CICU Pathway for Sedation/Analgesia in the Mechanically Ventilated Patient

Daily Sedation Interruption

Score
  • A time interval in which there is interruption of an intubated patient's sedative and opioid medications to allow patients to "wake up" and reduce the dose of medications by 50%
Purpose
  • Identified as an intervention to reduce mechanical ventilation days and ICU and hospital length of stay
Inclusion Criteria
  • All intubated patients after 48 hours of initiation of mechanical ventilation
Exclusion Criteria
  • CICU Attending deems patient to unstable
  • Patient awake and able to calm or SBS ≥ 0
  • Neuromuscular blockade in use
  • End of life care
  • Critical airway
  • Pulmonary hypertension
Process
  • At 8:00 AM daily, if SBS is < 0, RN will inform FLOC and then discontinue all sedatives and opioid infusions
  • Patient's SBS and Pain Scores will be recorded at least every 30 minutes while infusions are held
  • When patient's SBS is ≥ 0, RN will resume sedative and opioid infusions at 50% of original dose
  • RN will consult FLOC to request new order for infusion at 50% of previous dose
  • RN / FLOC resume treatment according to Sedative / Analgesia Pathway