Guidelines for the Prevention and Management of Pain ...

... Patients in the ICU, known as the PADIS Guidelines, are an update to the 2013 Pain, Agitation, Delirium Guidelines. The PADIS Guideline:. SCCMConnect MySCCM Store Join LogIn LogIn ForgotPassword? ForgotUsername? NewUser?SignUpFree Membership BecomeaMember ReneworUpgrade GetInvolved SpecialtySectionsChaptersKnowledgeEducationGroupsCommitteesandVolunteerOpportunitiesSocialMediaAmbassadorProgram CareerandLeadership CareerCentralAwardsAmericanCollegeofCriticalCareMedicineYoungProfessionals ConnectwithSCCMMembers SponsoredFellowsProgram ShareYourStory SCCMApparelandMerchandise DownloadtheSCCMApp Education EducationalProgramming CriticalImpactFundamentalsCriticalCareUltrasoundMultiprofessionalCriticalCareReviewNeurocriticalCareReviewAdvancedPharmacotherapyinCriticalCareCriticalCareEchocardiographyReviewCourseCurrentConceptsLeadership,Empowerment,andDevelopmentProgramVirtualCriticalCareRoundsMCCKAP Webcasts JournalClub:CriticalCareMedicineJournalClub:SpotlightOnPharmacyCOVID-19RespiratorySupportandOxygenationReviewManagingMoralDistressDuringaPandemic OnDemandandOnlineActivities NewCriticalCareResourcesOnlineCE-MOCEnduringMaterialsSuggestionsByKnowledgeAreaMechanicalCirculatorySupportDevicesintheICU LatestUpdates CriticalConnectionsBlog iCriticalCarePodcasts CriticalConnections CriticalCareUpdate   HostaCourse FreeFundamentalsTrainingFindInstructors,Directors,andConsultants FindaHostedCourseNearYou SCCMEventsCalendar   CriticalCareCongress 51stCriticalCareCongress 50thCriticalCareCongress PastCongressResources Abstracts SessionProposals CongressOnDemand Research Discovery,theCriticalCareResearchNetwork VIRUSCOVID-19Registry SARI-PREPGettingStartedDiscoveryActivitiesDiscoveryResources Journals CriticalCareMedicineJournalPediatricCriticalCareMedicineJournalCriticalCareExplorationsJournalSCCMCOVID-19JournalArticles ResearchGrants ResearchSurveys SCCM-WeilResearchTrust ClinicalResources Guidelines AllSCCMGuidelines AdultSurvivingSepisCampaignGuidelines(Hour-1Bundle) Children'sSurvivingSepsisCampaignGuidelines AdultICULiberationGuidelinesandBundle(A-F) ManagementofAdultswithCOVID-19 DisasterandEmergencyResources COVID-19Response COVID-19RapidResourceCenter   ICULiberation GetStartedAboutICULiberationICULiberationBundle(A-F)ElectronicHealthRecordIntegrationICULiberationProducts Collaboratives STOP-VIRUSICULearningCollaborative ICUManagement ChoosingWiselyinCriticalCare LearnICU SurvivingSepsisCampaign SepsisDefinitions   Searchfor: Searchfor: LogIn Forgotusername? Forgotpassword? NewUser?SignUpFree MySCCM Store Join Membership Education CriticalCareCongress Research ClinicalResources Membership OverviewMembership BecomeaMember GetInvolved CareerandLeadership ConnectwithSCCMMembers SCCMApparelandMerchandise Education OverviewEducation EducationalProgramming Webcasts OnDemandandOnlineActivities LatestUpdates HostaCourse CriticalCareCongress OverviewCriticalCareCongress 51stCriticalCareCongress 50thCriticalCareCongress Abstracts SessionProposals CongressOnDemand Research OverviewResearch Discovery,theCriticalCareResearchNetwork Journals ResearchGrants ResearchSurveys SCCM-WeilResearchTrust ClinicalResources OverviewClinicalResources Guidelines DisasterandEmergencyResources ICULiberation Collaboratives ICUManagement ChoosingWiselyinCriticalCare LearnICU SurvivingSepsisCampaign BecomeaMember OverviewBecomeaMember ReneworUpgrade GetInvolved OverviewGetInvolved SpecialtySectionsChaptersKnowledgeEducationGroupsCommitteesandVolunteerOpportunitiesSocialMediaAmbassadorProgram