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This guide is for:
• People who have survived a frightening medical experience, such as being admitted to
critical care (intensive care).
• People who have been hospitalized with severe medical problems related to COVID-19.
• Their family and friends.
• Mental health and medical professionals who want to understand more about how to help.
If you have had any of the experiences described in this guide, you might find some of the examples ‘triggering’ or upsetting. Remember that there is nothing in this guide which can harm you, and that learning about what has happened (and is still happening) to you can help your recovery. We suggest that you read it slowly in sections, and that if you find it too overwhelming to approach it with the help of a health professional.

Brief description of media:

Economic evaluations of interventions in the hospital setting often rely on the estimated long term impact on patient survival. Estimates of mortality rates and long-term outcomes among patients discharged alive from the intensive care unit (ICU) are lacking from lower- and middle-income countries. This study aimed to assess the long-term survival and life expectancy (LE) amongst post-ICU patients in Thailand, a middle-income country.

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Delirium has been previously described as a syndrome of organ dysfunction involving the central nervous system. The prevalence of delirium in the ICU varies from 20-80%. Delirium has been associated with increased hospital length of stay, duration of mechanical ventilation, and mortality. Sedative and narcotic use has been shown to increase the risk and severity of delirium. Haloperidol is the mainstay of delirium management as recommended by the Society of Critical Care Medicine (SCCM) due to extensive clinical experience with this medication. However, its usage is often limited by safety concerns. Atypical antipsychotics such as quetiapine have been shown to have equivalent success in the treatment of delirium while being associated with fewer side effects.

Brief description of media:

This guide is to help family and friend of the ICU patients to identified if the patients had delirium and how to help them.

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Delirium is a medical condition that increases length of stay, risk of death, functional decline, healthcare cost, caregiver burden, and impaired quality of life.
The Delirium Toolbox is low-cost, efficient option of non pharmacological tools to use in delirium prevention and management.

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The communication board helps the ICU patient to communication with the care giver.

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Survival can seem like the only goal during a stay in a hospital’s intensive care unit. But for many patients, the aftermath can be just as harrowing. Now, an international initiative has launched support groups designed to help those who have left the ICU — if they can be persuaded to come in and talk about their struggles.

Brief description of media:

The learning objectives of this presentation is to teach the audience to be able to verbalize and understanding of the constructs of the ICU Diary: Written entries and photographs. The second learning objective is to teach the audience to understand the construct of post intensive care syndrome: Gap in memory, and PTSD.

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The flow sheet help the medical practitioner to evaluate the confusion level of the patient in the ICU.

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The delirium protocol helps the medical practitioner to perform Delirium assessment via CAM-ICU

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Rationale: The US has seven times as many intensive care unit (ICU) beds per capita as the UK; the effect on care of critically ill patients is unknown.
Objective: Compare medical ICU admission in the US and UK.
Methods: Retrospective (2002-2004) cohort study of 172,785 admissions (137 US ICUs, Project IMPACT database; 160 UK ICUs, UK Case Mix Programme), with patients followed until initial hospital discharge.
Results: UK (vs US) admissions were less likely to be admitted directly from the emergency room (ER), (33.4 vs 58.0%), had longer hospital stays before ICU admission (mean days 2.6±8.2 vs 1.0±3.6), and fewer were ≥85 years (3.2% vs 7.8%). UK patients were more frequently mechanically ventilated within 24h after ICU admission (68.0% vs 27.4%), were sicker (mean Acute Physiology Score 16.7±7.6 vs 10.6±6.8), and had higher primary hospital mortality (38.0% vs 15.9%; adjusted Odds Ratio (OR) 1.73, 95%CI 1.50-1.99). There was no mortality difference for mechanically ventilated patients admitted from the ER (adjusted OR 1.09, 0.89-1.33). Comparisons of hospital mortality were confounded by differences in casemix, hospital length of stay (UK median 10 days (IQR 3-24) vs US 6 (3-11)), and discharge practices: more US patients were discharged to skilled care facilities (29.0% of survivors vs 6.0% in the UK).
Conclusions: Lower UK ICU bed availability is associated with fewer direct admissions from the ER, longer hospital stays before ICU admission, and higher severity of illness. Interpretation of between-country hospital outcomes is confounded by differences in casemix, processes of care and discharge practices.

Brief description of media:

Almost 6 million patients land in an intensive care unit every year, and for many, it marks a turning point in their lives. A substantial number of patients leave the ICU with newly acquired problems, from dementia to nerve disease. Medical leaders have developed new standards to reduce the use of drugs and get patients moving, but adoption has been slow. Special correspondent Jackie Judd reports.