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Course Image Pain, Agitation and Delirium in Intensive Care

Pain, Agitation and Delirium in Intensive Care

ACE
Anaesthesia and Perioperative Medicine

Summary

Patients require admission to the intensive care unit (ICU) for treatment of a specific underlying pathology. Unfortunately, the burden of critical illness has many associated sequalae. Pain, agitation and delirium are such problems frequently encountered in the ICU. 

Pain can result from not only the underlying pathology, but also from surgical procedures and invasive interventions required to manage it. During this module we will explore pain in the ICU, highlighting the reasons patients experience it, the detrimental consequences of pain, how we can assess it and how we can manage it. 

Agitation is common in the ICU. This module will examine the reasons why it occurs and the measures we can take to address it. We will look in detail at the use of sedative medications in intensive care, the different drugs used, their indications and their risks. We will also explore how best to assess agitation and adjust sedatives in order to maximise their benefits while reducing their harm. 

Delirium is not only common in the intensive care population, it can also be considered a marker of disease severity and is associated with an increased risk of death. This module will examine the pathophysiology underlying delirium, its risk factors, how we can detect and measure delirium as well as how we can prevent it and potentially treat it. 

By the end of this module we hope you will have a greater understanding of these common problems encountered in critical care. Ultimately, we hope that this module provides a framework from which you should develop a tailored, person-centred and holistic approach to managing pain, agitation and delirium in your patients.




General Information

Enrolled trainees 1949

Open 18.10.2018

Available for ESICM members

Student effort 2

Last Updated October 18, 2018

Intended Learning Outcomes

After studying this module on Pain, Agitation and Delirium in Intensive Care, you should be able to:

  • Define pain
  • Know the approximate incidence of pain in ICU patients
  • Understand the common causes of pain in ICU patients
  • Be able to assess pain in cooperative and uncooperative patients in ICU
  • Be able to manage patients pain in ICU according to current evidence
  • Define agitation and sedation
  • Describe indications for and risks associated with sedation
  • Develop a structured approach to implementing, monitoring and adjusting sedation
  • Describe the various drugs used for sedation
  • Define delirium
  • Assess and screen for delirium
  • Understand the evidence base for treating/managing delirious patient

Relevant competencies in CoBaTrICE

  • 4.1 Prescribes drugs and therapies safely
  • 7.1 Identifies and attempts to minimise the physical and psychosocial consequences of critical illness for patients and families
  • 7.2 Manages the assessment, prevention and treatment of pain and delirium and other distress
  • 7.3 Manages sedation and neuromuscular blockade
  • 11.6 Critically appraises and applies guidelines, protocols and care bundles
  • 11.7 Describes commonly used scoring systems for assessment of severity of illness, case mix and workload

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