Society of Critical Care Medicine
View all recommendations from this societyReleased January 29, 2021
Don’t delay mobilizing ICU patients.
Patients can develop significant muscle weakness and atrophy (including the diaphragm) during their ICU stay due to immobilization. However, multidisciplinary facilitated early mobilization has been shown to be safe in the ICU setting. Numerous, patient-centered, clinically meaningful outcomes are supported by early mobilization of critically ill patients.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.
How The List Was Created
A diversified, multiprofessional task force of 17 critical care quality and clinical experts was formed with an aim to identify five new Choosing Wisely for Critical Care recommendations. The task force included practicing clinicians representing community, military and academic centers. A priori three domains were deemed important: 1) patient safety and quality of care; 2) strength of evidence to support the recommendation; and 3) potential improvement in patient outcomes. Using a modified Delphi consensus building methodology and a quantitative survey analysis, eight novel recommendations were identified and deemed representative of wasteful critical care practices. Following a quantitative survey of the SCCM membership and review by the SCCM Council, the five highest ranked recommendations established SCCM’s next five Choosing Wisely for critical care were approved. The five recommendations address invasive devices, proactive liberation from mechanical ventilation, antibiotic stewardship, early mobilization, and providing goal-concordant care.
Sources
Pohlman, MC, Schweickert, WD & Pohlman, AS, et al. (2010). Feasibility of Physical and Occupational Therapy beginning from initiation of mechanical ventilator. Critical Care Medicine;38:2089-2094.
