Page 19 - Critical Care Notes

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Implementing the ABCDE Bundle at the Bedside From
the American Association of Critical Care Nurses
The ABCDE bundle is a group of evidence-based practices that help prevent
unintended consequences in critically ill patients. Detailed guidelines can be
found at: http://www.aacn.org/wd/practice/content/actionpak/withlinks-abcde-
toolkit.content?menu=%20practice
The ABCDE bundle consists of:
ABC—Awakening and Breathing Trial Coordination: Awakening trials daily
(sedation vacations), with spontaneous Breathing trials to promote earlier
extubation as Coordinated with respiratory therapist.
D—Delirium Assessment and Management: Early identification and manage-
ment of patients with delirium.
E—Early Exercise and Progressive Mobility: Enable patients to become pro-
gressively more active and, possibly, walk while intubated.
Analgesia/Sedation Protocol for Mechanically Ventilated Patients can be
found at: http://www.mc.vanderbilt.edu/icudelirium/docs/Sedation_protocol.pdf
■ Sedatives
■ Anxiolytics
■ Analgesics
Sedation weaning also includes:
■ Use of short-term sedatives
■ Daily sedation interruptions using the “Wake Up and Breathe” protocol.
Refer to: http://www.mc.vanderbilt.edu/icudelirium/docs/WakeUpAnd
Breathe.pdf
■ Treatment of pain
■ Use of sedation scales (refer to Basics tab on Sedation)
■ Regular assessment of delirium using the CAM-ICU (refer to Basics tab on
Delirium)

BASICS