CareerandLeadership OverviewCareerandLeadership CareerCentralAwardsAmericanCollegeofCriticalCareMedicineYoungProfessionals ConnectwithSCCMMembers OverviewConnectwithSCCMMembers SponsoredFellowsProgram ShareYourStory SCCMApparelandMerchandise OverviewSCCMApparelandMerchandise DownloadtheSCCMApp EducationalProgramming OverviewEducationalProgramming CriticalImpactFundamentalsCriticalCareUltrasoundMultiprofessionalCriticalCareReviewNeurocriticalCareReviewAdvancedPharmacotherapyinCriticalCareCriticalCareEchocardiographyReviewCourseCurrentConceptsLeadership,Empowerment,andDevelopmentProgramVirtualCriticalCareRoundsMCCKAP Webcasts OverviewWebcasts JournalClub:CriticalCareMedicineJournalClub:SpotlightOnPharmacyCOVID-19RespiratorySupportandOxygenationReviewManagingMoralDistressDuringaPandemic OnDemandandOnlineActivities OverviewOnDemandandOnlineActivities NewCriticalCareResourcesOnlineCE-MOCEnduringMaterialsSuggestionsByKnowledgeAreaMechanicalCirculatorySupportDevicesintheICU LatestUpdates OverviewLatestUpdates CriticalConnectionsBlog iCriticalCarePodcasts CriticalConnections CriticalCareUpdate   HostaCourse OverviewHostaCourse FreeFundamentalsTrainingFindInstructors,Directors,andConsultants 51stCriticalCareCongress Overview51stCriticalCareCongress 50thCriticalCareCongress Overview50thCriticalCareCongress PastCongressResources Abstracts OverviewAbstracts SessionProposals OverviewSessionProposals CongressOnDemand OverviewCongressOnDemand Discovery,theCriticalCareResearchNetwork OverviewDiscovery,theCriticalCareResearchNetwork VIRUSCOVID-19Registry SARI-PREP GettingStartedDiscoveryActivitiesDiscoveryResources Journals OverviewJournals CriticalCareMedicineJournalPediatricCriticalCareMedicineJournalCriticalCareExplorationsJournalSCCMCOVID-19JournalArticles ResearchGrants OverviewResearchGrants ResearchSurveys OverviewResearchSurveys SCCM-WeilResearchTrust OverviewSCCM-WeilResearchTrust Guidelines OverviewGuidelines AllSCCMGuidelines DisasterandEmergencyResources OverviewDisasterandEmergencyResources COVID-19Response ICULiberation OverviewICULiberation GetStartedAboutICULiberationICULiberationBundle(A-F)ElectronicHealthRecordIntegrationICULiberationProducts Collaboratives OverviewCollaboratives STOP-VIRUSICULearningCollaborative ICUManagement OverviewICUManagement ChoosingWiselyinCriticalCare OverviewChoosingWiselyinCriticalCare LearnICU OverviewLearnICU SurvivingSepsisCampaign OverviewSurvivingSepsisCampaign SepsisDefinitions   SCCMisupdatingitsSCCMConnectCommunity.AccesstoSCCMConnectmaybelimiteduntilApril23. AreyouclaimingACEorMOCcreditfromanSCCMeducationalprogram?Beaware:theACCMEPARSsitewillbedownfromNovember11-16,2021.Youwillnotbeabletoclaimcreditduringthisperiod.Theupdatedsiteisexpectedtobeavailableagainby9a.m.CentralTimeonNovember16. SCCM  >  ClinicalResources > Guidelines > AllSCCMGuidelines > GuidelinesforthePreventionandManagementofPain,Agitation/Sedation,Delirium,Immobility,and Guidelines  QualityandPatientSafety  GuidelinesforthePreventionandManagementofPain,Agitation/Sedation,Delirium,Immobility,andSleepDisruptioninAdultPatientsintheICU Published:8/22/2018 CritCareMed.2018Sep;46(9):e825-e873   GuidelinesforthePreventionandManagementofPain,Agitation/Sedation,Delirium,Immobility,andSleepDisruptioninAdultPatientsintheICU Citation:CritCareMed.2018Sep;46(9):e825-e873 ClinicalPracticeGuidelinesforthePreventionandManagementofPain,Agitation/Sedation,Delirium,Immobility,andSleepDisruptioninAdultPatientsintheICU The ClinicalPracticeGuidelinesforthePreventionandManagementofPain,Agitation/Sedation,Delirium,Immobility,andSleepDisruptioninAdultPatientsintheICU,knownasthePADISGuidelines,areanupdatetothe2013Pain, Agitation,DeliriumGuidelines.  