Critical Matters 2018 PADIS Guidelines
Jun 12, 2019
John Devlin, a Professor at Northeastern University and lead author of the 2018 SCCM guidelines, dives into critical topics affecting ICU patients. He discusses the updated guidelines for pain, agitation, sedation, and sleep disruption, emphasizing individualized care. The conversation highlights innovative pain management strategies and the importance of early mobilization and sleep hygiene for recovery. Devlin also underscores the collaborative nature of care and how empowering patients can revolutionize ICU practices.
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Expanded Focus in 2018 Guidelines
- The 2018 guidelines expand focus from pain, agitation, and delirium to also include immobility and sleep disruption.
- They emphasize longer-term, post-ICU outcomes such as cognitive function and physical recovery beyond traditional ICU outcomes.
Include Patients in Guideline Development
- Involve patients and non-experts as collaborators to shape guidelines and define meaningful outcomes.
- Consider patient preferences like sedation depth individually, recognizing variability in patient comfort.
Pain Management Priorities
- Always assess pain first in ICU patients, using self-report or behavioral scales if patients cannot communicate.
- Consider multimodal analgesia including opioids, acetaminophen, ketamine, neuropathic pain meds, and non-pharmacologic approaches like cold or massage therapy.
