C
ccrawford
Not too long ago, we had a long thread going because a newbie (me) was anxious about entubation. The experts finally got me calmed down, and we collectively learned that the medications used in ICU probably had a lot to do with good experiences vs bad ones. I recently came accross an article in the British Journal of Anaesthesia that shed a little more light on the topic, so I thought I'd share that by loosely paraphrasing parts of a 9 page article. Drugs used in surgery are typically different than those used in ICU - ie in surgury, they often want drugs to stop muscle movement such as in heartbeats or breathing. Criteria for ICU drugs include effectiveness, safety, cost effectiveness, fast acting, ability to produce sleep (sedation), ability to mask pain (analgesic), and the ability to prevent anxieties and unpleasant memories for the patient. Despite advances in medications, some patients will have adverse experiences from
hysical discomfort from procedures, inability to communicate while entubed, and lack of sleep in the ICU. With both the drugs tested in the article, the patients could be extubed 30 minutes after discontinuing the sedation. Extubation occurs only after the patient is shown to meet a whole list of criteria such as alertness, cardiovascular stability, shows signs of spontaneous respiration, breathing volume above a given level, breathing rate that exceeds a given rate, etc. Even though both of the drugs in this particular comparison were known to have amnesic properties, some of the patients remembered being mechanically ventilated. Some patients in both drug groups also remembered discomforts regarding sleep, pain, noise, and the ventilator. What does all this mean ? This gives us a little more of an idea what to expect, also the notion that the perfect drug does not exist, and that some of us will experience some discomfort. Try to remember that you are being cared for by a skilled professional one on one, and that you will need to try to relax. It will get better, and you'll be feeling better as time goes on. Hope this was informative - I found it interesting. As a control freak, the more I know about a topic, the more comfortable I am. Chris
hysical discomfort from procedures, inability to communicate while entubed, and lack of sleep in the ICU. With both the drugs tested in the article, the patients could be extubed 30 minutes after discontinuing the sedation. Extubation occurs only after the patient is shown to meet a whole list of criteria such as alertness, cardiovascular stability, shows signs of spontaneous respiration, breathing volume above a given level, breathing rate that exceeds a given rate, etc. Even though both of the drugs in this particular comparison were known to have amnesic properties, some of the patients remembered being mechanically ventilated. Some patients in both drug groups also remembered discomforts regarding sleep, pain, noise, and the ventilator. What does all this mean ? This gives us a little more of an idea what to expect, also the notion that the perfect drug does not exist, and that some of us will experience some discomfort. Try to remember that you are being cared for by a skilled professional one on one, and that you will need to try to relax. It will get better, and you'll be feeling better as time goes on. Hope this was informative - I found it interesting. As a control freak, the more I know about a topic, the more comfortable I am. Chris
