative Care in the ICU