ICU psychosis is a disorder in which patients in an intensive care unit (ICU) or a similar setting experience anxiety, hear voices, see things that are not there, and become paranoid, severely disoriented in time and place, very agitated, or even violent, etc. In short, patients become temporarily psychotic. — Medicinenet.com et al.Causes of ICU psychosis (partial list):
- Sleep deprivation, exhaustion
- Disruption of day/night schedule
- Constant interruptions
- Unfamiliar surroundings
- Disruption of regular routine & activities
- Sensory deprivation
- Windowless rooms
- Little human contact
- Sensory overload
- Hallway and neighbor noise
- TV
- Flashing monitors
- Beeping alarms
- Loss of control over surroundings
- Lights on/off
- Windows open/closed
- Door open/closed
- Access to food, drink, belongings, lip balm, etc.
- Pain
- From medical condition
- Post-surgical
- Needle sticks, injection with stinging medications
- Discomfort
- Furniture
- Sleeping positions
- Room temperature
- Tubes & wires
- Hunger, thirst
- Lack of hygiene
- Poor caregiver communication
- Slow response to call button
- Failure to explain procedures
- Refusal or inability of caregivers to honor requests
- Nurses' need for doctors' approval, and slow response thereof
- Inability to communicate
- Due to medical condition or breathing apparatus
- Due to declining mental state
- Medication problems
- Disruption of regular medications
- Especially psych medications
- Reactions and side effects of new medications
- Interactions of old and/or new medications
- Powerlessness
- Immobility
- Due to medical condition
- Due to monitors, IVs, other tubes
- Due to fatigue or atrophy
- Lack of personal privacy
- Indignities
- Exposure
- Detailed monitoring and measuring of bodily functions
- Requiring assistance with bodily functions
- Loss of control of bodily functions
- Catheters, etc.
- Fear, anxiety, depression
- About medical condition
- About ongoing or upcoming procedures/treatments
- About anything/everything on this list
- Exacerbated by disruption of psych medications
- Compounding confusion, agitation
- Caregiver frustration
- Self-injury or interference with needed treatments
- Possible physical restraints
- Family and friends "siding" with caregivers "against" patient
Disclaimer: health professionals are generally great and try their best, but most do not have adequate staff time to handle ICU psychosis, nor will they necessarily have an arsenal of valuable techniques for dealing with it.
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