Best Innovations That Support Awake and Walking ICU Care: Part 1

My journey into the realm of critical care medicine began in an Awake and Walking ICU back in 2012. Back then, our toolkit was quite modest—think basic walkers and gait belts. Encouraging patients to be awake and achieve their highest mobility levels reduced risks and minimized the equipment and staff needed for mobility.

Of course, we did have some "wild west" methods. We’d manually move weaker patients to the side of the bed, or we’d find ourselves lifting them into standing positions—all while using traditional restraints for those few who were more impulsive. Communicating with intubated patients who didn’t speak English? Well, we just accepted that was a impossible.

Fast forward five years, and my quest to usher in more Awake and Walking ICUs has unveiled some amazing products. These innovations not only enhance ease and effectiveness but also bring humanity back to critical care.

I’m eager to share a handful of standout innovations that I’ve been fortunate to encounter, work with, or witness in real-time. These are developments that enhance delirium, sedation, and mobility management in the ICU to master the ABCDEF Bundle. I’m not sponsored, but if someone wants to send a check, I’m open to negotiations. ??

Verticalization Beds

Discussed at length in one of my podcast episodes, verticalization therapy is a potential game-changer during critical illness. Historically, tilt tables and combilizers did the job, albeit for only a select few in elite ICUs due to the heftiness of shifting dependent patients from bed to device.

The new star players in town? Verticalization beds by Kreg Therapeutics and Vitalgo.

These rental beds start as regular beds but can elevate patients vertically with just one clinician. In my ideal ICU universe, every bed would be a verticalization bed, but for now, these magical and low-cost rental beds can appear in an ICU within about four hours. They allow even complex patients, those on femoral ECMO and more, to stand and bear weight, paving the way for our shift towards ICU PRE-habilitation.

Vidatalk

Communication is a fundamental human right. When patients are intubated and non-verbal, communication barriers can grow into skyscrapers. If exceptions like non-English speakers, ICU-acquired weakness, injuries, or learning disabilities are in the mix, written communication isn’t feasible, resulting in frustration, agitation, and often sedation.

Enter Vidatalk. Dr. Lance Patak talks about how his time in the ICU as a CNA, inspired his innovation in this podcast episode. This app, compatible with tablets, iPads, and phones, offers ICU-centered communication "menus" and converts text to speech in over 40 languages.

At first, I was skeptical, thinking our ICU wouldn’t need this much. Once I realized its full potential, however, I wished it in every ICU everywhere. This tool is a transformative force for patient experience and outcomes, and it makes financial sense due to reimbursable codes.

Refraints

Avoiding restraints is crucial, but some patients, with life-saving devices galore, can be too risky to roam free. Enter the Refraint device by HD Medical—think of it as titratable security without the trauma. Collaboratively developed by Marie Pavini MD FCCM FCCP and ICU nurses, it allows motion without the risks of line and tube dislodgement. Listen to Dr. Pavini talk about it in this episode. It’s revolutionary for reducing self-extubation risks and minimizing trauma, all while helping avoid sedation.

Movement and Compression System (MAC)

No more cumbersome SCD devices with pumps and tubes! MAC from Recovery Force is a wireless, wearable SCD system also tracks everything: time in bed, steps, you name it. The data syncs right into the electronic health record (EHR), filling that irritating gap in mobility charting and ensuring accountability and compliance to boost ICU mobility.

Secure-Move TLC

Roddy Medical’s Secure-Move TLC excels at keeping lines, tubes, and cords safely organized and ART lines calibrated during movement. With a pressure tolerance of up to 80 lbs, rest assured that even the slightest inevitable tugs won’t cause dislodgment during mobility.

ICU Diaries

ICU Diaries give survivors a window into their often-fuzzy ICU experience. Whether it’s daily logs or heartfelt notes from family, they’re invaluable for addressing post-ICU PTSD.

Exciting innovations like Post-ICU’s digital tools streamline these records as discussed in this podcast episode with Seth van der Meer . While ACE Planning Company's diaries, created by ICU nurse Carly Hickey, are physical journals that enrich the journey with educational guidance.

Through these innovations, ICUs can be increasingly more equipped to fulfill their potential, aiming to merge professional care with the innate human touch that every patient deserves. They are helping bring the standardization of Awake and Walking ICUs into fruition.