In this episode, I’ll discuss awareness with paralysis in the ICU.
In episode 578 I discussed the ED-AWARENESS study, a single-center, prospective, observational cohort study on 383 mechanically ventilated ED patients that found a 2.6% incidence of awareness with paralysis in ED patients.
Recently in Critical Care Medicine a meta-analysis including 7 additional studies and 941 patients found a 3.4% incidence of awareness with paralysis.
The reported incidence of awareness with paralysis occurring in OR patients is just 0.1%.
The reported incidence of awareness with paralysis in the ED and ICU setting is alarmingly high. Pharmacists in these settings result in the faster provision of postintubation analgosedation, and this may translate to reduced awareness with paralysis. Post-intubation while the rest of the care team is confirming tube placement, and continuing to stabilize the patient, a pharmacist can remain solely focused on ensuring the prompt provision of analgosedation, keeping in mind the duration of action of sedatives and paralytics given during RSI.
Airway Pharmacology training is just one of the over 160 practical trainings inside my Hospital Pharmacy Academy.
If you’re not currently a member and have been wondering if the Hospital Pharmacy Academy is right for you, now is a great time to check it out. Until 10 pm EST this Friday, February 5, you can get a trial membership to the Hospital Pharmacy Academy for 7 days for just one dollar.
The Hospital Pharmacy Academy is my online membership site that will teach you practical critical care and hospital pharmacy skills you can apply at the bedside, keep you up to date with the medical literature, give you resources to enhance your rotation experience for students/residents, and give you access to me and hundreds of other hospital pharmacists to get answers to your clinical questions. To start a trial membership to the Hospital Pharmacy Academy, go to this page.
If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies.