When her sister was in and out of intensive care last year, Theodora Peters noticed she no longer had to push so hard for information about her sister’s condition and treatment, or to stay by her bedside after visiting hours.”There seemed to finally be recognition that we were part of the team,” Peters said about the way the medical staff treated her and her sibling. “There was recognition we all needed to work together to get the best outcomes.”ADVERTISINGFor decades, hospital intensive-care units focused on facilitating the care provided by doctors and nurses to the gravely ill, while access was limited for patients’ families, partly so they wouldn’t get in the way. That’s beginning to change under a new approach known in medical circles as “family-centered care” that’s gaining traction in ICUs as hospitals look for ways to improve care and cut costs.
This guide contains advice and information about intensive care. It tells you how critical illness may be treated and what recovery may be like. Not every patient will experience all of these things, but they are more likely to if they have been in intensive care for more than a few days. Most of this guide is written for patients but there is a section specifically for relatives and visitors. By reading the guide, relatives will learn what a patient’s recovery may involve and it will give them the answers to some of the questions they may have.Recovery is often a long and slow process. To begin with, patients may not feel up to reading this information, so if you are a relative, please keep hold of this booklet and pass it on when the patient is ready.One of the scariest things about having a critical illness is not knowing what’s going to happen. This section covers many of the questions that patients and relatives often have following a critical illness. It tells you what may happen and where you can find out more information. Each section covers a different stage of the process of treatment and recovery.This guide has been written by people who have either been treated in an intensive care unit or are close relatives of someone who has. It has also been reviewed by a wide variety of intensive care professionals.
When his fever spiked, he thought someone was setting him on fire. When orderlies slid him into an MRI, he thought he was being fed into an oven. Frequent catheter changes seemed like sexual abuse. Dialysis? He thought someone was taking blood out of a dead woman’s body and injecting it into his veins.The horrifying, violent hallucinations plagued David Jones, now 39, during a six-week stay in the intensive care unit at Chicago’s Northwestern Memorial Hospital — and for months after he was discharged. He thought he was going crazy and felt very alone.He wasn’t.
A growing number of patients are being discharged from intensive care units, cured of the critical illness that put them there but facing a new and potentially debilitating condition — ICU-acquired weakness.Intensive care patients are known to lose muscle mass and function for many reasons, ranging from prolonged immobilization, to the effects of ICU treatments such as mechanical ventilation to the critical illness itself.While the mechanisms of muscle atrophy (loss) and function during an ICU stay have been studied well, little research has been conducted into the cellular and molecular mechanisms responsible for recovering muscle strength over the long-term.
Source: Many ICU patients trade critical illness for new illness, ICU-acquired weakness: Sustained muscle atrophy in the long term is result of impaired regrowth, associated with decrease in satellite cells — ScienceDaily
Silvana Breur, who lives in Rotterdam, The Netherlands, is thankful.In February, 2003, Silvana went to the hospital for her third surgery on her jaw. The previous unsuccessful surgeries were in July, 2002, and August, 2002. At that time, the then thirty-nine year old Silvana hoped that this would end her medical problems.Her surgeon told her that she would be in the ICU overnight. But that was not to be. Silvana had problems with her lungs coupled with difficulty breathing. Three days after, a trach was performed at the urging of Silvana’s mother.Silvana was in a coma for fourteen days. She required at least one chest tube. She was in the ICU for three weeks. She spent a couple of nights out of the ICU and then asked her doctors if she could go home early. Since she had a of family help, she was released.When she came home, Silvana was so weak; she could not dress herself and people came into the house to help her with the cleaning. Though she wanted physical therapy, she received none.Six months after getting ARDS, Silvana thought she could return to her part time job as a receptionist. But it was too soon. It took a full year to recover. She was diagnosed with diabetes afterwards. She has lost the feeling in some of her fingers and at times, she feels disoriented.
AbstractTwo hundred fifty intubated patients were followed during the first 48 h after intubation in order to identify potential risk factors for developing pneumonia within this period. Thirty-two developed pneumonia during this time. Univariate analysis established that large volume aspiration, presence of sedation, intubation caused by respiratory/cardiac arrest or decrease in the level of consciousness, emergency procedure, cardiopulmonary resuscitation (CPR), and Glasgow coma score < 9 were significantly associated with pneumonia. In contrast, prior infection and prior antimicrobial use were associated with a protective effect. Presence of subglottic secretion drainage and 15 other variables had no significant effect. Multivariate analysis selected CPR (odds ratio [OR] = 5.13, 95% confidence intervals [CI] = 2.14, 12.26) and continuous sedation (OR = 4.40, 95% CI = 1.83, 10.59) as significant risk factors for pneumonia, while antibiotic use (OR = 0.29, 95% CI = 0.12, 0.69) showed a protective effect. Our findings emphasize that risk factors for pneumonia change during the intubation period, and preventing pneumonia requires a combined approach
When Lygia Dunsworth was sedated, intubated and strapped down in the intensive care unit at a Fort Worth hospital, she was racked by paranoid hallucinations:Outside her window, she saw helicopters evacuating patients from an impending tornado, leaving her behind. Nurses plotted to toss her into rough lake waters. She hallucinated an escape from the I.C.U. — she ducked into a food freezer, only to find herself surrounded by body parts.Mrs. Dunsworth, who had been gravely ill from abdominal infections and surgeries, eventually recovered physically. But for several years, her stay in intensive care tormented her. She had short-term memory loss and difficulty sleeping. She would not go into the ocean or a lake. She was terrified to fly or even travel alone.Nor would she talk about it. “Either people think you’re crazy or you scare them,” said Mrs. Dunsworth, 54, a registered nurse in the Dallas-Fort Worth area. In fact, she was having symptoms associated with post-traumatic stress disorder
AbstractBackground: Decreased consciousness is a common reason for presentation to the emergency department (ED) and admission to acute hospital beds. In trauma, a Glasgow Coma Scale score (GCS) of 8 or less indicates a need for endotracheal intubation. Some advocate a similar approach for other causes of decreased consciousness, however, the loss of airway reflexes and risk of aspiration cannot be reliably predicted using the GCS alone.Study Objective: A survey of all poisoned patients with a decreased GCS who were admitted to an ED short-stay ward staffed by experienced emergency physicians, to establish the incidence of clinically significant aspiration or other morbidities and endotracheal intubation.Methods: A prospective, observational study was conducted of all patients admitted to the ED short-stay ward with a decreased level of consciousness (GCS < 15).Results: The study included 73 patients with decreased consciousness as a result of drug or alcohol intoxication. The GCS ranged from 3 to 14, and 12 patients had a GCS of 8 or less. No patient with a GCS of 8 or less aspirated or required intubation. There was one patient who required intubation; this patient had a GCS of 12 on admission to the ward.Conclusions: This study suggests that it can be safe to observe poisoned patients with decreased consciousness, even if they have a GCS of 8 or less, in the ED.
I woke up to find myself in ICU. How I got there I still have no memory of to this day. I personally felt fine. Couldn’t understand why I was still in hospital. Nobody told me anything.I was given medication (which I took), because I assumed someone would tell me why I was suddenly on so many new tablets. I can’t remember anyone sitting down & talking to me,about what had happened.My husband told me how I ended up in ICU, but no-one told him anything about the experience of ICU either.What no-one, not even my doctor’s, mentioned was the side effects I was likely to have. Mental as well as emotional side effects that is.For instance no-one told me how WEAK I would be.Did you know you can lose approx. 2% of body muscle per day in ICU.Why? I don’t know, does anyone?ANGER because you feel unable to take your 2nd chance at life.You loose WEIGHT when your in ICU. I lost 2 stone.Did you know your NAILS (hand and toe) stop growing for a while.CONCENTRATION & INTERESTS take a long time to come back. MEMORY LOSS, & HAIR LOSS is another example no-one tells you about.Lack of SLEEP, & APPETITE.You could end up with DEPRESSION &/or PTSD.