Thread by @iceman_ex

This is a brilliant slide that covers why ICU follow up matters.

A standard GP will see about one ICU survivor a year. In a 10 minute appointment, how can they cover all these issues?

We all need to support our ICU survivors #icmtrainingday

I’m not even sure ICU “survivor” is the right word.

Someone please help me with a better, kinder term

#icmtrainingday ping @drjoelmeyer

Dr Bastin describing asking patients “how are you” and them bursting into tears because no one has asked them that

People not understanding why they were in ICU, and having an opportunity to discuss this

Moving stuff #icmtrainingday

“We really have no idea about the quality of care we deliver until we ask patients who have experienced our care down the line”

This is important for both patients and staff.

Powerful words

#icmtrainingday

Should ICU clinicians follow patients up?

@yourICM paper from @drjoelmeyer
link.springer.com/article/10.100…

One year outcomes in survivors of ARDS

Eye opening paper

nejm.org/doi/full/10.10…

#icmtrainingday

Same cohort 5 years down the line

Still evidence of significant impairment

ncbi.nlm.nih.gov/m/pubmed/21470…

#icmtrainingday

Just to throw things into the mix- a paper from @yourICM arguing that we shouldn’t follow patients up after discharge

link.springer.com/article/10.100…

#icmtrainingday

Okay. Let’s talk about delirium.

50% of ventilated patients.

With long term consequences- similar proportions to people with traumatic brain injury.

nejm.org/doi/full/10.10…

The psychological outcomes are frightening.

Dr Bastin reckons the 1 in 5 statistic is an underestimate.

#icmtrainingday

“normal” post cardiac surgery patients are offered cardiac rehab

ICU patients tend to get missed.

Cardiac rehab is an evidence based therapy that improves outcomes.

Follow up allows an opportunity to do that.

(This is probably same for pulmonary rehab etc) #icmtrainingday

Lessons learned from clinic- Dr Bastin

ALWAYS introduce yourself even when patient is sedated. They remember.

Be careful with bedside discussions.

#icmtrainingday

Statement at the end:

Doing follow up clinic has made Dr Bastin question:
1. Ability to predict outcomes
2. Why we really do ICM. What it’s for; what it means

#icmtrainingday

@threadreaderapp unroll pls