maranara

I agree, intubating those going through DT's is different than intubating/sedating for true pysch issues. Unfortunately, we have become the psych unit/facility, so I can't get advice from them.

How do you wean from the vent when they seem to be in a manic state for weeks? We have had people in our trauma unit for weeks on end, trach'd & peg'd; on & off the vent when they get crazy. Sure, it's easier to take care of them when they are vented/sedated/restrained, but we are craving another way for our patients.

Our patients typically come in due to MVC's & shooting/stabbings. Granted, this population is no stranger to drugs; street or pharmaceuticals. A lot of times they do come in intubated. We work hard to extubate patients who don't have a respiratory reason to be vented. A lot of these patients do have mental health disorders. When they have a psychotic episode in our unit, we may or may not try a little Haldol or a little Geodon; but typically our trauma docs intubate & sedate. We don't feel as if this is a solution. Of course, starting these patients on antipyschotics would be appropriate but that is not our culture. I'm wondering if any one has advice or an example of a delirum/pyschosis protocol. We actually haven't thought of making these patients strict 1:1's, probably because our staffing wouldn't allow this.

Hello! I'm looking for some information on how other trauma facilities deal with pyschotic(either chronically diagnosed or acute pyschotic episodes) patient populations. Our unit needs an effective treatment plan for these folks. Currently, our trauma surgeons tend to bypass consulting psychiatrists & instead treat these patients by intubating &/or sedating. It's obviously not working! Our vent days & LOS days are sky-high. Any advice is appreciated!

I hope this nurse was trying to be funny :monkeydance: Otherwise, this is REALLY scary!

It's a pandemic, not just a regional problem. What can we do? I'm not a psych nurse, I'm in the ICU. A good percentage of our pts. are purely psych pts. because they have nowhere else to go!

Wow, I don't know what hospital your @; our ER nurses send us crashing pt's on a daily basis. I am not disagreeing with you, I do consider ER to be critical care. I am just surprised @ your description, it sounds to me you work in a ED that seconds as ICU.:pumpiron:

I would recommend starting from head to toe; using the same format with every documented assessment EVERY time you document. That way it becomes 2nd nature & (hopefully) you include everything, everytime. Be objective, B-E objective.:pumpiron: