Insight on ICU Delirium

To me, it is very scary to take care of a patient on a ventilator. To think that a machine is making the patient breath and keeping them alive is quite intimidating. I am sure it is a scary sight to witness a delirious patient while in an intense environment. Having to monitor critical patients when sedation vacation is happening could be very frightful especially when they start trying to pull out tubes, IVs, and foleys. I am absolutely for the mnemonic THINK solution. Where the components within the pneumonic is looked at when a patient is delirious. Toxic, Hypoxia, Immobility, Non-pharmacological interventions (clustering care, having hearing aids and glasses available) and the Potassium level are the most important factors that could tell you why a patient is delirious. Making sure these factors are not causing the patients delirium is very important. The video of the gentleman who was in the hospital for 22 days was very eye-opening. He stated he can remember these vivid nightmares like it actually happened. He remembers the 15 IVs in the constant worrying that he continues to go with on the daily basis. To be on paralytic and sedatives for so long can cause cognitive impairment. This gentleman is living with post-traumatic stress disorder (PTSD) due to the flashbacks he experiences of the nightmares he endured during his time in the ICU. He also stated that his family wanted to be involved more than they were. This is a scary situation and I am surprised that family members would want to be more involved but I can understand because it could be a scary being in an environment and seeing their loved ones in a situation like this. Study show that early ambulation in the first three days decreases delirium. So the study shows this I think it needs to be done. Evidence-based practice is done because of the best patient outcomes. One hospital decreased the amount of sedatives and paralytics and noticed that 15% of their patients were less likely to die and their length of stay was shortened by four days. Combining the decrease in the amount of drugs given an early ambulation can decrease delirium in the ICU patient. I also agree that follow-up care at home should be done because there’s no way of knowing if the patient had an out of body experience or the constant state of worry and fear while they were under the strides. Being able to identify the psychological stresses and intervene can help them get back to life they were living before the incident.