EMCrit 359 - FoundStab Project - Foundational Stabilization Guideline for Post-Intubation Sedation

Foundational Stabilization: Establishing a Minimum Standard of Care

The M-Crit podcast introduces the concept of foundational stabilization, which aims to establish an absolute standard of care below which the treatment of critically ill patients should never drop. The current state of critical care and resuscitation education in emergency medicine is examined, and the need for a different approach to ensure optimal care is emphasized. The project of foundational stabilization is proposed as a set of guidelines that should be the baseline for all specialties involved in resuscitative care. The goal is to ensure that every patient, regardless of location, receives the minimum level of care defined by these guidelines, with the possibility of exceeding them. The project is introduced with a provisional guideline on post-intubation sedation, which emphasizes the use of propofol over benzodiazepines and the importance of proper pain management. Other guidelines include using an agitation sedation scale for sedative titration, starting with a bolus of pain medication, having continuous capnography for intubated patients, and considering soft restraints for intubated patients in the emergency department.