CTSNet Podcasts podcast

The Cardiac Recovery Room: Early Mobility, Verticalization, and Delirium, Oh My!

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In this episode of The Cardiac Recovery Room, moderator Amanda Rea, a nurse practitioner and Lead of Advanced Practice and Clinical Program Manager in the Division of Cardiac Surgery at the University of Maryland St. Joseph Medical Center in Townson, MD, USA, spoke with Kali Dayton, a critical care nurse practitioner, host of the Walking Home From the ICU and Walking You Through the ICU podcasts, and CEO of Dayton ICU Consulting, about early mobility, verticalization, and delirium.  

Chapters

00:00 Intro 

01:04 Patient Philosophy 

02:45 Early Sedation-Delirium Relationship 

05:23 RASS Scale, Sedation 

07:06 Cardiac ICU Patients 

08:35 Lack of Delirium Tracking or Data 

10:56 ROI from Good Care & Data 

14:44 Preventative Approach 

16:16 Convincing Hesitant Adopters 

18:59 Patient Case Study 

21:19 Cultural Paradigm 

24:48 Mobilization 

27:07 Verticalization Beds 

30:03 Gravity on Patient Health 

32:14 Mobility Screening 

33:14 Defining Walking 

34:47 Mobility Responsibility 

36:55 Standardization & Predictability 

38:23 Key Points 

They discussed what an awake and walking intensive care unit (ICU) is, how early mobility and sedation tie in with delirium, and the history of critical care medicine. The conversation also covered the Richmond Agitation-Sedation Scale (RASS) and deep sedation, as well as risk factors for delirium, outdated sedation practices and mobility management, and the importance of having a high reliability environment. Additionally, they explored the ABCDEF bundle and a case study of a patient experiencing delirium. The episode further addressed verticalization beds, walking pads for verticalization, nurse screening tools, and ambulation. 

The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society. 

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