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Thread: ICU Psychosis

  1. #11
    Senior Member Wesley's Avatar
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    I think the good news about ICU psychosis is that it goes away after you get out of ICU! My experience was that the sudden lack of sensory input made my mind go wild. Like Bethany, I still don't know what was real and what had been hallucinated. I'm pretty sure I wasn't on a hospital ship but you couldn't convince me of that at the time.

    One of the things that I remember is that I was very sensitive to conversation going on around me and my imagination would go wild when anything negative was said. I really appreciated family and staff that could keep things upbeat and simple. It's not a time for a real rational discussion of the pros and cons of his situation. You just need to be really supportive and positive about potential outcomes. Even if those outcomes now don't seem so positive. It's just really hard to come to grips with reality in such a sensory deprived situation. it's like being a child again. you lose your defense mechanisms and much of your sense of identity. The result is a profound sense of vulnerability.
    Last edited by Wesley; 10-13-2008 at 06:18 PM.

  2. #12
    Talk to the head nurse or clinical nurse specialist on the unit. Ask to have a family conference. There are methods that help to decrease ICU psychosis (if this is what is going on). Consultation from a psychiatric clinical nurse specialist and/or psychiatrist may also be very helpful. The need must have a plan that everyone follows consistently (health care team, family, friends, etc.).

    It is also possible, esp. in an elderly person, that excessive use of sedating/anti-anxiety drugs or electrolyte or hormone imbalances can contribute to this. If there is a room with a window or skylight, get him moved to it and keep the curtains open during the day. If not, then be sure the nurses are darkening his area at night and turning on the lights during the day. They should minimize care at night (too many ICUs do bathing on the night shift, for example). Day/night confusion is a major contributor to ICU psychosis.

    Here are some good resources:

    http://www.medicinenet.com/icu_psychosis/article.htm

    http://include.nurse.com/apps/pbcs.d...=2002204120307

    http://www.icu-usa.com/tour/medical_...s/delirium.htm

    (KLD)

  3. #13
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    Quote Originally Posted by betheny

    I do know the black holes on the acoustic ceiling tiles weren't really little villagers that got progressively meaner. I even knew that then, but they were still scary.
    Yes, I am pretty sure that the Halloween Cookies that were trying to push me down the cellar stairs weren't real. There were other scenes as well.

    For me, the real key was company at night. It took about 3 nights. Just someone there to grab their hand when I woke up in the middle of one of these spells. I am pretty sure they put me on some sort of anti anxiety med at the time, but I would have to look back at the notes my mom made to be sure. Bud lack of sleep jus compounds the effects, and finally getting some sleep helped greatly. The issues didn;t go away completely, but were greatly lessened.

    (I really don't think family staying overnight was a hospital policy, I think that they just allowed it on a case by case thing, b/c no one stayed with me again. )

    My daughter says that she knew when I was getting better, when I DIDN:T little tiny men walking on the walls, but saw boxes of gloves instead.
    Last edited by sjean423; 10-13-2008 at 08:27 PM.
    T7-8 since Feb 2005

  4. #14
    Senior Member cali's Avatar
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    Quote Originally Posted by betheny
    I do know the black holes on the acoustic ceiling tiles weren't really little villagers that got progressively meaner. I even knew that then, but they were still scary.
    o my god that was way too funny!!!!!!!!!! i laughed so hard!

    i never had any of that stuff but darvoset made me keep trying to find my car, then when i did, i couldn't find my keys and kept repeating itself.

    i did have one where i was in the football stadium's squawk box and there was a bread box in there full of gray kittens...
    Never take life seriously, nobody gets out alive anyway

    Frank's blog:
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  5. #15
    I had some major anxiety issues during my 22 days in the ICU i only slept about four hours of spread out sleep a night. Its very hard to comprehend that just about every aspect of your life has changed in the blink of an eye... it gets better with time...

  6. #16
    I remember when my father woke up thinking he was in Australia.... which was particularly distressing he said, since he didn't know anyone in Australia. Another time while he was intubated he drew an intricate map on a piece of paper (he was intubated and couldn't speak), with XX marks where he knew crimes had occurred, and he demanded we investigate immediately. But once he saw us, and we re-oriented him, and reminded him of the Law and Order episode that had been playing on the TV earlier in the evening, things improved....

    It does help a lot to have family around. We used to stay with him at night a lot. Most of the time they wont prevent you, and if they try to, demand to speak to the patient advocate/ombudsperson. But you need sleep too. Simple things like asking the nurses to turn off the lights/TV at night to help him sleep can help too.

    Yes, there are medicines that can help anxiety, but unfortunately many of them can make you sleepy which can also contribute to confusion. It is a very good idea to ask for a psych or neurology consult to help advise the primary doctors what to do. Often ICU doctors like to worry about the "important" things - like breathing, blood pressure etc... and sometimes don't think as much about behavioral issues (stress/anxiety/pain), but these are so important to the patient and family. And as you can see, they can also interfere with "important" things like getting extubated as well!

  7. #17
    Eureka!! Now I understand what I was going through. I was in ICU on one occasion and was so scared of the things I saw. It is was a horrible experience for me since I thought it all was really going on. Still not over it yet though.

    Raven

  8. #18
    Quote Originally Posted by Wesley
    I think the good news about ICU psychosis is that it goes away after you get out of ICU! My experience was that the sudden lack of sensory input made my mind go wild. Like Bethany, I still don't know what was real and what had been hallucinated. I'm pretty sure I wasn't on a hospital ship but you couldn't convince me of that at the time.
    When I was in ICU, I thought I was on a ship, too. A barge with containers. And prisoners with shivs. I'm still not sure why I kept seeing words in the acoustic ceiling tiles.
    Daniel

  9. #19
    Quote Originally Posted by dan_nc
    When I was in ICU, I thought I was on a ship, too. A barge with containers. And prisoners with shivs. I'm still not sure why I kept seeing words in the acoustic ceiling tiles.
    It was the villagers, messing with you! OMG, funny now, wasn't then.

  10. #20
    Senior Member cali's Avatar
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    were you all in icu for a long time? i was in 3 days and i usually woke up to get sick then fall back asleep. i remember them trying to make me eat jello, asked what color i wanted and didn't have it anyway. they'd give me water with those green spongy swabs too.

    sorry you guys had such a horrible experience!
    Never take life seriously, nobody gets out alive anyway

    Frank's blog:
    http://www.franktalk-scurry.blogspot.com
    My regular blog:
    http://www.ithinkithinktoomuchblog.blogspot.com

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