What Is ICU Delirium? What Should Be Done About It?
ฝัง
- เผยแพร่เมื่อ 5 พ.ค. 2019
- Disclaimer:
the following content is designed as a way to help us better understand what is going on during ICU conversations and patient response. This information is NOT intended to influence anyone to break clinical practice guidelines (CPGs) or institution regulations set forth by the clinical director.
Peer reviewed journals and approved medical documentation remain the standard for changes in patient care.
This content is intended to trigger awareness and interest in understanding clinical principles.
Medicine is not taught, it’s learned.
---
If you have been in rounds on a patient before you have likely heard the nurse and doctor talk about the patients metal status, whether they are alert moving to commands, usually measured on the glascow coma scale.
Why is it so important to have the patients awake?
Main take away
Identify causative drugs and response, evaluate needs and levels
Identify underlying disease processes,
Get the environment changing, Early mobilization, spontaneous breathing and awakening trials (SBT/SAT)
If the patient has glasses/hearing aids get these items to the patient and get them using them.
Get the patient back to normal routines as early as possible in their ICU stay to reduce the time spent in a state of delirium.
www.icudelirium.org
(non sponsored site)
![[FULL EP.14] เซียนหรั่ง สอน มาร์ชจุ จับปูนา ฮากระจาย | เฮ็ดอย่างเซียนหรั่ง | One Playground](http://i.ytimg.com/vi/M8mPjd_T2lo/mqdefault.jpg)
This video needs to be watched at every ICU center! All I was told about my mom was they thought she had that and nothing else which is what made me look up this video.
My delerium hell was 4 years ago but I still remember and tell my story of hell.
Thank you I can tell you really really care, unfortunately many now are not like you. The nurses can drive you nuts too loud too in your face and NOISY if 2 nurses come in and even talk to the patient next to you and between themselves.. I swear they are insane and drive the patients insane when they are trying to sleep or rest. You are wonderful thank you
I was recently kept sedated for about a week and a half after a serious mva. I believe my mix was Oxy, ketamine and fentanyl.
Let me tell you, it was horrifying. The hallucinations were god-awful. I did not know what had happened to me at first, and the nurses and fam had to repeatedly tell me that it was a car crash. I kept going to this "other place" where I thought I was being kept from my family. I kept screaming for them, to later find out I was intubated. Silent screams. I even pulled out my feeding tube during a hallucination. So, I was restrained. At least I understood why. My nurse and doc were not happy with me.
So caregivers, this is for you. Please realize that we can hear when sedated like that. We may not be hearing correctly. Please do not make fun or be nasty if we are being difficult. To someone hallucinating like that, you have no idea what we are seeing and hearing. Just know it is hell on Earth. Going for my 1st counseling session this week.
I respect your concern and message. Again thank you 😊 🙏
My husband is currently going through this. He's been in the ICU for 3 weeks now and on the ventilator for 2 weeks. It's really scary and difficult because he's not sleeping, having hallucinations and can't always remember where he is or why. A few days ago he said he's not sure what's real and what's not. He said he's seeing things. 😔 I hope he gets better.
Hope everything s improving for ur husband? My daughter s going through this at age 25 after being in ICU. I was not told anything about it, i am so scared for her. I was not told until i asked Drs about her behavior, and even after that i was not told how to respond or take care of her, i kept correcting her for first 2 days. I was with her in hosp 24/7 making it worst for her and no Dr or nurse said anything. Its been 2 months since she s been discharged but she still has her episodes :(
I was in for 2 months last year. I experienced the same thing, it's almost like your living in a different world, disconnected from the rest. After that experience, I began to believe in the matrix
We are dealing with this with my mom right now!
Did he recover? My father in-law is still struggling 5 years later.
Ahh BAMC. Was my go to for 15 years when living in SA. Great care.
Thank yoou! I was in an induced coma and off the vent with ARDS for 5 weeks and nobody knows so thank you
Very informative video!
Great suggestions
Love this video thanks for sharing sir
Never heard of this before today why does no one talk about it? A lot of people with post operation ICU delirium could be causing PTSD memory to haunt them.
excellent video
My mom has this! She has a seizure followed by a massive heart attack, stroke pneumonia and internal bleeding! Yesterday they took her off the ventilator but something wasn’t right! Today they said she had icu delirium I’m so scared for her as she went 53 minutes without proper oxygen.
My mom's currently going through this. After being on the ventilator with pneumonia. For over a week, the Dr doesn't seem hopeful. She'll be to where she was before. But with covid restrictions, I'm unable to visit her. They want her to go to a rehab facility. Which I'm very scared of. Thank you for this video.
I’m sorry to hear about your mom, I was a respiratory therapist and know the struggle that lung problems bring, one of those things we don’t think about much until it’s gone. I am even more sorry that you are not able to visit your mother, these times must be hard for your both. Pray for those taking care of her, that she will get precisely what she needs for it is not always obvious in more difficult cases. May she recover quickly, but no matter what happens, take courage and live with hope. Hope, even in tragedy, heals many wounds.
