Joanna L. Stollings, PharmD, is a critical care pharmacotherapy expert at Vanderbilt University Medical Center and co-chair of the updated PADIS guidelines. In this engaging discussion, she dives into the crucial updates on managing pain, anxiety, and sedation in ICU patients. Joanna emphasizes the need for improved assessment tools for anxiety and highlights the shift towards dexmedetomidine for sedation. She also explores the advancements in delirium treatment, innovations in alcohol withdrawal management, and the significance of post-ICU care to enhance patient recovery.
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Importance of Treating Pain and Delirium
Treating pain and delirium is crucial in ICU care due to significant negative patient outcomes.
Harper Lee's "To Kill a Mockingbird" is a classic novel that explores themes of racial injustice, childhood innocence, and moral courage in the American South. The story is narrated by Scout Finch, a young girl who witnesses the trial of Tom Robinson, a Black man falsely accused of a crime. Lee's powerful storytelling captures the complexities of race relations in the Jim Crow South, highlighting the prejudice and injustice faced by Black people. The novel's enduring appeal lies in its exploration of universal themes of empathy, compassion, and the importance of standing up for what is right. It remains a powerful reminder of the ongoing struggle for racial equality in America.
In this episode, Dr. Zanotti discussed the Society of Critical Care Medicine “Focused Update on the Clinical Guidelines for the Prevention and Management of Pain, Anxiety. Agitation/Sedation. Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU." This is also known as the PADIS Guidelines. He is joined by Joanna L. Stollings, PharmD, a Board-Certified Pharmacotherapy Specialist and a Board-Certified Critical Care Pharmacotherapy Specialist. Joanna is the Medical Intensive Care Unit (MICU) Clinical Pharmacy Specialist at the Vanderbilt University Medical Center. She also served as vice chair for the PADIS Guideline Focused Update and co-authored the guidelines.
Additional resources:
Society of Critical Care Medicine Focused Update on the Clinical Guidelines for the Prevention and Management of Pain, Anxiety. Agitation/Sedation. Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. PADIS 2025 Update: https://pubmed.ncbi.nlm.nih.gov/39982143/
Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. PADIS 2018 Guidelines: https://pubmed.ncbi.nlm.nih.gov/30113379/
Link to a previous episode of Critical Matters discussing the PADIS 2018 Guidelines: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=635606964
Landing page for the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center: https://www.icudelirium.org/
Books mentioned in this episode:
The Prophet. By Kahlil Gibran: https://bit.ly/4lA2Jhx
Critical Matters 