Korean J Crit Care Med.  2016 Aug;31(3):181-193. 10.4266/kjccm.2016.00682.

The ABCDEF Implementation Bundle

• Marra A
• Frimpong K
• Ely EW

• KMID: 2350902
• DOI: http://doi.org/10.4266/kjccm.2016.00682

Abstract

Long-term morbidity, long-term cognitive impairment and hospitalization-associated disability are common occurrence in the survivors of critical illness, with significant consequences for patients and for the caregivers. The ABCDEF bundle represents an evidence-based guide for clinicians to approach the organizational changes needed for optimizing ICU patient recovery and outcomes. The ABCDEF bundle includes: Assess, Prevent, and Manage Pain, Both Spontaneous Awakening Trials (SAT) and Spontaneous Breathing Trials (SBT), Choice of analgesia and sedation, Delirium: Assess, Prevent, and Manage, Early mobility and Exercise, and Family engagement. The purpose of this review is to describe the core features of the ABCDEF bundle.

Keyword

delirium; family; ventilator weaning; sedation; spontaneous awakening trials (SAT); spontaneous breathing trials (SBT)

MeSH Terms

Analgesia
Caregivers
Cognition Disorders
Critical Illness
Delirium
Humans
Organizational Innovation
Respiration
Survivors
Ventilator Weaning

Figure

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  Fig. 1. “Wake up and Breath” protocol: Spontaneous Awakening Trials with Spontaneous Breathing Trials. PEEP: positive end-expiratory pressure.[65]

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  Fig. 2. Sample delirium protocol.[65]

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  Fig. 3. Dr. DRE causes of delirium.[65]

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  Fig. 4. Brain road map: a framework for bedside rounds. CAM-ICU: confusion assessment method in the ICU; ICDSC: intensive care delirium screening checklist; RASS: Richmond agitation-sedation scale; SAS: sedation agitation scale.

Reference

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