Thank you so much for your kind words they mean a lot. Yes been extremely difficult. And covid don't help.
In ICU I was in what I can only describe as hell. I remember it as vividly as I write this. it was that real. when I "came to" there were two gorgeous nurses suspended above me in this weird sexual contraption that caused them a lot of pain until I both ejaculated and evacuated my bowels. As soon as I did they were released and one of them proceeded to use my.fecal matter as hair gel. That was day one.
I had a delusion that I was nothing more than a prototype android made up of wires. my wife left me. I was only in this state for 14 days but I lived 4 years in my mind. every hellish day of four years. the rules didn't apply. all I wanted was a homemade lemonade and a smoothie. I spent two weeks in a desert finding one. I went demon hunting with my dead uncle. I was in three jet crashes. I saw heaven from a distance. it looked like a huge black twenty sided die.
my Arnp was named Michael and I came to believe he was Saint Michael the Archangel. He was there to protect me from the demiurge. Laughter made me believe I was being mocked and I know I was letting the "N" word fly which is normally not in my vocabulary.
by the end I was done. I had no reason to live. I was declining still.... until I heard my wife's voice on the phone. After that I was reinvigorated. within a week I was still messed up but could go home. I fought for it.
a year later I'm scared of hospitals. people.in masks scare me. physically I still have a partially collapsed lung cirrhosis, and cardiomyopathy. I have to ask if some things really happened. strangely, I have some precognition but can't remember short term things
oh and I still can't sleep through the night and my energy is shot. I'm practically incontinent. can't wear my CPAP because it gives me flashbacks
Thank your for your comment. I am sorry your had to endure such horror, the mind is an amazing contraption and can often emphasize the ‘trap’ part of that word. Please continue to mend. The hospital stay is over and now you face recovery. Stay hopeful and love and care for those around you as well as yourself. You can make it.
Could you try hypnosis or some real derp therapy to help you recover so it doesn't impact you so much? I wish they had sedated you so you were not conscious to help you with your 4 days.
I had colon surgery after a cancer diagnosis. They took out about ten inches of my colon and then resectioned it. Unfortunately there was an anastomotic leak and I had to be readmitted for emergency surgery which involved ten days in ICU. It was a living nightmare because I was definitely aware of being outside of my body but desperately wanting to get back into it. There were hideous images and faces and voices that were truly scary like a horror movie. At other times bizarrely I thought I was in a pixar movie where everything around me was painted and there was a mouse there sitting quietly at peace and I felt at peace too just staring at him. I think the sexual abuse was probably the worst. Not the surgeons but the imaginary nursing nightshift who were evil and looking at me with dirty looks like I was disgusting and filthy and had done something wrong and they told me what they were going to do to me. It was like they were angry or something and I was exposed. My private parts were showing and they all filed past my bed and looked and muttered how disgusting I was.
I think that was the ICU delirium phase. I was in ICU for six weeks and imagined that I was there because of my mental incapacity to think straight because I had messed about with drugs ( which I had not ) and plus the fact that I couldn’t move because my legs had given up being bedridden for so long. All the male staff on the ward were gay (I imagined) and I was in danger, I felt, of being abused.
I can only echo what Jennifer 619 said. PLEASE be very careful and sensitive when dealing with anyone going through this. You don’t know what it is like.
My husband has been ventilated for 6 days, the last 3 days they are trying to ween down his sedation. He's 38. So far, he's seemingly in a delirious state. Noneye contact, head thrashing, restrained to the bead so he doesn't pull out tubes. I did get him to make eye contact with me last night. What more can I expect? Will it just take longer to ween off the sedation?
I am sorry to hear you went though that, he is lucky to have you. Recovery can be difficult on both the patient and the family, he may have acted in ways that he won’t remember. I hope all is well at this point.
My mom was discharged from the hospital with a uti that wasn't addressed and has horrible delirium. She didn't even have surgery. Nobody cares and said it was normal. This could have been prevented.
I’m not in medical field but, had a theory on Covid delirium. I have sleep apnea if sleeping on back. I can avoid this by side sleeping. However, the 10-12 times this happened....I had horrific nightmare ish dreams that I was either being strangled or had an obstruction that was preventing me from breathing.. In my dream...am gasping, flailing in a room with other people not taking notice that I can’t breathe.....gasping and then in my NM realize “I’m sleeping”! In my dream.....frantically yelling to self. “WAKE UP BETTY! THIS IS A DREAM! WAKE UP, WAKE UP! In dream am biting lip, pinching/punching my arm or leg......screaming...WAKE UP, IT JUST A DREAM! When I finally do wake, it’s with a huge gasp for air. I believe the brain had gone into survival mode using dream scenario because brain was dying/flow of oxygen cut off. Funny, after all the lip biting and hard pinching trying escape nightmare, there are never outward sighs of bruising. This dream sequence has played out at least 10/12 X in 35 years. Just saying .....these induced Covid patients
have such reduced levels .........brain is screaming for help! Hope this makes sense!
