Brief description of media:

Each year, hundreds of thousands of patients in the U.S. and millions
worldwide become critically ill. Patients who require care in the
intensive care unit (ICU) have the most serious illnesses, often requiring
multiple forms of life support. While the science of medicine has
significantly advanced in the past 30 years, these advances sometimes
create many questions, such as:
• Will my loved one be able to live independently after this?
• What kind of rehabilitation will my loved one need?
• What will my loved one’s quality of life be after this illness?
More than ever, medical teams rely on families to help them make
important decisions about their loved ones’ care, and their futures.
The purpose of this series is built on the ideas that knowledge is power
and that every patient needs an advocate. Here, we share some of the
most important advances in ICU medicine so patients and their families
can ask educated questions.

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Aim: In this review, we sought to succinctly review what Post intensive care syndrome is, it’s risk factors, consequences, assessment, diagnosis, prevention and treatment among family members of intensive care patients.
Background: The proportion of family members caring for a patient in intensive care units is expected to proportionally increase with increase in utilization of intensive care units due to various reasons. Subsequently, unfavorable physical, psycho-social responses due to exposure to complications following admission of a family member in intensive care due to critical illness will consequently increase among family members. These unfavorable family responses to critical illness have been termed “Post intensive care syndrome-family (PICS-F).” Post intensive care syndrome-family encompasses: anxiety, acute stress disorder, post-traumatic stress, depression and complicated grief. Healthcare providers as well as family members need to be knowledgeable on the extent, diagnosis, prevention and outcomes of these sequelae. Relationship to the patient, younger patients, prior experience of ICU, low economic status, length of ICU stay, unmet self-care, communication needs and distance from the hospital seem to predispose family members to PICS-F. Longer distance from hospital and higher resilience seem to protect family members from PICS-F. Prevention of PICS-F includes: effective family-ICU staff communication, enhancing resilience and coping, post discharge planning and follow-up interventions.
Conclusion: results highlight the importance of acknowledging experiences of family members having a patient admitted in intensive care unit. Healthcare professionals need to have insights into this phenomenon and optimally intervene to prevent these physiological and psycho-social sequelae.

Brief description of media:

Annually, about five million patients stay in an intensive care unit in the United States. Studies show that up to 35 percent may have symptoms of PTSD for as long as two years after that experience, particularly if they had a prolonged stay due to a critical illness with severe infection or respiratory failure. Those persistent symptoms include intrusive thoughts, avoidant behaviors, mood swings, emotional numbness and reckless behavior.

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In response to the many challenges faced by ICU survivors today, there has been an increasing need to relieve this burden. Despite that many clinical trials have been implemented to find new strategies, post intensive care syndrome is still a common possibility for both patients and families.

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In 2010, the Society of Critical Care Medicine organized a task force to raise awareness of the long-term cognitive, psychological, and physical impairments in survivors of critical illness. Impairments in these three domains are collectively known as post-intensive care syndrome (PICS). PICS affects 50–70% of intensive care unit (ICU) survivors, and its effects can persist for 5–15 years after ICU hospitalization. One major barrier in the assessment of PICS is the lack of a single, validated clinical tool to rapidly assess impairments in all three domains of PICS.

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Medical advances over the past few decades have led to an overall decrease in patient mortality for those experiencing a traumatic health challenge. Research on long-term health out comes post-traumatic illness has shown there is an increase and worsening of functional morbidity resulting from the critical illnesses and associated therapies and treatments experienced by patients.Pollack et al.(2014) estimates morbidity (the rate of ongoing clinical health challenges) to be as high as4.8%, twice the rate of mortality. Preventing or reducing mortality is no longer the sole outcome measure for effectiveness of critical care interventions(Herrup et al.,2017). Rather, ensuring optimal long-term health outcomes post-trauma are a major focus of current healthcare interventions in the intensive care unit (ICU).

Brief description of media:

A steadily increasing number of patients survive their stay in the Intensive Care Unit (ICU), and a significant percentage become chronic cases. Patient post-intensive care syndrome (PICS-P) is a recently described condition that affects an important number of patients (30---50%). It encompasses the physical (mainly respiratory and neuromuscular), cognitive (memory and attention) and psychological sequelae (depression, anxiety, stress and/or post traumatic stress syndrome)
at discharge from the ICU, and which have a negative impact
upon patient quality of life.

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This is the pocket card version of RASS scale and new CAM-ICU Flowsheet.

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The ICU can be an intimidating and stressful environment. This manual is intended to help support medical students, interns, and residents working in the
ICU. This manual is a guide for care in the ICU. Clinical treatment decisions are variable and nuanced depending on patient, nursing, and attending factors.

Brief description of media:

Millions of patients are admitted to intensive care units (ICUs) each year, one third of whom need a machine to help them breathe (ventilator). These critically ill patients may develop health problems related to their illness, injury, ventilator or other treatments. Such problems cannot be totally prevented and can continue after the patient leaves the hospital. Delirium, acute respiratory distress syndrome, and sepsis increase the chances of these problems occurring. They, too, may not always be prevented.

If you are an ICU patient or family member, this guide helps you understand the health problems known as post-intensive care syndrome, or PICS, so you know what to look for when you return home. It also includes tips on how to minimize PICS. Many people develop PICS, and help is available. You will have the best chance of recovery if you explain your health problems to your primary care doctor, who can refer you to the specialists you need.

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Introduced what the caregivers' ABCDE stands for, and explained them in detail.

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Delirium is one of the most common behavioral manifestations of acute brain dysfunction in the intensive care unit (ICU) and is a strong predictor of worse outcome. Routine monitoring for delirium is recommended for all ICU patients using validated tools. In delirious patients, a search for all reversible precipitants is the first line of action and pharmacologic treatment should be considered when all causes have been ruled out, and it is not contraindicated. Long-term morbidity has significant consequences for survivors of critical illness and for their caregivers. ICU patients may develop posttraumatic stress disorder related to their critical illness experience.