Care of the Ventilated Patient- The New Paradigm

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Lecture and video on the care of the ventilated patient. Specifically this addresses the use of the sedatives, spontaneous awakening trial, spontaneous breathing trials, evaluation of delirium as well as the long term consequences, and the benefits of early ambulation and exercise.

One thought on “Care of the Ventilated Patient- The New Paradigm

  1. Hi, I viewed your respiratory video. I do get the part where sedation is a concern, however I do not agree that the sedation causes long term effects… and I disagree that sedation is harmful to the patient. I was a critical care patient who required intubation and connection to a mechancial respirator, and I was sedated for my comfort. The sedation, contrary to what medical science would say, did not have a harmful effect on me and it did not contribute to a negative view post icu. Had I not been put to sleep prior to the tube placement, there were would have been rounds of pain and times three gagging response especially since I have an amplified, extra strong gagging reflex. Being sedated, I feel like I did not have an worries… and because of sedation I was able to rest more comfortably. When I was fully awakened for cognitive checks, I found that the sedation did not disturb my ability to think or to communicate on paper or by gesture. And because of that sedation, I did not have to experience the horror of the placement of the tube and I did not have to experience horror and constant gagging throughout my icu stay. As a patient, I think it is a whole lot unkinder not to sedate a patient than to sedate. And under sedation, I feel that I rested well and found myself refreshed when being wakened for the daily cognitive checks, and after I was removed from the respirator and moved from the icu. Because I was sedated, I think having that patient comfort factor increased a positive view as to my whole icu experience. I did not have scary or strange dreams while under sedation, and I wasn't having any scary or strange dreams after sedation was terminated. I realize I may be one of those rare patients who didn't have any after-effects per being sedated, but I do have to say that being sedated offered a much more comfortable and significantly less horrifying icu experience had I NOT been sedated. Less may be more from a medical standpoint, but a patient who has or is offered the comfort of sedation should not be ruled out. The patient should be allowed to have that choice, and to have sedation treatment, under the care of a doctor. And because I was allowed the compassion of sedation, I fully feel that not having a horrifying experience per the comfort of having sedation, increased my ability to recover quicker from my lung collapse and I feel that having been sedated increased my post-hospital view of positive, effective, and compassionate treatment. Please, don't rule out sedation for patients on a respirator. I think it is more harmful not to sedate, than to act with compassionate sedation in the name of science or purported "patient harm". Harm is causing a patient distress. Sedation should still be considered a necessary and compassionate care solution for patients who are easily upset or in my case have an exaggerated gag reflex. Thank you for taking time to consider my posting, and thank you for the helpful information provided in this video.

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