Thank you for your comment. I won’t attempt to diagnose over a comment stream but please take care of yourself. Make sure you talk to your doctor about bipap or cpap, if you are having these gasping wake ups still, continue to go back get better fitting masks or adjusted settings. Sleep apnea causes loss of sleep (and there by many other problems form lack of rest, immune system being one.) and prolonged loss of oxygen in your sleep is not safe. I appreciate you sharing this, and I wish you the best.
I truly wish I could talk to you bc it has taken me many years to get to this point right here ,to where I actually have my vocabulary etc back. It's all my fault. I'm a recovering drug addict. I use to over dose over & over . I suffer ( I still struggle with severe anxiety & depression) but I use to over dose to the point I'd end up on in the ICU weekly( I know it's horrible). I've been sober for 4yrs now). I'm a grandma now and I absolutely adore my grandsons! But I guess my point is ,I've lost so many memories and I have seizures and I can't really describe my symptoms to anyone. It's almost like it's made up or it doesn't make sense ( unless you were there). But after randomly coming across this video ,I'm wondering if I may have been experiencing this or something close to it? I was on a ventilator more than I can count. And I still catch myself losing memories. Idk , it's strange how the brain works. I know I've done some damage , that's a fact but I'd like to be more educated on exactly what I've done so that I can try to understand what it is I'm going through,so I can handle it better. Sometimes I get very depressed bc I feel " stupid" at the ridiculous damage I've done. I just get so mad at MYSELF!!! Thank u for all your info...;)and BTw ,idk if I even have this but when I heard about this my stomach dropped. I immediately thought OMG ,this really sounds like something I was going through many years ago and NOONE would hear me and I completely get it ( I wasn't the most trusted or understood person "at the time").
wish you the best in your journey ❤
Could vitamin D or Magnesium deficiency be related?
UNFORTUNATELY I AM NOT A VERY PATIENT PATIENT ! ! !☹️☹️☹️☹️☹️☹️☹️
Suggest me doctor name in this deases who is best doctor. Phycatrist or Neurologist?
Doctor please talk about -Pump Head syndrome -
after open heart surgery my life sucks
How are you doing now Paul .........
My boyfriend is currently experiencing this after a week under. It’s so scary & his family is trying to tell him its okay & these things actually happened to him. I don’t know what to do. My best friend is struggling and I don’t know if I should be trying to convince him of the truth everyday or not 😢
Is it possible for a patient to exhibit these symptoms for even a short stay (2 or 3 days) in ICU? I’m witnessing this behavior right now, but ICU encounters have not been any longer or shorter than 3 to 5 days, but there were about 4 or 5 ICU admissions over the past 16 months or so, and very frequent visits with different types of doctors. Thank you in advance.
It is possible. Some of these symptoms can by caused by prolonged oxygen depravation or even some drug sensitivities or adverse effects. So even a stay of 12 hours, if accompanied with injury to the brain, can have delirium effects. More important to know is that every patient is different, some may recover quickly others take longer. We must do our best and provide the best care we can. Hopefully we can continue to learn and curb the effects of delirium, even in short ICU visits.
Some effects come from long term isolation; even with appropriate medical care. Isolation can come from the fact that the patient is recovering and, even without sedation, can find themselves lost inside and unaware of their surroundings. After the face forgetting details they may seem to be conscious of during their visit.
I'm sure I had delirium after my open heart surgery. I was desperately looking for my son
Scott, I just went through delirium in the ICU. I wanted to see if I can use your definition of delirium in a documentary I am making.
Stefanie, I’m glad to hear you are out of the hospital and seem to be doing well. I would be excited to see your documentary. My definition is a personal interpretation and may not be all encompassing, nor is it a peer reviewed statement. You are free to use my definition of ICU delirium, though I ask you to not use my audio, photo, or video. Please take care of yourself and thank you for reaching out. Best wishes.
@@fortheloveofmedicine4634 thank you!
Great.
But the fact that we’re even asking “why should I care?” in this context is deeply concerning.
My sister is also suffering delirium deases kindly suggest me whats better doctor in this deases . phychatrist or Neurologist? Kindly guide me dr please help me she is 22 years old 😢 em waiting ur suggestion nd answer please help
How long normally a patient was in ICU until this delirium risk can be developed?
Waking up from ICU after major operation seems to be a delirium trigger. Often having family talk to them can help bring them back faster ground them into reality again.
What exactly is causing this in the icu if it’s becoming too common for many people that’s going in there to the hospitals or icu
it is not that it is becoming more common but rather that it is being understood more. The ICU poses a few innate challenges that are in most cases unavoidable such as being bed ridden, stuck on a ventilator, poked/prodded/tubed in arms legs and other access points for fluids access and monitoring increasing the need for medication. while all these things may be needed for allowing the body to heal, we are finding that the mind suffers. Also when a patient suffers a near death experience, the damage done on the brain can be mild to severe depending on the circumstance. We are learning that some of these can be mitigated, time off the ventilator and spontaneous breathing trials, physical therapy where they can walk around when possible, and weening medications as soon as is safe to do so. most importantly, we should be empathetic with what these patients face and patience should be our constant goal.