When we admitte a patient at one of our Intensive Care Units, in the majority of cases, our main goal is that he/she will survive. It is something almost intuitive to an intensivist, mainly in the first moments after the admittance.
Later, we are proposing other objectives and goals, according to the pathology, and this is the moment in which we ask: surviving ICU: Yes, but…how?.
Post-Traumatic Stress Disorder (PTSD) is a type of anxiety disorder. It occurs after having experienced or observed a highly traumatic event, in which it´s experienced an exceptional threat to life.
In this disorder, patients develop thoughts related the experience and its consequences. To those, much importance is given, increasing the degree of stress and exhaustion, both emotional and physical, as well as insecurity. The world is perceived as a highly dangerous environment, perpetuating the spiral of anxiety and stress.
The ICU discharge is considered a success for the health care team, but it is not always perceived as something positive “to the other side of the pajamas”: it may cause fear, both the patient and his family, generating a sense of helplessness and loss of safety, and giving rise to a stress response and confusion to perpetuate the physical and emotional exhaustion.
Surviving ICU, occasionally represents a tremendous challenge for patients, and a very important change from his/her previous life. PTSD is a sequel that may impede the objective which we have both worked: return the patient to their previous life.
In the ICU of Hospital Infanta Margarita we have been working in a protocol for prevention of PTSD (only available in Spanish):
I hope you find it helpful.
Intensive Care Physician. ICU of Hospital Infanta Margarita