The Intern At Work: Internal Medicine 101. Biting the Bullet - Sedation in the ICU
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Aug 8, 2021 Exploring the history and principles of sedation in the ICU, including terminology and measurement methods. Discussing sedation protocols, common sedative agents, and associated risks. Exploring sedation practices, utilization of Acetamine for patient transport, and shift towards lighter sedation objectives. Emphasizing the need to assess outcomes like self-extubation and PTSD in survivors.
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Analgesia First, Lighter Sedation
- Analgesia-first and lighter sedation are core ICU principles that reduced harms from deep sedation practices.
- Targeting light sedation improves outcomes like shorter ICU stay and less tracheostomy need.
Use Validated Sedation Scales
- Use validated sedation scales like RASS or SAS to communicate sedation depth clearly at your institution.
- Apply the scale your ICU uses consistently to guide bedside titration.
BIS Is Adjunctive, Not Definitive
- Objective monitors like the BIS can help when patients are paralyzed but have reliability limits.
- BIS readings may be contaminated by EMG and should not replace clinical assessment.