ThePADISGuideline:  Adds twoinextricablyrelatedclinicalcaretopics(immobilityandsleep) Includespatientsascollaboratorsandcoauthors Abstract  Objective: Toupdateandexpandthe2013ClinicalPractice Guidelines fortheManagementof Pain,Agitation,and Delirium inAdultPatientsintheICU. Design: Thirty-twointernationalexperts,fourmethodologists,andfourcriticalillnesssurvivorsmetvirtuallyatleastmonthly.Allsectiongroupsgatheredface-to-faceatannualSocietyofCriticalCareMedicinecongresses;virtualconnectionsincludedthoseunabletoattend.Aformalconflictofinterestpolicywasdevelopedaprioriandenforcedthroughouttheprocess.Teleconferencesandelectronicdiscussionsamongsubgroupsandwholepanelwerepartofthe guidelines’development.Ageneralcontentreviewwascompletedface-to-facebyallpanelmembersinJanuary2017. Methods: Contentexperts,methodologists,andICUsurvivorswererepresentedineachofthefivesectionsofthe guidelines: Pain,Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation),and Sleep (disruption).EachsectioncreatedPopulation,Intervention,Comparison,andOutcome,andnonactionable,descriptivequestionsbasedonperceivedclinicalrelevance.Theguidelinegroupthenvotedtheirranking,andpatientsprioritizedtheirimportance.ForeachPopulation,Intervention,Comparison,andOutcomequestion,sectionssearchedthebestavailableevidence,determineditsquality,andformulatedrecommendationsas“strong,”“conditional,”or“good”practicestatementsbasedonGradingofRecommendationsAssessment,DevelopmentandEvaluationprinciples.Inaddition,evidencegapsandclinicalcaveatswereexplicitlyidentified. Results: The Pain,Agitation/Sedation, Delirium, Immobility (mobilization/rehabilitation),and Sleep (disruption)panelissued37recommendations(threestrongand34conditional),twogoodpracticestatements,and32ungraded,nonactionablestatements.Threequestionsfromthepatient-centeredprioritizedquestionlistremainedwithoutrecommendation. Conclusions: Wefoundsubstantialagreementamongalarge,interdisciplinarycohortofinternationalexpertsregardingevidencesupportingrecommendations,andtheremainingliteraturegapsintheassessment,prevention,andtreatmentof Pain,Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation),and Sleep(disruption)incriticallyilladults.Highlightingthisevidenceandtheresearchneedswillimprove Pain,Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation),and Sleep (disruption)managementandprovidethefoundationforimprovedoutcomesandscienceinthisvulnerablepopulation. Yourbrowserdoesnotsupportthevideos. GuidelineType:Clinical RelatedResources: ExecutiveSummary:PADISGuidelines  InterpretingandImplementingthe2018PADISClinicalPracticeGuideline MethodologicInnovationinCreatingClinicalPracticeGuidelines:InsightsFromthe2018SCCMPADISGuidelineEffort VisitICULiberationforguidelineimplementationsupporttools. PADISGuidelinesTeachingSlides PADISGuidelinesTeachingSlides:Pain PADISGuidelinesTeachingSlides:Delirium PADISGuidelinesTeachingSlides:Sedation PADISGuidelinesTeachingSlides:Immobility PADISGuidelinesTeachingSlides:Sleep Translations KoreanTranslation-PADISGuideline JapaneseTranslation-PADISGuideline PortugueseTranslation-PADISGuideline(ExecutiveSummary) PortugueseTranslation-PADISGuideline SpanishTranslation-PADISGuideline SpanishTranslation-PADISGuideline(ExecutiveSummary) FrenchTranslation-PADISGuideline ThaiTranslation-PADISGuideline Category: QualityandPatientSafety, ReadFullGuideline Acompletelistoftheguidelinesauthorsandcontributorsisavailablewithinthepublishedmanuscript.